A cranial remolding orthosis or helmet is a custom orthotic device that helps guide head growth to a specific direction, to help reshape a baby’s head. Cranial remolding helmets work through directed growth, there are void spaces inside the helmet where we want the head to grow and fill into and there is light contact on areas we do not want to be growing as quickly. The head grows towards the path of least resistance, the helmet does not push on the head to reshape it.

A lot of times, plagiocephaly (flatness on one side of the head) will start because of in utero positioning or if a baby has developed torticollis. Torticollis is a tightening of the neck muscles that make it difficult for a baby to turn their head to both sides equally. When a baby is not able to turn their head to both sides equally, they end up spending more time turned to one side and plagiocephaly develops.

Brachycephaly (flatness across the back of the head) has been more common since the introduction of the Back to Sleep program. While the Back to Sleep program has significantly reduced the incidences of Sudden Infant Death Syndrome, there has been an increase in brachycephaly cases, as infants are spending more time laying on their backs.

Babies that have flat spots across the back of their head or on one side of their head may benefit from a helmet. Babies’ heads are growing and changing most rapidly between the ages of 4-6 months old and that is the optimal time to be fit with a helmet. Helmets can still be successful when they are fit on older babies, but they might be in the helmet for a longer time as their head growth has started to slow down.

No! The helmet quickly becomes a part of their everyday routine, and it is worn for 23 hours a day. Everything is new and changing in a baby’s world and they are very adaptable. Babies start to recognize the helmet as theirs and will often reach for it when it is not on. The biggest reason some babies are fussy in a helmet is if they get too hot. The helmet does trap some heat that is normally released through the head, but by dressing your baby in less layers, turning a fan on in their room, and making sure they are staying cool, most babies tolerate the helmet very well.

It is a good idea to schedule a cranial evaluation with an orthotist as soon as you start to notice a flat spot developing. At Crown Cranial & Orthotics, initial evaluations are free and do not require a referral from a doctor.  At an initial evaluation, the orthotist can take measurements and pictures of your baby’s head to see if the head shape can be corrected with repositioning or if a cranial remolding helmet might be needed. They can also help to educate about different repositioning techniques and will have baseline measurements to monitor if repositioning is working.