August 2, 2017

Head Shape Irregularities in Infants – Those Tiny Helmets Make a Huge Difference

By Jeremy Migner
CarePartners Orthotist/Prosthetist

You’ve likely seen a baby wearing a cute plastic helmet. But did you know the reasoning behind it?

Head shape irregularities in infants are becoming increasingly common. These can be caused by positioning – either while in utero, during the birthing process or from positioning during the first few months of life, commonly from extended time in a car seat/carrier or lying on a baby’s back.

There are two types of head shape irregularities:

  • Plagiocephaly – This can be caused by torticollis (tight neck muscles that cause a baby to favor looking to one side more than the other) and is usually characterized by a flat spot on the back of the head, shifted either to the right or the left side, resulting in a somewhat parallelogram-like head shape. Plagiocephaly may also result in asymmetry of the ears, eyes or forehead.
  • Brachycephaly – This is characterized by a very prominent flat spot directly at the middle of the back of the head, resulting in an abnormally short and wide head shape. In either case early intervention is the key to correction.

Cranial Remolding Helmet Therapy

While some cases of head shape irregularities can be corrected through some combination of repositioning, tummy time and or physical therapy, babies often require use of a cranial remolding helmet. If indicated, these helmets are commonly covered by most private insurance and Medicaid. Helmets are worn 23 hours a day, and average treatment time is 3 to 4 months, depending on the child’s age at the beginning of treatment. Helmets are normally worn for one half of the baby’s age at the time of fitting, so an earlier fitting age results in less time spent in the helmet.

Helmets are usually tolerated well by babies and helmet therapy can begin as early as 3 months of age. Generally it is best to start treatment at about 6 months of age, and should begin before a baby’s first birthday for optimal results. Treatment can begin as late as 18 months.

CarePartners Orthotics & Prosthetics recommends getting an evaluation as soon as a head shape irregularity is suspected or identified. An ideal timeline would be initial valuation at 3 to 4 months of age, helmet fitting at 5 to 6 months and end of treatment at 8 to 9 months.


CarePartners Orthotics & Prosthetics offers free evaluations for babies with head shape irregularities, with no doctor’s referral required.

Call (828) 254-3392 to schedule an appointment or to speak with an expert.


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