Helmet Therapy for Your Baby: How Does It Work?

Helmet therapy is used to correct a misshapen head in infants due to conditions like positional plagiocephaly (flat head syndrome). Gentle remolding of the skull, also known as cranial orthosis, is prescribed by a physician, and the duration of therapy can last several months or longer. The helmet gradually reshapes the skull and prevents any further flattening.

Key takeaways:
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    Helmet therapy, or cranial orthosis, is used to reshape the skull in infants. It is a gentle, painless treatment that usually takes several months to complete.
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    Helmet therapy is an elective treatment for babies with positional plagiocephaly, craniosynostosis, or scaphocephaly.
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    Diagnosis can often be made through clinical presentation and assessment. An X-ray or CT scan of the head can also confirm the diagnosis.
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    The helmet should be worn for 23 hours a day, only removing it for bathing and briefly checking the skin for breakdown.
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    Babies in helmet therapy will have multiple follow-up appointments for adjustments/refitting.

When is helmet therapy necessary?

Helmet therapy is an elective treatment used to correct flat head syndrome, also known as positional or deformational plagiocephaly. Babies lying in the same position will develop a misshapen head. It is estimated that nearly half of U.S. infants develop plagiocephaly, and the incidence has increased since the Back to Sleep campaign was initiated in 1994.

A physician will prescribe helmet therapy for an infant less than one-year-old who has a form of the flat head syndrome, birth defect craniosynostosis, or the premature fusion of the skull called scaphocephaly. Not all infants are eligible to receive helmet therapy. Depending on the situation, the flat head syndrome can resolve on its own as a baby gets older and begins to sit up and rollover.


Parents may notice that their baby has an area of the head that appears flattened. There is often a bald spot present. The head will appear misshapen, the ears can look uneven, and the forehead or one cheek may seem to bulge. Parents should discuss these findings with their pediatrician.

A physical assessment can determine the presence of flat head syndrome. If physical appearance is not obvious enough for diagnosis, an X-ray or a computerized tomography (CT) scan of the head may be ordered for confirmation.

How does helmet therapy work?

By applying continuous, gentle pressure through the use of a helmet, the skull will begin to remold, and the areas of flatness will eventually resolve. The helmet is made of a hard outer layer with a soft foam inner lining. As the helmet helps to reshape the head, it also protects it against further flattening.

Babies receiving helmet therapy will have frequent follow-up appointments to adjust the helmet as the skull shape changes. Treatment can last several months or more, depending on the situation and severity of the misshapen head.

How to use a helmet

After the physician prescribes helmet therapy, the baby will be fitted for their own customized helmet. Measurements of the head will be taken to ensure proper sizing.

Helmets should be worn throughout the day and while the baby sleeps at night. Ideally, the helmet should be on for 23 hours a day. It can be removed during bathing and briefly check underneath the helmet for any areas of skin breakdown.

Helmet therapy is generally painless. Babies will notice the presence of the helmet, but they tend to get used to it and can tolerate wearing it constantly. The longer the baby wears the helmet, the quicker the remolding will occur.

If you notice your baby becomes increasingly irritable, remove the helmet to check for areas of redness or skin breakdown. Contact your physician if you feel there is a problem. An adjustment or refitting may be necessary.


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