Many babies are now seen wearing helmets primarily to address flat spots on their heads, a condition known as flat head syndrome or positional skull deformities. These specialized, foam-lined helmets are designed to gently reshape a baby's skull as it grows, helping it become rounder and more symmetrical. It's important to understand that these helmets are not used to protect babies from falls or injuries.
The Primary Purpose of Baby Helmets
Baby helmets, often called cranial orthosis or molding helmets, serve a specific medical purpose: correcting skull irregularities. A baby's skull is very soft and pliable, especially in the first few months of life. If consistent pressure is applied to one part of the head, it can lead to a flattened area. The helmets work by providing gentle, consistent pressure on the prominent parts of the head, while leaving space for the flattened areas to grow and expand.
Understanding Flat Head Syndrome (Positional Plagiocephaly and Brachycephaly)
Flat head syndrome broadly refers to misshapen areas on a baby's head due to external pressure. The two most common types are:
- Positional Plagiocephaly: This results in a flattened area on one side of the back of the head, often causing the ear on that side to be pushed forward and the forehead to bulge slightly.
- Positional Brachycephaly: This involves a flattening across the entire back of the head, making the head appear wider than it is long.
These conditions are primarily cosmetic but can sometimes be associated with other issues like torticollis (tight neck muscles) that limit head movement.
Why the Increase in Cases "Now"?
The noticeable increase in babies needing helmets is largely linked to changes in infant care practices aimed at promoting safety. Since the early 1990s, the "Back to Sleep" campaign (now "Safe to Sleep"®) strongly recommended placing babies on their backs to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS). This crucial recommendation has been incredibly successful in saving lives.
However, a side effect of babies spending more time on their backs is that the softer areas of their skulls are more consistently pressed against flat surfaces. Without adequate time spent off the back of their heads, such as during supervised tummy time, these positional flattenings can develop.
Factors contributing to positional flat spots include:
- Increased Back Sleeping: While vital for SIDS prevention, prolonged time on the back can lead to pressure on the developing skull.
- Limited Tummy Time: Babies who spend less supervised time on their stomachs have fewer opportunities to relieve pressure from the back of their heads and strengthen neck and core muscles.
- Use of Infant Devices: Extended periods in car seats, swings, bouncers, or carriers can also contribute to consistent pressure on one area of the head.
- Restricted Head Movement: Conditions like torticollis, where neck muscles are tight, can make it difficult for a baby to turn their head, leading to them resting consistently on one spot.
How Helmet Therapy Works
Helmet therapy is typically prescribed for infants between 3 and 8 months of age, when the skull is still rapidly growing and most amenable to reshaping. The process usually involves:
- Assessment: A specialist measures the baby's head to determine the severity and type of flattening.
- Customization: A custom-fitted helmet is created, often using 3D scanning technology.
- Wear Schedule: The baby wears the helmet for 20-23 hours a day, removing it only for bathing and cleaning.
- Adjustments: Regular adjustments are made by the orthotist as the baby's head grows and reshapes, typically every 1-3 weeks.
- Duration: Treatment can last anywhere from 2 to 6 months, depending on the baby's age and the severity of the condition.
The helmet works by providing a snug fit around the prominent areas of the skull while leaving a small space over the flattened area. As the brain naturally grows, it pushes the skull into the unoccupied space, allowing for more even and symmetrical growth.
Prevention and Early Intervention
While helmets are effective for correcting existing flat spots, prevention and early intervention are key:
- Prioritize Tummy Time: Supervised tummy time is crucial for all infants. Aim for several short sessions throughout the day, increasing duration as the baby tolerates it. This not only relieves pressure on the back of the head but also strengthens neck, shoulder, and core muscles essential for developmental milestones.
- Vary Head Position During Sleep: When placing your baby on their back to sleep, occasionally alternate the direction their head is facing in the crib.
- Limit Time in Devices: Reduce the amount of time babies spend in car seats, swings, and bouncers when not in transit.
- Hold Your Baby Often: Carrying or holding your baby frequently helps distribute pressure evenly on their head.
- Monitor Head Shape: Regularly check your baby's head shape, especially during diaper changes or after baths. If you notice persistent flattening, consult your pediatrician.
By understanding the causes and implementing preventative measures, parents can help encourage healthy skull development for their babies.
