Why do some babies have to wear helmets?
You may have seen babies out and about or pictures on the internet of babies wearing a helmet and wondered what they’re for. Some babies develop a flattening of the back of the head soon after birth, this is called brachycephaly or plagiocephaly and the helmet is designed to gently guide the malleable skull to become a more natural shape, correcting the deformity over the course of a few months. We recommend helmet therapy on a case by case basis for babies with moderate to severe flattening. Another question we often hear is, ‘does a baby’s flat head correct itself?’. The NHS assures parents that it does and we aim to address this question by looking at these well-regarded studies on the effects of helmet treatment.
The first paper we’ll look at is titled Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years. It was published by the Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand. The paper sets out to compare head shape measurements and parental concern about head shape and developmental delays in infants with measurements obtained at follow-up ages 3 and 4. The research was a longitudinal cohort study which means the data was gathered for the same 129 subjects repeatedly over the course of observation.
The initial assessments took place at a plagiocephaly clinic with follow-up assessments in the subjects’ homes. The 129 children ranged from 3 years and 3 months to 4 years and 9 months with a mean age of 4 years. All children had been diagnosed in infancy to have deformational plagiocephaly or brachycephaly.
The conclusions of the research showed that head shape measurements and developmental delays in infancy showed dramatic improvement when remeasured at 3 and 4 years old in most children. However, most are not all, and it’s the few whose heads didn’t correct that we endeavour to treat at Technology in Motion.
A second paper from New Zealand, titled Plagiocephaly and Brachycephaly in the First Two Years of Life: A Prospective Cohort Study aimed to assess the occurrence and history of nonsynostotic plagiocephaly in the first two years of life, along with factors that may contribute to its development in infants.
Following 200 infants from birth, their head circumferences were monitored and photographed at regular intervals. The research showed that there is a wide range of head shapes in infants and the occurrence of nonsynostotic plagiocephaly increases to four months old but decreases with age. While the majority of cases will have resolved by two years of age, not all will.
Pulling the data from these studies together, 3-4% (1 in 25 of the population) of infants who had a severe head shape at the age of 2 showed no change by the age of 3 or 4. While this is a small percentage, we take the impact of flat head syndrome seriously and are committed to helping this group of infants through treatment.
The third and final paper we’ll review is titled Effectiveness of conservative therapy and helmet therapy for positional cranial deformation published by a group of organisations in Chicago. The paper investigates the effectiveness of repositioning therapy with or without physical therapy and helmet therapy, identifying factors associated with treatment failure. 4378 patients were evaluated for deformational plagiocephaly and/or brachycephaly were given conservative or helmet therapy and monitored until complete correction or for 18 months.
The results showed complete correction was achieved in 77.1% of conservative treatment patients, 15.8% required transition to helmet therapy, and 7.1% had incomplete incorrection. The risk factors for failure included ‘poor compliance’, advanced age, prolonged torticollis and severity of the initial cranial ratio and diagonal difference. 94.4% of patients who received helmet therapy as first-line therapy achieved complete correction as did 96.1% of patients who received helmets after failed conservative therapy. The risk factors for helmet failure included poor compliance (not wearing as instructed, etc.) and advanced age.
The study showed conservative therapy and helmet therapy were effective for positional cranial deformation and that treatment can be affected by patient-specific risk factors.
Summary – Does a baby’s flat head correct itself?
In summary, while it is possible for a mild head shape deformity to improve to an acceptable degree, for the more severe cases this is not so. We know that helmet therapy is successful in correcting a head shape deformity is treatment is started early enough, ideally at around 4 to 7 months and definitely before 14 months which is the very upper end of time that we will be able to help. After this age, there is not enough growth available to us to use helmet therapy successfully. We hope this helps answer some of your questions such as ‘does a baby’s flat head correct itself?’ and ‘why do some babies have to wear helmets?’.
Thinking of the long term effects if the flat head syndrome is not treated, we recommend that concerned parents contact us to book a free pre-assessment at one of our clinics for an assessment and expert opinion advice. For more information on the process, meet the clinicians in our recent blog post or view parent stories for real-life cases.