Cranial Molding Helmet
A cranial molding helmet is used to treat plagiocephaly or brachiocephaly. Plagiocephaly is the uneven flattening of one side of the back of the head, combined with an uneven bulging of the forehead on the opposite side of the head. For example, if the back right of the head is flat, the front left forehead will bulge. Brachiocephaly is the even flattening of the back of the head. The condition has become more prevalent since pediatricians began recommending that babies sleep on their backs to reduce the risk of SIDS (sudden infant death syndrome).
The cranial helmet is used to remold the head into a symmetrical shape as the baby grows. It allows the flattened areas to round out and prevents the bulging areas from bulging more. The helmet does not put pressure on the baby’s head, but rather guides the growth to specific areas to improve the head shape. It is very important to start treatment early since the growth of the head slows down after the age of 12 months. Usually the earliest an infant can start wearing a helmet is at 5 months. Infants younger than that typically do not have the appropriate strength in the neck and head muscles to control the movements of the head. It is also important for the baby to be screened for other conditions that may have caused the uneven head growth.
Application and Removal
The infant starts by wearing the helmet for small increments of time throughout the day. Each day, the amount of time in the helmet increases until the patient is in it for 23 hours per day. Increased time wearing the helmet allows the device to capture as much growth as possible. It also allows for the child to be bathed and clothed. Since the helmets are custom made, they are easy to put on the baby. The device should not rub on the ears or slip down over the eyes. When the helmet is removed, there should be no prolonged redness on the baby’s head (longer than 20 minutes). If these problems arise, contact your orthotist.
Care and MaintenanceThe cranial helmet is made of plastic and foam. Allergies to these materials are rare but may occasionally occur. Since the helmet is worn for 23 hours per day, it is important to clean the helmet when the helmet is off. The most common cleaning method is to scrub the inside of the helmet with a soft toothbrush and the same shampoo or soap that is used on the baby’s head. In the course of one to two weeks, areas inside the helmet may become pale yellow in color. This is the dead skin that rubs off of the head and onto the foam. The yellowing serves as an indicator to the orthotist as to where adjustments need to be made, in order for the most correction to occur.
Regular appointments with the orthotist (usually every two weeks) are necessary to adjust the fit of the helmet. Adjustments are usually made by removing small amounts of the foam in the helmet that correspond to areas of increased contact on the head. The decision to stop using the helmet is usually made jointly between the parents, physician and orthotist. The infant is then weaned out of the helmet in a similar manner to which he or she started wearing the helmet. Very seldom will the shape of the head regress after the helmet use has been discontinued. A helpful website regarding cranial remolding helmets is www.orthomerica.com.