Helmets Help Reshape Babies' Heads

Baby Girl Wears a Helmet to Treat Plagiocephaly

“Show No Marcy” was the name we applied to the back of our daughter’s roller-derby-themed helmet. My husband and I figured that if Marcy needed to wear a helmet 23 hours a day for up to three months, we’d at least try to have some fun with the situation.

More and more often, you may see babies wearing strange helmets with a hole on the top. Did they have a head injury? Are they stunt doubles? What did those parents do wrong?

In actuality, these helmets are designed to reshape the heads of kids who have a flat spot on the back or side of their heads. This condition, called plagiocephaly (pley-jee-uh-sef-uh-lee), has become more common because of the importance of placing babies on their backs to help prevent SIDS (Sudden Infant Death Syndrome). The soft skulls of infants mold easily, so babies who lie in one position may develop this abnormal head shape. For the most part, minor to moderate plagiocephaly does not cause developmental problems. If the flattening is more severe, however, it can change the shape of the entire head and face, leading to eye imbalance and change in jaw shape.

There are many possible causes of plagiocephaly:

  • Too little tummy time during wakefulness
  • Too much time spent in car seats, infant carriers and strollers
  • Cradling the infant on one side versus switching between right and left
  • Restrictive intrauterine environment so the fetus is unable to adjust head orientation, often an issue with twins or low amniotic fluid
  • Prematurity with a lot time spent in a Neonatal Intensive Care Unit (NICU) lying on back when the skull is most malleable
  • Torticollis, a condition in which one or more of the neck muscles develops a tightness, causing the head to tilt or turn

In Marcy’s case, she had moderate plagiocephaly, caused by torticollis. No matter how much tummy time or placement of fun toys to her right, she’d always end up leaning slightly to the left side.

We first noticed a minor flat spot on the left side of the back of her head when she was 2 months old. We raised our concern to our pediatrician at literally every monthly check-up, but she didn’t think it was very noticeable. At Marcy’s six-month check-up, our pediatrician referred us to the hospital to fix the flattening.

The pediatrician referred us to the Division of Plastic Surgery at Cincinnati Children’s to address the flat spot as well as the Division of Occupational and Physical Therapy to treat the torticollis. The clinician who measured Marcy’s head said her imbalance was mild to moderate, so it was our choice whether to use a helmet or not. She would need to wear the helmet for 6 weeks up to 3 months depending on how quickly her skull reshaped. I was worried about Marcy being uncomfortable in the helmet, but knowing that it might take a month or two to treat the tightness of the muscles in her neck (and having the fear that she would one day wear lopsided pigtails), my husband and I opted for the helmet. It was a very good decision. The process to create and fit her unique-to-her helmet was painless and actually pretty cool. Marcy quickly got used to wearing the helmet and six weeks later her head was balanced and she was finishing up her physical therapy sessions.

I’m sure there are many stories like mine. Here’s my advice to parents:

  • Raise your concerns with your pediatrician as soon as you notice any degree of flatness. Time is of the essence because the head is most malleable in the first 0-6 months, so it is easier and quicker to reshape the head in your baby’s first months.
  • If the doctor does not think that you need to see a specialist, push back – you are your child’s advocate. You know your child best and your instincts are likely right. Doctors can be wrong sometimes! (This is applicable for any and all health concerns. Don’t be afraid to push back  if you think they may be brushing off a valid concern or not listening to your child’s specific situation.)
  • Have some fun decorating the helmet. If you aren’t feeling crafty, there are several online shops that specialize in fun helmet sticker designs (some have funny phrases like “just fixin’ my flat”, “you should see the other guy” and “every princess needs a crown”!). Here’s an example: www.blingyourband.com. Or if you’re in the Cincinnati area and would prefer to shop local, Bunches of Bows in Northern Kentucky can help. You can find them on Facebook. After you apply your stickers I’d recommend using Mod Podge or some sort of glossy sealer/finish to keep the stickers from rubbing off during helmet cleaning and normal wear and tear.

 

  • Keep the helmet clean. After several days of wear, some helmets may start to smell funky. We kept a spray bottle of rubbing alcohol and scrubbed the interior of the helmet once a day with a toothbrush or a rag. Then dry it with a towel and let it dry completely before placing it back on your baby.
  • Take pictures! Even though all parents likely feel some level of guilt or embarrassment, these weeks and months are an amazing time of development. Your baby is just as cute with a helmet as without, and your child will want to see those pictures when they’re older; it was a key part of his/her life that should not go undocumented.
  • Don’t worry about removing the helmet for parties or other special events. Sometimes you just don’t want to have to explain plagiocephaly to everyone in the room. Your baby’s head won’t be ruined forever if the helmet is off for a few hours!
  • Spread the word. Although plagiocephaly cannot always be avoided in cases of fetal positioning or torticollis, it can be prevented by limiting time on the back during wakefulness. Let your friends and family know that supervised tummy time and limitation of time in car seats and infant carriers can make all the difference in the world.

The moral of the story is that there is no shame in having a child with plagiocephaly, and if a helmet is recommended, go for it. This is a common condition, and as my husband asked me when I was worrying about Marcy’s comfort in the helmet, “Are you concerned about Marcy or about how others will view you when she’s in her helmet?” It really made me realize that, although I was genuinely concerned for Marcy’s comfort, I was selfishly concerned about being judged by other parents. That made the decision crystal clear, and, thanks to the great clinical team at Cincinnati Children’s, Marcy’s pigtails will be beautifully level one day.

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Emily Weathers

About the Author: Emily Weathers

Emily lives in Cincinnati with her husband and wonderful 1-year-old little girl. She loves to watch her daughter’s personality blossom more and more each day. Emily is a member of the Marketing & Communications group at Cincinnati Children's, leading the web team that manages www.cincinnatichildrens.org. As a new mom, Emily appreciates even more the life-saving work that takes place every day at the hospital and feels so fortunate to work there.

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Comments

  1. Tom Henry August 23, 14:39
    Great article Emily; very informative but did not create an unnecessary cause for alarm. I plan to share this information with my nephew, who has a new born.
    • Michael May 22, 13:33
      Did the hospital custom make the helmet for Marcy? How did they measure her head for the helmet?
      • Emily Weathers Author May 29, 08:11
        Hi Michael, Yes, Cincinnati Children's custom-fit the helmet specifically for Marcy, and they used a 3D imaging system of her entire head to ensure the best fit.
  2. Dawn Godfrey August 21, 11:52
    Great article, Emily. I was searching for doctors in this area who treat plagiocephaly in order to offer my helmet-decorating services, and I came upon your article. I'm a muralist in Mason, but am willing to paint children's helmets for free if anyone is interested. I would paint them in a single day, as I'm sure the parents would not want to go too long without the helmets. I would just require that the helmets be dropped off and picked up. 513-368-6166
  3. Emily Adams April 04, 12:43
    Hello, My son is almost 4 months with plagiocephaly. It is very noticeable with the ear pushed forward and one eye affected. I had to push for a referral later this month by a neurosurgeon. Here in Maine no babies from his pediatrician's office have been referred. Luckily his doctor is from Michigan and had referred babies there. I've read the recent studies claiming no benefits from using helmets. I'm not convinced by the results. I would rather be proactive in giving my baby a normal head. In light of the recent studies, would you have still pushed to use a helmet? Any advice for us in case the opinion of the specialist is to do no nothing? I would be so appreciative of any advice or thoughts. I feel like we are living on a desert island in terms of help with this! Sincerely, Emily Adams, mom of Can Emaz1088@hotmail.com
    • Emily Weathers Author April 06, 14:44
      Hi Emily – I actually haven't read any recent articles about ineffectiveness of helmets. We saw great improvement in the shape of Marcy’s head, and hers was fairly mild. I would suggest that you push for the helmet therapy, and it will also be good to see a specialist in case it is caused by torticollis, in which case physical therapy can also help. From my understanding, typically mild to moderate plagiocephaly doesn’t cause actual developmental delays, but even from a cosmetic standpoint, it is important to take action early to balance the eyes and ensure normal jaw shape. So I’d say push for the helmet! It’s just one mommy’s opinion, but I hope this helps!
  4. Emily Adams April 07, 09:05
    Thanks for the opinion! No one in our doctor's practice is referring babies for treatment. We live in Bangor, Maine. I was surprised, but for most specialists we have to travel two hours south. We do have a neurosurgeon, physical therapy, and osteopath appointments soon, so hopefully we'll get some help. I can't imagine doing nothing until it's too late! Despite what a recent study showed, there were flaws in it, and everything I've read sounds in favor of trying a helmet. We'll see what happens. Thanks!
  5. Jessica July 22, 11:01
    Hi Emily, We are only a few days into helmet wearing for my five month old son and it has been a tough transition. Besides the sleepless nights I'm concerned about his development - is that silly? I notice that when he's laying flat on his back, he won't turn his head from side to side and he definitely won't try to roll over (which is something he was trying to do pre-helmet). Is this just a phase? What did you experience? Thanks!
  6. Emily adams July 24, 11:16
    Hi Jessica, How's it going now? We're 4 wks in, and our boy is doing really well. The first full week was really hard, and even the second. Did you start with a progressive schedule? Like 1 hour on, one off, increasing over 7 days? That helped us. I felt really horrible his first full night. He screamed in protest for five or ten minutes the first few nights, but now is fine. He's a late sitter, but is getting better. He sees a wonderful physical therapist for torticollis. She has been very reassuring. The helmet is clunky and gets in the way sometimes, but I've gotten so much more used to it in a short time! If this helps, I used to automatically think the helmet was bothering him, but actually he was just cranky or tired in a normal baby way. I know all babies are unique, so you have to trust your instinct with your baby. I hope it goes better. I'd love to know, I don't know anyone else in the same boat yet. :)
    • Brenda November 08, 19:06
      My grandson is in the process of getting a helmet. In saw on another site where another baby had what they called a Doc-Band similar to a full helmet. Looked less restrictive and more comfortable. Just curious if u ever saw that? Hope your little one is doing ok.
  7. Lisa November 19, 11:46
    Hello Emily, Your sharing is so helpful. We are considering to get a helmet for my daughter. We live in Dayton, Ohio. We went to hanger clinic last week to have a consultation. I have a question here. How can you make sure the orthosist is experienced and dedicated? Thanks!
    • Emily Weathers Author November 19, 15:55
      Hi Lisa - good question. We went to Hanger as well and were very pleased. The Hanger company is a well-established national maker of helmets and other types of orthotics. Hanger orthotists (the people who make the helmets) are ABC certified (American Board of Certification) orthotists and are licensed in the state of Ohio. In addition, Hanger requires that all hires attend Hanger Cranial Helmet Class which covers the use of the scanner and other equipment; they are then certified. I'm sure that Hanger would also be happy to answer any questions/concerns if I've not covered here. Best of luck to you and get ready to have some fun designing that helmet! - Emily
  8. B. September 01, 10:23
    Thank you so much for sharing your story. I am in a very similar situation and reading your story has helped me with the decision to move forward with a helmet.