Have you ever seen a baby wearing headgear that looked like a helmet? They may be doing helmet therapy or cranial orthosis. Some babies who require helmet therapy have a condition called craniosynostosis.
What Is Craniosynostosis?
Our skull is made up of five thin, bony plates. These plates are held together by fibrous tissue or sutures. These sutures allow our skull to expand as our brains grow. As we develop, these sutures harden and fasten our skull bones together.
Craniosynostosis is a condition that causes one or more sutures to close too soon.
If your baby has craniosynostosis, it may affect the shape of their skull, depending on how many sutures close before they should. If only one suture closes too soon, your baby's brain may still develop normally, but their head may be oddly shaped. If more than one suture closes too soon, your baby's brain may not grow at the appropriate rate.
Types of Craniosynostosis
There are several types of craniosynostosis that may affect your baby, including the following:
Scaphocephaly. Also called sagittal craniosynostosis, scaphocephaly is the premature fusion of the sagittal suture, which runs front to back and down the middle of the top of the head.
Scaphocephaly makes the skull long and narrow. It puts pressure on the brain, making the brain not grow normally.
Trigonocephaly. Also called metopic synostosis, trigonocephaly is the fusion of the metopic— or forehead—suture. The metopic suture runs from the top of the head and down the middle of the forehead toward the nose. Early closing of this suture may cause a prominent ridge running down the forehead to form, and then, the forehead may grow a triangle-like point as a result.
How Is Craniosynostosis Diagnosed?
You or your doctor may notice that your baby has an odd-shaped head at birth shortly after birth, or later at a well-child checkup or annual exam.
To diagnose craniosynostosis, your baby’s pediatrician may do the following:
- Visually examine your baby's face and head
- Measure your baby's head
- Feel the sutures and soft spots (fontanelles) on the skull
- Feel the top and sides of the head, where sutures are located, for unusual ridges or bumps
- Order a skull X-ray or CT scan
None of these examinations or procedures cause pain for your baby.
When Does Helmet Therapy Start?
Studies show that the best age to begin helmet therapy for babies is between 5 and 6 months. This allows for the helmet to gently shape your baby’s skull as they grow. By the time your baby is 1 year old, helmet therapy treatment is generally considered ineffective because the growth of the skull, including fusion of sutures, is much further along.
Other than bath time, your baby should always wear their corrective helmet—even when they sleep.
How Long Does Helmet Therapy Take to Work?
The average duration of helmet therapy is about three months. The duration of helmet therapy for your baby will depend on several factors, including their age and the severity of their craniosynostosis.
Other Reasons to Use Helmet Therapy
If your baby has a misshaped head, it doesn’t necessarily mean that they have craniosynostosis. The shape of their head could be affected by how they were positioned in the uterus, the birth process, or their sleeping position.
For example, deformational (or positional) plagiocephaly occurs when babies sleep in the same position excessively, especially on their back. It causes babies to develop a flat spot on one side of their head or the entire back of their head. Deformational plagiocephaly is also sometimes called “flat head syndrome.” In deformational plagiocephaly, there is no fusion of the skull bones.
Other things that may lead to deformational plagiocephaly include the following:
- Muscular torticollis: Muscular torticollis is a congenital health issue that causes one or more of the neck muscles to become very tight, forcing the affected baby’s head to stay in the same position.
- Prematurity: Premature babies have softer skull bones softer, and many premature babies spend a lot of time in the neonatal intensive care unit, typically on respirators, with their heads in the same position.
If you have any concerns regarding your baby’s head shape or development, talk to their pediatrician before starting helmet therapy.
