Protective Helmets
When will my child start wearing the helmet? Typically the protective helmets are fitted at the time of discharge from the hospital. How many hours each day should the helmet be worn? The helmet will need to be worn in a car or around around other children any time an injury could occur. Can my child resume normal activities? Your child will need close supervision and should avoid rough activities until the bones heal. If your child is walking or crawling at time of surgery or if around other small children a protective helmet will be provided to use until the bones have a chance to heal which is typically 3 months for the children who have spring cranioplasty. Once most of the bony defect has healed which is typically 4-6 months after placement, the springs will be removed in a small outpatient surgical procedure and no protective helmet will be required.
Plagiocephally and Minimally Invasive Surgical Correction Helmets
Plagiocephaly known as flat head syndrome (FHS) - is an abnormal shape of the baby’s head that results from many factors. These factors may be present before and/or after birth. Parent, family members, friends and other health care professionals may notice that the head to be asymmetrical or disproportional rather than oblong and round. This can be corrected with a shaping helmet. Typically worn 4-6 months and initiated by 6 months of age. Minimally Invasive Surgical Correction of Craniosynostosis requires that shaping helmets are started just after minimally invasive strip craniectomy surgery and worn for 6-12 months. It is common to need two helmets over this time period due to growth and they must be worn 23 hours per day.
The exact effects of untreated plagiocephaly are unknown although medical evidence suggests that plagiocephaly should not be considered purely cosmetic. Some of the concerns include: continued skull asymmetry and/or disproportion, facial asymmetry, problems from jaw misalignment, disruptions to visual fields, difficulty fitting eyewear, poorly fitting safety helmets and neck muscle asymmetry.
Repositioning and tummy time are considered to be conservative treatment options. These are most effective in very young infant up to about four months of age and can reduce the severity and improve the overall head shape in some cases. Repositioning and tummy time can be discussed with your pediatrician and/or therapist. An orthotist can be involved to make a cranial scan or anthropometric measurements to document the current head shape. Over time, another scan or measurement series will compare the changes and determine if a helmet is needed.
Many babies are born with neck and trunk tightness or weakness that create positions of comfort or preferred postures. Torticollis is another common condition that is caused by an imbalance of the neck muscles and prevents full turning of the head to both sides. Preferred postures may lead to neck tightness and may increase time spent in these positions. These situations may be resistant to repositioning and cause the infant some distress during tummy time. It is important to understand that flattening of the head, preferred postures, neck imbalance, resistance to tummy time and repositioning should be discussed with your pediatrician.
Have you noticed that the shape of your baby’s head looks different from other children? Are there areas of concern such as flat spots, unevenness or differences between right and left sides? What is plagiocephaly? How does plagiocephaly happen?
Plagiocephaly: Also known as flat head syndrome (FHS) - is an abnormal shape of the baby’s head that results from many factors. These factors may be present before and/or after birth. Parent, family members, friends and other health care professionals may notice that the head to be asymmetrical or disproportional rather than oblong and round. These altered head shapes are very common. Studies estimate that 1 in 10 babies has a misshapen head that requires further assessment and treatment.
Plagiocephaly head shapes are caused by many factors:
- A restrictive utero environment
- Prematurity and delayed development
- Neck muscle weakness or imbalance
- Back sleeping
- Low tone
- Assisted birth delivery methods
- Infant carriers
- infant safety devices
After birth, children have preferred head and trunk postures where they are content to lay and sleep with limited head movement. From six to eight weeks of age, normal physical development and treatment should help to change the appearance of the head towards a more normal shape. If the shape does not improve, it is a good topic to discuss with your pediatrician.
