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Baby helmets for flat head syndrome – your questions answered

Mother and baby

Flat head syndrome – the common name for plagiocephaly or brachycephaly  – affects one in 10 babies. Here, your questions on plagiocephaly, brachycephaly and 3D-printed helmet therapy are answered.

Baby helmets for flat head syndrome – your questions answered

How can I tell if my baby has Plagiocephaly or Brachycephaly?

Plagiocephaly presents as an asymmetry of the head, where one side is flatter than the other. To assess for plagiocephaly, its best to assess the head from above (birds eye view).

Sometimes, plagiocephaly can also result in an uneven appearance of the facial features, especially the ears and eyes.

Brachycephaly presents as a flattening at the back of the head specifically, so the head doesn’t appear round. To assess for brachycephaly, its best to assess from the side.

Plagiocephaly and Brachycephaly
What causes Plagiocephaly and Brachycephaly?

There are several factors that can lead to the development of plagiocephaly of brachycephaly, including:

  • Torticollis (a tight neck muscle that will keep your baby’s head tilted in one direction).
  • A preference for sleeping/feeding on one side.
  • Not enough tummy time.
  • Trauma during birth.

Who do I see for an assessment of my baby’s head shape?

If you are concerned your baby might have a torticollis, a paediatric physiotherapist is a great place to start, and they will help you to loosen your baby’s neck muscles.

You may also book an appointment to see your GP, paediatrician or chiropractor to discuss any concerns you have about your baby’s head shape.

Who do I see about a helmet?

Helmets are prescribed by an orthotist, and there is no referral required. You simply call them to book your first appointment, which will include a head assessment and cranial scan.

Not all orthotists manage plagiocephaly however, so it is important to find one who does.

How are measurements taken?

The orthotist will take a cranial scan, where a white-light scanner is used to scan the head, and this will produce a 3D image (the white-light scanner is completely safe for baby and is like taking a bunch of photographs in quick succession).

The orthotist will then use their specific software to analyse the cranial scan, and the results will be generated. This objective method can help to minimise some of the human error that occurs when measurements are taken manually.

Flat head syndrome helmet

When is a helmet recommended?

The orthotists use the Cranial Vault Asymmetry Index (CVAI) and the Cephalic Ratio (CR) scales to determine if a helmet is recommended.

The orthotists will recommend a helmet when the patient falls within the ‘severe’ and ‘very severe’ categories, and sometimes within the ‘moderate’ category depending on the age of the baby.

A helmet will not be recommended if the baby falls within the ‘normal’ or ‘mild’ categories.


Flat head syndrome severity
How are 3D-Printed helmets made?

Once your baby has had their cranial scan and you have received the measurements, you can then make an informed decision about whether a helmet is right for your baby. If you decide to move forward with helmet therapy, the orthotist will send the scan to the 3D-printing facility.

From here, a second team of orthotists will tailor a treatment plan specifically for your baby and add the helmet features to the scan. This helmet file will then be 3D-printed, and results in your custom made, 3D-helmet.


How do the helmets work?

The helmets work by redirecting head growth, that is, they create a space for the head to grow. They are not painful, nor do they ‘squeeze’ the head.

The helmet will sit snuggly over the areas of head that are well developed, while leaving space over the flat regions of head. Therefore, when the head grows, it’s going to grow into the space that has been created over the flat spot, and this will round out the head.



At what age should my baby start helmet therapy?

The best time to start treatment is when baby is between four to six months of age, as there is the most potential for head growth.

We are relying on growth spurts for the helmets to be effective, as each growth spurt will be directed into the space created over the flat spot.

The younger the baby is, the more growth spurts they will have.

How long does treatment last?

On average, treatment with a helmet will last about four months. Your baby will wear their helmet for 23 hours every day, including during sleep. You will remove the helmet for about an hour each day, during bath time.

Once your baby is wearing a helmet, you’ll see your orthotist every four weeks for another cranial scan appointment, where you will see what progress has been made, and the orthotist will assess how much room is left in the helmet. Once you are happy with the result, and/or there is no room remaining in the helmet, treatment will conclude.

Generally, the younger the baby starts helmet therapy, the shorter the treatment duration will be. For example, a baby starting treatment at 4 months of age may only need 3 months to complete treatment, whereas a baby starting therapy at 10 months of age may need 6 months of treatment.

Will my baby adjust to wearing the helmet?

Yes! Babies are amazingly adaptable, and you will be given a wearing-in plan so your baby can get used to wearing the helmet over a short period of time (usually about a week). After this point, there should be minimal to no effect on eating, sleeping, general temperament and behaviour.

Are there any side-effects?

When wearing a helmet, your baby will likely be warmer than usual, so we generally recommend dressing down a layer. You can also monitor for sweat on the neck and arms.

Occasionally a baby may also develop heat rash, especially during the warmer months, so it is important to keep an eye out for this when you remove the helmet.

How much will it cost? Are they covered by Medicare?

Unfortunately, helmet therapy is not covered by Medicare. It is important to note that each orthotic clinic will have their own pricing, but usually a 3D-printed helmet will cost around $2000. Some clinics are now offering payment plans to assist with the costs of treatment.

About Dr Rebecca Micallef

Dr Rebecca Micallef started her career as a veterinarian, before becoming an advocate for children's health. She now works for Serkel, an Australian, 3D-printing medical device company where she uses her clinical ...

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