They are meant to be worn for 8-12 weeks for at least 23 hours a day, during sleep and play. Plagiocephaly helmets are cranial orthoses made out of a hard plastic shell with foam lining, custom made to each child, and designed to keep pressure off the flat spots to help the head naturally round itself out. How do plagiocephaly helmets work and what’s the best time to get one? Often times, the asymmetries are resolved with simple repositioning and stretching exercises to encourage the child to look to both sides, physical therapy, as well as nap and play time on the tummy, all with supervision of course. Plagiocephaly and brachycephaly can be associated with many conditions, from prematurity and twin births, to torticollis (asymmetrically tight neck muscle), to developmental delay. Any prolonged external force leads to some skull shape changes. While most parents think they were partially responsible for the flat spot developing in their newborn, an infant’s head is extremely malleable before it reaches cranial maturity. Plagiocephaly and brachycephaly are two terms used to describe the abnormal head shape, depending on the degree of distortion and location of the flatness. Since the beginning of the “Back to Sleep” program in the 1990s, which kept babies off their tummies to prevent Sudden Infant Death Syndrome, many babies started to develop flat spots on the back of their heads. The first questions they ask are “could I have prevented this?” and “will he need a corrective helmet?” What is plagiocephaly and what causes it? These babies are often accompanied by bewildered first-time parents with worried looks, scared by those big diagnostic words. A majority of the babies I see in the clinic are those diagnosed with torticollis and plagiocephaly.
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