Treatment Options

Helmets or Headbands for Infants with Irregularly Shaped Heads

Little Value

Helmets and headbands have been researched as a non-surgical treatment for an irregularly shaped head, also known as cranial asymmetry.  The irregular shape is caused by an infant’s head shape being changed by external/outside forces, such as the infant’s sleeping position or pressure in the womb.  The purpose of a specially made helmet or headband is to improve the head shape by guiding the growth of the infant’s head.  Treatment is typically started early (before the infant is 7 months old) and continues for an average of 4 to 5 months.  The helmets and headbands are worn 23 hours a day with an hour off each day for exercises and skin care.  Note:  A similar condition in which the sutures along the top, back and sides of the head close too early is more serious than the existence of an irregularly shaped head and must be treated by surgery.

The conservative treatment for an irregularly shaped head is repositioning.  Repositioning involves frequent changes in an infant’s laying position from their back, left side, or right side, and allowing the infant to spend time while awake on their stomach for play when supervised.  This form of treatment can easily be performed at home at no cost.  Repositioning does require that the parent(s) or guardian(s) be diligent in turning the infant.  Improving the shape of the head by repositioning may also take longer than reshaping the head using helmets or headbands.  (Note:  Pediatricians recommend that infants not sleep on their stomachs – the face down position.  This position has been linked to the occurrence of Sudden Infant Death Syndrome - SIDS).  Also, physical therapy is occasionally used with repositioning as a treatment for an irregularly shaped head.  Treatment initiated before 6 months of age has been shown to be most effective.  No treatment has proven effective after 1 year of age.

There is little or no evidence that an irregularly shaped head causes any loss in length of life, any loss in quality of life, any learning disabilities or mental delays; nor do helmets or headbands have any beneficial effect on learning or mental function.  Published studies do not clearly support one treatment as being better than another or even better than no treatment.  The major reason for using a helmet or headband to treat infants with irregularly shaped heads is to improve the shape (i.e., contour) of the head in order to obtain an acceptable appearance, not to prevent or correct adverse developmental or physical results.

Things to Consider

  • Helmets and headbands (i.e., cranial orthotics) are a treatment for infants with irregularly shaped heads. The specially made helmet or headband guides the growth of an infant’s head for a better appearance.
  • If used early (before 6 months of age for best results), helmets and headbands can improve the shape of the head.  However, the use of repositioning to treat affected infants can also improve the shape of the head.  Helmets/headbands and repositioning have not been shown to be effective on infants age 1 year or older.
  • Irregularly shaped heads do not appear to cause learning disabilities or delayed mental development; nor do helmets or headbands have a beneficial effect on learning or mental function.  The major reason for using a helmet or headband is to improve the shape of the head for an acceptable appearance, not to prevent or correct developmental or physical problems.

Results

Little Value

Will my infant live longer if I have this procedure?

There is no indication that the use of helmets or headbands in the treatment of infants with irregularly shaped heads prolongs life.

Will the treatment of an irregularly shaped head improve my infant’s quality of life?

There is no indication that an irregularly shaped head causes learning disability or mental delays or that the use of a helmet or headband has any effect on learning or mental function.  Severe cases of irregularly shaped heads, while rare, have been associated with deformity of the bones around the eyes and could potentially cause abnormalities in eye movement and/or other vision problems (e.g., strabismus).

Will the use of a helmet or headband improve the appearance of my infant’s head?

Helmets and headbands can correct or improve an irregularly shaped head, if the treatment is started early.  It’s generally recommended that treatment begin before an infant is 6-7 months old.

Safety

Intermediate Value

Minor reported complications:

  • Poor construction and/or inappropriate fit
  • Skin irritation
  • Poor fit and/or excessive weight that alters the infant’s ability to lift the head

Major reported complications:

  • Skin breakdown followed by infection caused by pressure on skin
  • Eye trauma due to mechanical failure
  • Head or neck trauma due to the weight of the device on a young infant
  • Impairment of brain growth and development from mechanical restriction of head growth
  • Asphyxiation (inability to breath) due to mechanical failure

Comparison

Intermediate Value

Alternative Treatments:

Other treatments for infants with an irregularly shaped head include:

  • Repositioning
  • Physical therapy

Adjunctive Treatments:

No other treatments are required to be used simultaneously with the helmet or headband.

Cost

Little Value

The expense of a traditional helmet ranges from $150 to approximately $1,000.  The expense of some newer types of headbands/helmets range from approximately $2,000 to almost $4,000.  Due to an infant’s rapid growth, a second headband or helmet is occasionally required during the treatment period.  Repositioning, or turning the infant while awake, has no associated costs.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

American Academy of Pediatrics. (2002). Incidence of cranial asymmetry in healthy newborns. Retrieved March 25, 2014 from http://pediatrics.aappublications.org/cgi/reprint/110/6/e72.pdf.

American Academy of Pediatrics. (2011). Prevention and management of positional skull deformities in infants. Retrieved March 25, 2014 from http://pediatrics.aappublications.org/content/early/2011/11/22/peds.2011-2220.full.pdf.

NHS Quality Improvement. (2007, April). The use of cranial orthosis treatment for infant deformational plagiocephaly. Evidence note no. 16. Retrieved March 4, 2013 from http://www.healthcareimprovementscotland.org/previous_resources/hta_report/en_16_cranial_orthosis.aspx.

Next Review Date

3/27/2015

This document has been classified as public information.

Table of Findings

results:  little value

safety:  intermediate value

comparison:  intermediate value

cost: little value


total: little value

legend

scale

Page modified:March 31, 2014