Babies can’t ride bikes or play contact sports — so why do they sometimes wear helmets? They’re likely doing helmet therapy (also known as cranial orthosis). This is a method for treating unusual head shapes in babies.

While the adult skull is hard, the skull of a baby is made up of several malleable plates with soft spots (called fontanels) and ridges (called sutures) where their cranial bones haven’t fused together yet.

This soft skull allows the baby to pass through the birth canal. It also creates space for rapid brain growth during the first years of life. Over time, the bones in the skull fuse together.

As a result of their softer skulls, babies can develop irregularly shaped heads. In some cases, they might need a helmet to correct the shape of the head and avoid future health issues.

Helmet therapy is used to treat conditions that impact the shape of a baby’s head.

Plagiocephaly

Plagiocephaly, sometimes called flat head syndrome, refers to the flattening of one of the soft skull plates of a baby’s head. This condition isn’t dangerous to a baby’s brain or development.

It tends to happen when babies spend a lot of time in one position, such as on their back. In that case, it may be called positional plagiocephaly.

Lying on the back is the recommended safe sleeping position from the American Academy of Pediatrics, so positional plagiocephaly isn’t uncommon.

The condition usually doesn’t cause any symptoms other than making one side of the head appear flattened. Plagiocephaly isn’t painful.

The most recent guidelines from the Congress of Neurological Surgeons recommend either physical therapy or frequently changing positions for very young babies.

A doctor might recommend a helmet for older babies around the age of 6 to 8 months who haven’t responded to other treatments.

Craniosynostosis

Craniosynostosis is a condition that occurs when a baby’s cranial bones fuse together too soon. It’s sometimes part of a genetic syndrome.

This early fusion can restrict brain growth and cause an unusual skull shape as the brain attempts to grow in a constricted area.

Symptoms of craniosynostosis may include:

  • unevenly shaped skull
  • abnormal or missing fontanel (soft spot) on the top of the baby’s head
  • raised, hard edge along the suture that has closed too early
  • abnormal growth of the baby’s head

Depending on the type of craniosynostosis, other symptoms may include:

  • headaches
  • wide or narrow eye sockets
  • learning disabilities
  • vision loss

Craniosynostosis almost always requires surgical treatment followed by helmet therapy.

Helmets used for cranial orthosis are different in several ways from other childhood helmets, such as those used while biking or snowboarding.

First of all, they must be prescribed by a licensed physician. This is usually done by giving the parent a referral to a certified pediatric orthotist, a doctor who works with orthotics for children.

They’ll take measurements of the baby’s head by creating a plaster mold of the baby’s head or using a laser light. Based on this information, they’ll create a custom helmet that’s designed to be adjusted as needed throughout the treatment process.

These helmets are made from a hard exterior shell and a foam interior that places gentle, consistent pressure on the protruding side of the head while allowing the flat spot to expand. They’re designed specifically to reshape the skull, not to protect the head from injury.

Babies usually need to wear the helmet for 23 hours a day. It usually only comes off for bathing or getting dressed.

This might seem like a long time to wear a helmet, but babies’ skulls are only malleable for so long. It’s important to make sure they finish any helmet therapy before their skull bones begin to fuse together.

Helmet therapy generally takes about three months, thought it may be shorter or longer depending on how severe the case is and how often a child wears the helmet each day. The child’s doctor will monitor the skull shape frequently and make adjustments as needed during treatment.

Helmet therapy shouldn’t be painful or uncomfortable for babies.

If the helmet isn’t fitted or cared for properly, issues such as odor, skin irritation, and discomfort may occur. If these issues come up, a doctor can make adjustments to the helmet to keep them from happening again.

Remember, these types of helmets are very different from what you might buy at a sporting goods store. They’re made using different materials, including softer foam on the inside. They’re also custom-made to fit each baby’s head, which helps to make them more comfortable.

Babies have softer skulls, which allow them to pass through the birth canal. This softness also allows for major brain growth during the first years of life.

But the amount of time babies spend sleeping in certain positions can lead to some unusual head shapes that can sometimes persist if not treated.

In other cases, babies may have a genetic condition that causes their skull bones to fuse too early, which inhibits brain growth.

Helmet therapy is a treatment method that helps to reshape a baby’s head, especially if physical therapy and frequently changing a baby’s position doesn’t do the trick.