What Is A Cranial Band For?

What is plagiocephaly?

Plagiocephaly is a condition that causes a baby's head to have a flat spot (flat head syndrome) or be misshapen.

The most common form is positional plagiocephaly. It occurs when a baby's head develops a flat spot due to pressure on that area. Babies are vulnerable because their skull is soft and pliable when they're born.

Positional plagiocephaly typically develops after birth when babies spend time in a position that puts pressure on one part of the skull. Because babies spend so much time lying on their back, for example, they may develop a flat spot where their head presses against the mattress.

Starting in the early 1990s, parents were told to put their babies to sleep on their back to reduce the risk of SIDS. While this advice has saved thousands of babies' lives, experts have noticed a fivefold increase in misshapen heads since then. (See below for tips on repositioning your baby to avoid both SIDS and plagiocephaly.)

More rarely, babies develop positional plagiocephaly when movement in the uterus is constricted for some reason – because their mother is carrying more than one baby, for example. It can also happen to breech babies who get wedged under their mother's ribs.

Another type of plagiocephaly is craniosynostosis, a birth defect in which the joints between the bones of the skull close early. Babies born with craniosynostosis need surgery to allow their brain to grow properly.

Treatments for positional plagiocephaly

If a doctor determines that your baby has positional plagiocephaly, his recommendations will depend on your baby's age and the severity of the condition.

If your baby is young enough and the condition is mild, he'll probably recommend repositional therapy, a combination of simple measures designed to help your baby's head round out. In severe cases, cranial orthotic therapy (using a helmet to change the shape of the head) may be required. Keep reading to find out more about these therapies.

Cranial orthotic therapy with a baby helmet or headband

Babies with severe plagiocephaly usually wear either a custom-fitted helmet or a headband (called a cranial orthotic) for about 23 hours a day to correct the shape of their head. This treatment generally lasts two to six months, depending on how early you start and how severe the problem is.

Helmet therapy is always coordinated with physical therapy to achieve the best results. It's most successful when started around 6 months of age. Some experts think the headgear offers little help after 12 months of age because the skull resists reshaping as the bone thickens.

If your baby needs cranial orthotic therapy, your doctor can recommend a helmet or band and tell you where you can have it made. You'll need to have a 3-D photographic image taken of your child's head so the device can be custom-fitted.

Wearing headgear all the time may sound awful, but the helmets and bands are lightweight, and most babies quickly get used to wearing one.

This kind of treatment can cost up to $4,000. Some insurance companies will cover it in their orthotic benefits, but others consider it cosmetic or experimental and won't pay. However, many parents have successfully appealed their insurance company's rejection and received payment in the end.

The success rates for this kind of therapy are high when it's started early (around 6 months). If you're starting late, your baby's skull may not become perfectly symmetrical. Keep in mind that some asymmetry is normal. And as your child's hair grows, it will likely hide some of the remaining flattening.