Why do some children wear helmets?

Have you ever seen a child wearing a headdress that looks like a helmet? They can do helmet therapy or skull braces. Most children who need helmet treatment have a condition called craniosynostosis.

What is craniostenosis?

Our skull is made up of five thin bony plates. These plates are held together by fibrous tissue or sutures. These sutures allow our skull to expand as our brain grows. As we grow, these sutures harden and hold our skull bones together.

Craniostenosis is a condition in which one or more sutures close too quickly.

If your child has craniosynostosis, it can affect the shape of their skull, depending on how many sutures close before it breaks. If one stitch closes too soon, your baby's brain may develop normally, but his head may be oddly shaped. If more than one stitch closes too soon, your child's brain may not be developing as fast as it should.

Types of craniostenosis

There are several types of craniosynostosis that can affect your child, including the following:

Scaphocephaly. Scaphocephaly, also called sagittal craniosynostosis, is a premature fusion of the sagittal suture that runs from front to back and down the middle of the crown of the head.
Scaphocephaly makes the skull long and narrow. This puts pressure on the brain, which prevents the brain from developing normally.
Trigonocephaly. Trigonocephaly, also called metopic synostosis, is a fusion of the metopic suture. The metopic suture starts from the top of the head and goes down the middle of the forehead to the nose. Early closure of this suture may result in a raised ridge on the forehead, and then a triangular point may form on the forehead.

How is craniostenosis diagnosed?

You or your doctor may notice that your baby's head is oddly shaped at birth, shortly after birth, or later during a checkup or annual checkup.

To diagnose craniosynostosis, your child's pediatrician may do the following:

Visually inspect your child's face and head
Measure your baby's head
Feel the sutures and soft points (fontanelles) on the skull.
Feel the top and sides of the head, where the sutures are, for unusual protrusions or bumps.
Order an x-ray of the skull or computed tomography

None of these tests or procedures will hurt your child.

When does helmet therapy start?

Studies show that the best age to start helmet therapy for children is between 5 and 6 months of age. This allows the helmet to gently shape your child's skull as they grow. By the time your child is 1 year old, helmet therapy is generally considered ineffective because skull growth, including suture fusion, is much faster.

Outside of bath time, your child should always wear a corrective cap, even when they are sleeping.

How long does helmet therapy take to work?

The average duration of helmet therapy is about three months. The duration of helmet therapy for your child will depend on several factors, including their age and the severity of the craniosynostosis.

Other reasons to use helmet therapy

If your child has a deformed head, it does not necessarily mean that he has craniosynostosis. The shape of their head could have been influenced by their position in the womb, the process of childbirth, or their sleeping position.

For example, deformational plagiocephaly occurs when babies sleep excessively in the same position, especially on their backs. This causes children to develop a flat spot on one side of the head or on the entire back of the head. Deformational plagiocephaly is also sometimes referred to as "flat head syndrome". With deformational plagiocephaly, there is no fusion of the bones of the skull.

Other things that can lead to deformative plagiocephaly include the following:

Muscular torticollis: Muscular torticollis is a congenital disorder in which one or more muscles in the neck become very tense, causing the affected child's head to remain in the same position.
Prematurity: Premature babies have softer skull bones and many preterm babies spend a lot of time in the neonatal intensive care unit, usually on a ventilator, with their head in the same position.

If you have any concerns about the shape or development of your child's head, talk to your pediatrician before starting helmet treatment.