Flat head syndrome: should you use a helmet?

All you need to know about using helmets to treat the condition, plus advice and support for worried mums and dads

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A surprisingly common condition, flat head syndrome, or plagiocephaly affects 16 in every 1,000 babies. Symptoms vary, but can include a flatter part at the back or the side of the head, misaligned ears, a bulging forehead, or one eye seeming bigger than the other.

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Doctors may recommend a physiotherapist or an osteopath if they’re worried about your baby’s neck, but often, you’ll be reassured that the condition will correct itself with time.

However, there are specially designed helmets that mould to the baby’s head are also claiming to solve the syndrome, but at £2000 each, they aren’t the cheapest form of treatment.

Do helmets work?

Opinions on the use of helmet therapy vary between professionals. Stephen Mottram is a clinical specialist orthodist for Ossur, the company behind Technology in Motion, which provides advice on orthopaedic braces and supports. He says, “I believe that helmets make a significant difference and so do the many parents we see. Without them, many infants continue into childhood with head shape irregularities.”

As with any product you consider for your baby, it’s important to do your research beforehand. Ian Wacogne, Consultant in Paediatrics at Birmingham Children’s Hospital, believes parents need to think carefully before deciding a helmet is the best option for their child. “The very serious cases of this condition only affects a small group of children. Even out of these serious cases, almost all of them get better with time and within 18 months; parents are often saying “what funny shaped head?”

Doctor Martin Ward Platt, a consultant paediatrician at the Royal Victoria Infirmary Hospital in Newcastle, says, “This condition preys on the insecurities of parents. A study showed that the problem had disappeared when the child reached 2-years-old. It’s important to remember there’s a history to the condition – babies have slept on their backs for decades, and if it was a persisting problem, you’d see bald men walking round now with oddly shaped heads. It’s a 21st century fad, which shows no signs of going away because children who wear the helmets are getting results. But this has nothing to do with the helmets and everything to do with nature.”

Pediatrician Dr James Laughlin, says that becasue babies spend almost all their time on their back “that leads to some positional flattening or molding of the head, depending on how the baby sleeps.”  Dr James’ aims to inform medical professionals about the condition and ways to treat it that avoid babies having to wear plagiocephaly helmets to reshape their skulls. He added that the condition was “entirely cosmetic” and did not post a developmental risk to babies. “There is currently no evidence that molding helmets work any better than positioning for infants with mild or moderate skull deformity”.

What do the NHS say about the use of helmets?

According to the NHS website baby helmets generally aren’t recommended because:

  • there isn’t clear evidence to suggest they work 
  • they often cause problems such as skin irritation and rashes 
  • they’re expensive, typically costing around £2,000 
  • your baby will need to be checked every few weeks to monitor their head growth and make any necessary adjustments 
  • they may be uncomfortable and distressing for your baby

So what should you do?

It’s completely down to you as a parent to decide what’s best for your baby. Dr Platt has suggested worried mums and dads talk to their GP, or a specialist such as the London Orthotic Consultancy. Clinical director Jo Drake says there is no right way of treating flat head syndrome, as every case is different. “It’s ultimately the parent’s decision, but we offer plenty of advice. If the baby is 4-7 months old, we’ll suggest the parents re-position their baby while sleeping.”

She explains that if the child is showing resistance to being re-positioned, or has a particularly severe head shape, helmet therapy will be recommended. “We give parents all the information they need to make a decision for themselves. Every case is different and the best treatment depends on a number of factors which we can assess.”

Dad’s story: “A helmet really worked for Ben”

Philip Saich was concerned after his son developed a flat head at 4-months-old in 2005. “We noticed one side of Ben’s skull was very flat, so we took him to the GP. But we actually had a frustrating experience with the NHS, as our consultancy appointment was cancelled for no valid reason.”

However, after Philip’s wife Karen attended a toddler group and noticed a young child wearing a helmet, they decided helmet therapy would be the best option for Ben. 

After wearing the helmet for around four months, his head shape was perfect. Philip and Karen set up a charity, Headstart4babies, shortly after, to offer help and advice to parents, as well as raise funds for low-income families who are unable to afford the helmets. 

Philip says the key to helping parents deal with the condition is education. “We aim to raise awareness and work with health officials so that eventually, fewer babies need helmets. I’m aware of the scepticism surrounding helmets, but they can help a number of families.”

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Read more on flat head syndrome and safe sleeping…

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