What is helmet therapy?
Helmet therapy is a non-invasive treatment used to correct cranial asymmetries in infants, such as positional plagiocephaly or brachycephaly. It involves the use of a custom-made helmet — also referred to as a cranial orthosis — that gently guides the growth of the infant’s skull by applying mild pressure to specific areas while allowing growth in others.
This therapy is intended for infants whose head shape has become asymmetrical due to prolonged one-sided positioning or other factors. Early diagnosis is essential, as an infant’s skull is particularly malleable during the first few months of life. Experts recommend initiating helmet therapy ideally between the fourth and sixth month of life, especially if conservative approaches such as repositioning or physiotherapy have not produced sufficient results.
The necessity and timing of helmet therapy depend on the severity of the asymmetry. A difference of approximately two centimeters or more between the diagonals of the skull is generally considered an indication for treatment, to help prevent potential long-term functional or aesthetic issues.
Which cranial deformities are treated?
Helmet therapy is used for a variety of infant cranial deformities. The most common are:
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- Plagiocephaly (oblique skull):
An asymmetrical flattening of the back of the head, usually caused by a one-sided position of the head. A displacement of the ear axis and an asymmetry of the forehead are characteristic.
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- Brachycephaly (broad skull):
Characterized by a symmetrical flattening of the back of the head, resulting in a broad, shortened skull. Often caused by prolonged supine position.
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- Scaphocephaly (long skull):
Caused by premature closure of the sagittal suture (sagittal craniosynostosis), resulting in a narrow, elongated skull. Treatment is usually surgical, followed by helmet therapy to correct the shape.
Causes and diagnosis of cranial asymmetries
Causes
Cranial asymmetries in infants can arise from a variety of factors. Common causes include:
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- Position-related deformities:
When a baby consistently lies on one side, it can lead to flattening or distortion of the skull. This is especially common in the first few months of life when the skull is still soft and flexible.
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- Prematurity:
Premature infants often have softer skulls and spend extended periods in fixed lying positions, which increases the likelihood of developing head deformities.
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Genetic factors:
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Congenital conditions such as craniosynostosis — where the cranial sutures fuse prematurely — can result in asymmetrical head shapes.
Diagnosis
Parents should pay attention to any noticeable changes in their baby’s head shape. A consultation with a specialist is recommended if:
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- The back of the head appears flattened
- The baby consistently turns its head to one side
- Facial or ear asymmetries become visible
A physical examination will be carried out, and imaging techniques may be used to determine the exact cause of the asymmetry. Orthopaedic technicians play a key role in designing and fitting cranial orthoses if required. The decision to proceed with helmet therapy depends on the degree of asymmetry and must be assessed individually in each case.
As a manufacturer of cranial orthoses, we are always available to support you as experts in the treatment of infant cranial deformities. You can learn more about how we carry out helmet therapy in the following section.
How does helmet therapy work at neja?
Initial examination and analysis
At the start of treatment, a comprehensive assessment is conducted either by specialists from our expert network or directly by our team. The shape of the baby’s head is measured precisely using advanced 3D scanning technology. This data forms the basis for creating the custom helmet orthosis.
Production of the custom helmet orthosis
Based on the scan data, a helmet is custom-made for your baby. It consists of a rigid outer shell and a soft inner foam lining, ensuring comfort and allowing for adjustments during the course of therapy. The production typically takes around two weeks.
Try-on & wearing time
Once the helmet is ready, it is fitted during a follow-up appointment. Final adjustments are made on site. To achieve the best therapeutic results, the helmet must be worn for approximately 23 hours per day, with one hour off for cleaning and skin care.
Regular check-ups
Routine follow-up appointments are scheduled every 3 to 4 weeks during the course of therapy. At each check-up, head growth is monitored and the helmet is adjusted as needed to ensure continued progress.
Completion of the therapy
The duration of helmet therapy varies depending on the child’s age and the severity of the deformity. On average, treatment lasts between 8 weeks and 8 months. Therapy is concluded once the desired head shape has been achieved.
