Flat heads are common in babies who snooze on one side, a problem that can be easily addressed with corrective helmets. Unfortunately, helmets aren’t often covered by insurance, and the expense could be prohibitive for your family. However, early intervention can often *prevent* the need for a helmet, lowering the likelihood of having to spend out of pocket.
Deformational plagiocephaly, or positional skull deformities, have grown increasingly common as a result of doctor advice that infants sleep on their backs to prevent SIDS, according to the American Academy of Pediatrics. Because their skulls are still soft, many babies end up favoring one side of their heads when sleeping on their backs, resulting in abnormalities. It isn’t harmful to the baby’s brain, but it can cause the baby’s exterior to develop abnormally.
If you’re a fan of John Legend and Chrissy Teigen, you’re probably aware with helmet therapy because their son Miles has been wearing one for the past year. According to John Hopkins Medicine, cranial remolding helmets are uniquely developed to aid in a child’s cranial development because they employ a hard outer shell with an internal foam lining that supports growth of the flatter parts. They will not harm your child as they correct, however they may not enjoy wearing the helmet for the requisite 23 hours every day for the treatment to function. It’s a quick and easy fix, and most newborns will only need to wear a helmet for three months.
Are cranial helmets covered by insurance?
Cranial helmets are classified as “Durable Medical Equipment” and are therefore fully covered by insurance. Before covering a helmet, your insurance provider will usually want to make sure it is medically required. This used to mean that your child only needed a pediatrician’s prescription to get their device covered. Insurance companies, on the other hand, now require more information than ever before to ensure that medical devices are not given unnecessarily. It’s critical to demonstrate medical necessity, which is where the experts come in.
Why are baby helmets not covered by insurance?
As Dr. Muhittin Belirgen, a Pediatric Neurosurgeon at Texas Tech Physician at Covenant Children’s, explains to Romper over the phone, most insurance providers do not automatically cover corrective helmets because flat heads are typically seen as a cosmetic issue that will not harm the child’s health.
How much does a helmet for a baby cost?
The first randomized trial of the helmets was published in the journal BMJ on Thursday. According to Brent R. Collett, an investigator at Seattle Children’s Research Institute and author of an accompanying editorial, the authors observed “absolutely no therapy effect.”
Face asymmetry may accompany skull flatness at the back of the head; one ear may be somewhat farther back than the other, and the side of the head may flatten. Helmets had previously been proven to help correct head shape in less thorough trials.
The helmets are sometimes decorated with stickers and painted to resemble a pilot’s helmet or a favorite football team’s logo. Dr. Mark R. Proctor, an associate professor of neurosurgery at Boston Children’s Hospital, said of the new study, “I was extremely startled with the results,” adding that it was “rigorous.”
The study does not rule out the possibility that the helmets could be effective for infants with severe skull flatness and tight neck muscles, which make it difficult for infants to swivel their heads and keep them in one position.
Renske M. van Wijk and colleagues at the University of Twente in the Netherlands put 42 babies with malformed skulls, aged 5 to 6 months, in a custom-designed helmet that permits flattened portions of the infant’s skull to round out as the skull expands.
For about six months, parents were told to have their children wear the helmets for 23 hours a day. Another 42 kids with abnormalities comparable to theirs were left untreated. Infants with the most severe abnormalities were not allowed to participate.
After two years, a researcher who had no idea which newborns had worn helmets assessed the infants’ skull shape. The improvements were not statistically different between the infants who wore helmets and those who did not.
“There are definitely cases of infants with mild to moderate skull deformities who are treated with helmet therapy, and this study confirms and reaffirms that this is not necessary,” said Dr. James J. Laughlin, one of the authors of the American Academy of Pediatrics’ (AAP) policy statement on skull deformities.
The cost of a helmet to rehabilitate flattened skulls ranges from $1,300 to $3,000, and parents are advised to make sure their children wear them all the time. The report gives pediatricians and worried parents “reassurance that not doing helmet therapy will give you the same results as doing helmet therapy, which is expensive” and “stressful for the family,” according to Dr. Laughlin.
Custom helmet designers questioned the study’s findings. A spokesman for Cranial Technologies, Tim Littlefield, described it as “inherently faulty.” Nearly three-quarters of parents whose children received helmets in the trial complained that the helmets shifted or rotated on their infants’ heads, according to William Gustavson, a spokesman for Orthomerica.
“The quality of the fit is completely dependent on the value of this study,” said James Campbell, vice president of the American Orthotic and Prosthetic Association, a trade group.
Some surgeons were concerned that the findings would be applied too broadly, compromising insurance coverage for seriously ill children who would benefit from helmets.
“What I fear is that children with severe deformities may be denied helmets based on this research,” said Dr. Alex A. Kane, director of pediatric and craniofacial surgery at UT Southwestern and Children’s Medical Center in Dallas.
Courtney Reissig, a stay-at-home mother in Little Rock, Ark., doesn’t regret her son Luke wearing a helmet for eight months. His neck muscles were so tense that he preferred to sleep on his left side, which Mrs. Reissig described as “looking like the side of a toaster flat, not round.”
He outgrew his first helmet, which cost $1,300, and needed a replacement, according to her. Wearing a helmet, though, helped him round out his head, and he now looks a lot like his twin, Zach. “I think the helmets were well worth it,” she added.
Only roughly a quarter of the babies in the BMJ study recovered completely by the age of two.
“This is an issue we created,” stated Boston Children’s Hospital’s Dr. Proctor. “All parents are taught to put their children to bed on their backs. They are not informed about flat heads or how to avoid them.”
Before adopting a helmet, several pediatricians and specialists urge parents to try adjusting an infant’s head.
Once the newborn is asleep on the back, repositioning requires switching which side the infant’s head turns. As a result, pressure isn’t always applied directly to the back of the skull.
Infants with torticollis, or rigid neck muscles, have a harder time repositioning. According to Dr. Chad A. Perlyn, a craniofacial and pediatric plastic surgeon at Miami Children’s Hospital, they may benefit from physical therapy.
In addition to repositioning, he recommends that parents try more tummy time and restrict the amount of time their children spend in car seats. Use a baby carrier, he said, because “there is no deforming force on the skull when the infant is awake.”
Some helmet manufacturers, according to doctors, urge parents to diagnose flattened skulls without consulting a doctor. It’s critical for a doctor to rule out craniosynostosis, or premature bone fusion, as a cause, they said. Surgery is required for the extremely rarer condition.
Assessment tools on the websites of certain helmet manufacturers enable parents to compare their child’s head shape to photographs.
Children with and without a history of positional skull deformation had different head shapes at 36 months. Matthew L. Speltz, Brent R. Collett, Brian G. Leroux, Erin R. Wallace, Emily Gallagher, Jason Shao 204-213 in Journal of Neurosurgery: Pediatrics, Vol. 21 / No. 3 (March 2018).
How long does a baby have to wear a helmet?
Plagiocephaly helmets provide pressure to the fragile skull of a baby to straighten the misshaped head. They’re usually made of plastic with a foam lining and resemble a child’s bicycle helmet in appearance. Your infant may wear the helmet for a month or two to as long as six months, depending on his condition. Most doctors will tell you to wear the helmet for 23 hours a day, just taking it off for bathtime. Although it may appear to be a lengthy procedure, if you follow the guidelines, flat head syndrome will be treated much more quickly. The helmet does not disturb most newborns, and they quickly adjust to wearing it.
Are baby helmets medically necessary?
When their child need a helmet, many parents begin to blame themselves. You could even wonder if those annoying flat spots, often known as plagiocephaly, could have been prevented. The truth is that most babies’ heads aren’t properly shaped. Most adults, in reality, do not have perfectly formed heads. Small bumps and flat patches are common. When your baby’s skull has a wide flat patch on it, it’s usually due to delivery your baby’s skull may have become irregularly shaped when passing through the birth canal or because they rest flat on their back on a regular basis.
The skull bones of an infant’s skull are flexible, which means they move more easily than they do in an adult’s skull. This allows your baby’s head to pass through the birth canal and their brain to develop during childhood. Constant pressure on the back or side of the head, on the other hand, can result in irreversible deformity if not rectified.
When does my baby need a helmet?
Your baby’s head shape is unlikely to cause brain damage or other developmental concerns. In reality, most insurance companies and doctors regard a flat area as a cosmetic issue. So, how can you know if your child requires a helmet?
At each well-child appointment, your doctor will examine your baby’s head size and shape. During infancy, these visits occur every two months or so. Your doctor may recommend a helmet if your kid has a large flat spot that isn’t improving by the time he or she is four months old. Treatment should begin between the ages of 4 and 6 months for a helmet to be effective. As your child grows, the helmet will gently sculpt his or her head. Because the skull has begun to fuse together, treatment is generally regarded unsuccessful beyond the age of one.
What does wearing a helmet involve?
The use of a helmet to correct positional plagiocephaly is not for the faint of heart. During treatment, you must keep the helmet on your infant for 23 hours every day. Helmets are typically worn for several months. To keep up with their growth and changing head shape, your child’s helmet will need to be adjusted on a frequent basis, perhaps weekly. It can be costly to purchase and modify a helmet on a regular basis because insurance does not always cover it.
Other treatment options for positional plagiocephaly
Simple repositioning strategies have been demonstrated to be just as effective as wearing a molded helmet in several studies. Your doctor may also recommend physical or occupational therapy to address any other issues, such as infant torticollis, which is characterized by a twisted neck. These approaches can assist you in repositioning your infant and allowing their skull to repair flat regions on its own:
- Make time for your stomach a priority. Every day, place your infant on his tummy under supervision. This relieves pressure on the back of your child’s head and helps him build his neck muscles.
- Cuddle. Holding your infant isn’t just a terrific way to bond with your child. It also relieves strain on your child’s back that occurs naturally when he or she sits in a car seat, swing, or carrier.
- Switch things up a little. Try positioning your baby in such a manner that he is forced to turn away from the flat region on his head. Both sides should be breastfed. Place him in his crib in various positions so that he must turn to view you. You can also move his crib every now and then so that no one region on his head becomes overused or flattened.
In the majority of cases, your baby’s head shape will correct itself. As they begin to move and accomplish more, your baby’s head will develop and return to normal with time and effort. Wearing a helmet to address major malformations or flat patches on your baby’s head is also a smart idea. Inquire with your doctor about whether your child requires a helmet and what you can do to help him correct his flat spot.
Should my baby get a helmet?
According to studies, the optimal age for babies to begin helmet therapy is between 5 and 6 months. As your baby grows, the helmet will gently sculpt his or her head. Helmet therapy treatment is generally deemed unsuccessful by the time your infant is a year old since the growth of the skull, including suture fusion, is much farther along.
Aside from bath time, your child should always wear his or her corrective helmet, even when sleeping.
How can I prevent my baby from wearing a helmet?
Babies need a lot of energy to turn their heads. As a result, those who have extreme flattening on one side tend to stay on that side, causing their necks to stiffen due to lack of use.
What Are the Signs & Symptoms of Flat Head Syndrome?
- Looking down at the baby’s head, the flattened side’s ear may appear pushed forward.
In severe situations, the forehead may protrude and seem uneven on the side opposite the flattening. If torticollis is to blame, the neck, jaw, and face may be unequal as well.
How Is Flat Head Syndrome Diagnosed?
By looking at the baby’s head, doctors can typically diagnose flat head syndrome. A doctor may examine a baby’s head and neck movement to determine if he or she has torticollis. Medical testing are rarely required.
How Is Flat Head Syndrome Treated?
Even if flat head syndrome is a possibility, caregivers should always position babies on their backs to sleep to help prevent sudden infant death syndrome (SIDS). Swings, car seats, bouncing chairs, and other gadgets should be avoided for sleep safety and to allow babies to move their heads freely.
So, what can parents do if their child has flat head syndrome as a result of sleeping or resting in the wrong position? It can be helped by simple techniques like as altering a baby’s sleep posture, holding your infant, and offering enough of “tummy time.” Consider the following suggestions:
- Tummy time is a good thing to do. Allow your infant to lie on his tummy for extended periods of time while awake during the day. Time in the tummy:
- helps newborns learn to push up on their arms and improve their neck muscles. This aids in the development of the muscles required for crawling and sitting.
- In the crib, try different positions. Think about how you place your kid in the crib. The majority of right-handed parents carry their children in their left arms and lay them down on their left side. The newborn must turn to the right to see out into the room while in this position. Place your infant in the crib such that he or she may actively turn his or her head to the side that isn’t flattened.
- Increase the amount of time you spend holding your infant. Limit the amount of time your youngster spends lying on his or her back or resting his or her head against a flat surface (such as in car seats, strollers, swings, bouncy seats, and play yards). If your baby has fallen asleep in a car seat, for example, rather than keeping your little one dozing in the vehicle, remove your baby out of the seat when you get home. Pick up and hold your baby frequently to relieve head pressure.
- While your infant is sleeping, adjust the head position. When your infant is sleeping on the back, change the position of his or her head (from left to right, right to left). Even if your infant moves around during the night, place your child with the flattened side of the head facing up and the rounded side of the head touching the mattress. To keep your infant in one position, don’t use wedge cushions or other gadgets.
Torticollis affects the majority of babies with flat head syndrome. As a result, physical therapy and a home exercise program are frequently included in treatment. A physical therapist can give you stretching exercises to undertake with your infant. The majority of the motions involve stretching the neck to the side that is not tilted. The neck muscles will lengthen and the neck will straighten out over time. The exercises are straightforward, but they must be completed correctly.
A helmet can be prescribed by a doctor for flat head syndrome. The helmet is made to fit a baby’s head snugly where it is flat and loosely where it is round. The head cannot grow in the helmet because it is already round. As a result, it thrives in areas that are flatter.
Helmets cause the head to round out faster than normal growth. However, after a few years, babies who wear helmets and those who do not have the same outcomes. Consult your doctor to see if a helmet might be beneficial to your child.
What Else Should I Know?
With time and normal growth, flat head condition improves. As babies grow, they begin to shift their sleeping positions, so their heads aren’t always in the same place.
When babies are able to sit independently, a flat area normally does not worsen. The flattening will then improve over months and years as the skull grows, even in extreme cases. The flat patch frequently becomes less obvious as hair grows in over the first few years.
The growth of a baby’s brain is unaffected by flat head syndrome. A stiff neck, on the other hand, can stifle early development. A check of the baby’s progress and additional exercises to treat any delays should be part of torticollis physical therapy.
Does the DOC band really work?
While the DOC Band has a track record of success, each baby’s situation is unique. While you’re going through treatment, keep the following things in mind: your baby’s age, the severity of her or his condition, and how consistently you follow the specified treatment plan. All of these variables will have an impact on the final result.
Beginning treatment at the appropriate age of 4 to 6 months produces faster effects and a better overall outcome, according to research.
- Within the first week of wearing the band 23 hours a day, changes in youngsters under the age of five months can be noted.
- Changes can be evident in children under the age of 12 months within the first two weeks of treatment.
- Changes can be noted in children over the age of 12 months within the first 2 to 3 weeks of treatment.
The more severe the form of plagiocephaly, like with any condition, the more difficult it will be to repair. As a result, it’s critical that babies with severe plagiocephaly start treatment as soon as feasible.
The DOC Band should be worn for a total of 23 hours every day. A doctor should make growth modifications on a regular basis. Your baby’s neck muscles should be stretched and exercised on a daily basis if necessary. To get the greatest potential outcome, everyone who cares for your newborn should be aware of the needs.
Do helmets really help flat heads?
(HealthDay News) FRIDAY, MAY 2, 2014 (HealthDay News) A new study reveals that special helmets are useless in treating a flat area on a baby’s head caused by resting in the same posture for lengthy periods of time.
Experts estimate that one out of every five babies under the age of six months has this condition. It’s grown more prevalent as a result of efforts advising parents to put their kids to sleep on their backs to lessen the risk of SIDS (sudden infant death syndrome) (SIDS).
The use of these pricey helmets to treat flattened skulls is contentious, according to the study’s authors, and there has been little research into their effectiveness.
84 newborns with moderate to severe flattening of the skull were studied by researchers in the Netherlands. Half of the newborns wore a custom-made, rigid, snugly fitting helmet for 23 hours a day for six months, starting when they were six months old. The others were not treated in any way.
According to a journal news release, there was no significant difference in the degree of improvement in head shape between the two groups by the time the children were two years old, nor in the number of them who made a full recovery to normal head shape 25.6 percent of those who wore helmets and 22.5 percent of those who did not.
Skin irritation (96 percent), an unpleasant odor (76 percent), perspiration (71 percent), and pain were all reported by parents of babies who wore helmets (33 percent). In addition, 77% of parents claimed the helmet made it difficult to cuddle their child.
When their children reached the age of two, parents in both groups said they were happy with the form of their child’s head. The average satisfaction score among parents whose newborns wore helmets was 4.6 out of 5, while the score among those whose babies had not received the treatment was 4.4 out of 5, according to the study.
“We discourage the use of a helmet as a standard treatment for healthy infants with moderate to severe skull deformation based on the effectiveness of helmet therapy, as well as the high prevalence of side effects and high costs,” concluded researcher Renske van Wijk of the University of Twente in Enschede and colleagues.
The vast majority of these situations, according to the American Academy of Pediatrics, can be addressed with physical therapy and noninvasive techniques.
What is considered mild plagiocephaly?
Although numerous research have looked into the effectiveness of CROs, no definitive results have been found. Although the best time to begin and end treatment for all skull deformations is still being disputed in the literature, the evidence appears to imply that treatment should begin at the earliest possible age for maximum results. Asymmetrical brachycephaly is only a minor part of the limited study on skull deformations that is currently available. With asymmetrical brachycephaly, the trend of stronger rectification with treatment of deformational head shapes (plagiocephaly and brachycephaly) with younger starting age is likely to be accurate. However, there hasn’t been a thorough examination of this in the literature. As a result, treatment for this illness is based primarily on clinical experience and varies widely. As a result, a retrospective chart review was conducted to assess the outcomes of newborns with asymmetrical brachycephaly who were treated with CROs at various ages and severity levels.
The goal of this study is to determine the efficacy of CRO treatment in terms of treatment duration and final head shape measurements in infants with asymmetrical brachycephaly in relation to starting age and cranial measurements, in order to answer the clinical question: what is the most effective starting age for CRO treatment for asymmetrical brachycephaly? The researchers wanted to know which parameters (prematurity, torticollis, initial starting age of therapy, initial severity of CI, and early severity of CVAI) are important in deformity correction. Another research topic is whether the severity of the brachycephalic portion (measured by CI) or the plagiocephalic portion (measured by CVAI) of the asymmetrical brachycephalic head shape has a greater influence on rectification.