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.
How much does helmet for 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 around 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).
Does insurance cover plagiocephaly?
Parents may be apprehensive about the cost of cranial therapy treatment, which is understandable. Many insurance companies, including Medicaid, do, in fact, fund cranial therapy. However, like with all conditions, different policies cover varying ranges of conditions; also, exclusions, deductibles, co-pays, and out-of-pocket charges may apply depending on your coverage.
Only if measurements show that the baby’s head has a moderate-to-severe malformation is plagiocephaly considered a medical necessity rather than a cosmetic condition by some insurance companies. Carrier requirements may also include a note from your doctor declaring that a custom cranial orthosis is medically essential. This letter should also mention any potential issues that may occur if the problem is not addressed quickly.
The following papers will be required before contacting your insurance carrier:
Are baby helmets medically necessary?
Helmet therapy for plagiocephaly is always an option, never a need. It can be useful under the correct circumstances, but it isn’t always required. With or without the use of a helmet, the head shape generally improves.
Helmet therapy is a decision made by some parents in collaboration with their child’s doctor to try to change the shape of their child’s head cosmetically.
You can discuss your baby’s individual case and the benefits and drawbacks of helmet therapy with your pediatrician or a pediatric neurosurgeon.
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 skull 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.
How long does a baby need a helmet?
How long will my child be wearing his or her helmet? The average duration of therapy with a helmet is three months, however this can vary depending on your child’s age and the severity of the condition. To guarantee that the skull is reforming properly, careful and frequent monitoring is essential.
Can plagiocephaly correct without helmet?
Milder plagiocephaly can be repaired without the need of a helmet in 77 percent of instances using a technique called as repositioning. The head can typically be restored to within the ‘normal’ range before the bones in the skull harden and the infant begins to move around more independently if the deformity is moderate and repositioning begins early.
As a result, many parents prefer not to use a helmet to cure plagiocephaly and instead reposition their child’s head until it returns to a normal shape. However, even when the deformity is moderate or severe, some parents choose not to pursue helmet therapy. This could be for a variety of reasons:
- Some people aren’t even aware that this choice exists, or they don’t learn about it until it’s too late. Because referrals to paediatric experts, neurosurgeons, and other specialists take time, many parents are uninformed of the severity of their children’s malformations or the treatment choices available until after a vital period in their development has passed.
- Many people are unwilling to treat an illness that is viewed as aesthetic rather than medical. This frequently follows advice from their health-care providers, giving many parents the uneasy impression that they are being vain by subjecting their children to unnecessary treatment.
- Many parents are taught to assume that their child’s head shape would improve on its own. On the contrary, according to a research released last year, “Only moderate instances can be adequately managed by conservative care, i.e., without the use of a helmet.”
- The cost of plagiocephaly helmets, as well as a lack of funding, might be a concern for many parents. The NHS only provides funding in extreme circumstances, and the bulk of private health insurance follow suit. Treatment costs, on the other hand, have remained consistent and are comparable to many dental and orthodontic treatments, and a few charities, such as Tree of Hope and Headstart4Babies, often assist with fundraising.
- Some parents are put off by some clinics’ forceful sales practices and the fear of being taken advantage of. One mother claimed that the practitioner she saw gave off the impression of being a doctor “Her faith in the profession as a whole was shattered when she was labeled a “charlatan salesman.”
- Others are concerned about the possible discomfort associated with wearing a plagiocephaly helmet. However, this is an uncommon occurrence that usually occurs when therapy protocols are not followed appropriately.
- Following the recent media attention on plagiocephaly helmets, some parents believe that the correction they provide is no better than what may be accomplished through repositioning. The great majority of earlier and subsequent research has rejected this claim. A visible, permanent repair can invariably be obtained if treatment is initiated within the first 14 months and the necessary protocols are followed.
We hope that this post has highlighted some of the points that you might want to think about when deciding whether to treat your child’s plagiocephaly without a helmet or with a helmet. If you’re still undecided, there’s a wealth of information available online, including study papers, parenting websites, blogs, and more.
How long does it take for a baby’s head to round out?
Between 2 days and a few weeks following delivery, your baby’s head should revert to its lovely, round shape. Other positioning considerations, though, can have an impact on your baby’s head shape. These are some of them:
when your kid is on their back, not switching the direction their head faces
There are actions you can take to encourage head rounding if your baby’s conehead is persisting longer than intended. (In the meantime, snap a lot of photos and enjoy the conehead cuteness while you still can.)
Make sure your infant does not spend too much time on their back with their head in one position, as this might cause plagiocephaly (flat side or back of head).
Place them facing different directions throughout the day or move mobiles or other toys to different viewing positions to encourage diverse positions.
You can also carry or wear your kid in a carrier frequently to ease pressure on the back of their head. When they’re awake, use swings and baby seats to change positions. For each feeding, switch sides.
Allow your infant to have supervised tummy time many times a day. Tummy time can help your baby build stronger neck and back muscles, providing them better control over their heads and allowing them to distribute head pressure appropriately.
If you’re still worried, go to your baby’s pediatrician, who may be able to advise other ways to round your baby’s head. Physical therapy or a specific helmet intended for head rounding may be recommended by your pediatrician.
Other concerns
A lump on the top of your baby’s head that occurs within a few hours or days of delivery could be an indication of cephalohematoma. This simply means that at birth, little blood vessels on your baby’s head are ruptured or trapped and collect between the skull and skin. It’s not a significant problem that won’t impact the baby’s development, and it should go away on its own in a few months.
Torticollis is a condition in which your baby’s head begins to tilt downward. It’s called congenital muscle torticollis if the twist appears from birth, but it can happen at any age, even in adulthood!
When a major muscle spanning the head and neck is shortened, the head bends toward the shortened side and the chin rotates in the opposite direction.
Torticollis can occur when your baby is in a cramped or breech position at delivery, causing the muscle to shorten. You may not notice this until your baby’s neck muscles begin to develop control about 6 to 8 weeks after delivery.
Your infant may find it difficult to breastfeed on one side or prefer to glance over one shoulder rather than turn their head to see you in the eyes. If you observe this, tell your pediatrician about it at your baby’s next wellness check. Early action can help prevent long-term issues.
Does the DOC band really work?
The DOC Band is a successful Plagiocephaly treatment for babies aged three to eighteen months. Starting treatment early has been demonstrated to minimize overall treatment time because the DOC Band relies on normal brain growth, which is high during the first 6 months of infancy, steady from 6 to 18 months, and then slows through 24 months. The length of treatment will be determined by your baby’s age and the severity of his or her disease. Starting therapy between the ages of 4 and 6 months, when the head is growing rapidly, has been proven to shorten treatment duration, while considerable progress can be accomplished utilizing the band between the ages of 3 and 18 months. The majority of treatments last between 5 and 4 months. Although I have seen newborns who require more time in the band and still have fantastic outcomes. I hope this information is useful to you, and I wish you and your child the best of success.