Molding helmet or headband or cranial orthoses therapy:

Criteria to begin helmet treatment

After first diagnosed with positional plagiocephaly, the family is given stretching exercises, instructions to alternate positioning, and physical therapy if the child has torticollis.

Approximately half of all infants with prominent positional plagiocephaly present at 4 months will have significant improvement by 6 months of age. During this period, most infants begin spending much less time resting on the back as they sit up and move about more. Because many infants will have marked improvement in the cranial shape by 6 months of age, many clinicians do not routinely begin molding headbands treatment prior to 6 months, except for exceptionally severe deformities.

A subset of infants with positional plagiocephaly will fail to show significant improvement by 6 months of age, even with an adequate trial of repositioning and physical therapy.

Some infants with associated torticollis will have concomitant improvement in cranial shape with the resolution of torticollis, whereas other infants will have a persistent cranial deformity despite the improvement in torticollis.

For infants with severe deformational plagiocephaly despite conservative treatment and improvement in torticollis, a cranial molding helmet can provide significant improvement in the cranial shape and minimize disfigurement.

The age suitable for head band treatment

The head band is most effective if it is fitted early. Babies should be fitted by 6 months, at the latest by 11 months. This is because babies' heads grow very quickly in the first 12 months of life. The head band helps the skull "grow back to normal". After 12 months of age, the bones of the skull are harder and more difficult to mold.

The head band therapy

This special type of custom made head band or orthotic device is called a DOC band (dynamic orthotic cranioplasty).

The head band presses gently on the prominent (misshapen) areas of the skull limiting growth in those areas. This method encourages the skull to grow in the flattened areas. The molding head band is also rounded on the outside to prevent the baby's head from falling to one side rather than the other.

The headband must be worn every day for 23 hours. The baby and the headband need to be checked and readjusted regularly to ensure the head is growing well.

Infants typically show significant improvement after the initial several weeks in the headband, and achieve most of the correction by 3 months.