Shriners Children’s offers helmet therapy (also called cranial remolding therapy) to correct the shape of a baby’s skull over time.

This treatment uses a special, custom-fit helmet to gently guide the natural growth of a baby’s head.

What Conditions are Treated with Helmet Therapy?

Young babies have skulls that are soft and susceptible to remolding from external pressures. Flat spots form from prolonged pressure on one side of the skull. Torticollis also increases the risk of flat spots by causing the baby to favor one side while lying down. Helmet therapy is used to correct these shape abnormalities of the skull in young babies.

Helmet therapy can help babies with a variety of conditions, including:

  • Plagiocephaly: Flattening of one side of the head.
  • Brachycephaly: Flattening of the back of the head.
  • Dolichocephaly: A long, narrow head shape
  • Craniosynostosis: An early fusing of the plates in a baby’s skull which may cause problems with normal brain and skull growth.

How Does Helmet Therapy Work?

Newborn babies’ skulls are made of soft plates with spaces between them. As a baby grows, these plates grow, gradually hardening and coming together. Shriners Children’s uses a cranial remolding orthosis. This custom-fit helmet is made of a plastic shell with a foam lining. It provides appropriate resistance over the rounded areas so that the natural brain and skull growth are directed into the areas of flattening. Adjustments are made frequently as your baby’s head grows. Early intervention is crucial for successful outcomes. In general, helmet therapy works best for children who start it when they are between 4-6 months old, during the period of rapid head growth.

What to Expect

At Shriners Children's, our Pediatric Orthotic and Prosthetic Services team will use a 3D scanner to measure and map your baby’s head. These measurements will be used to create the custom-fit helmet. Our staff will then review wear and care instructions with you.

During the first five days of treatment, you will be asked to follow a schedule that gradually increases the wearing time of the helmet each day. After the five days, the helmet is worn 23 hours a day with an hour off for bathing and hygiene. Regular follow-up visits are essential to monitor progress and make adjustments to the helmet as the baby’s head grows. The length of treatment depends on the baby’s age and how flat their head is at the start of treatment, but an average treatment lasts 3-5 months.

Specific treatments and services may vary by location. Please contact a specific location for more information.

Frequently Asked Questions about Helmet Therapy

Is helmet therapy painful for my baby?

No, cranial remolding therapy is not painful or uncomfortable for your baby.

Does my child need to wear the helmet all day?

Yes. The helmet must be worn 23 hours a day, whether playing, sleeping or feeding. Compliance with the schedule is essential for treatment success.

How long will treatment last?

Every child is different. Duration of treatment depends on the baby’s age and how flat their head is at the start of treatment, but an average treatment lasts 3-5 months.

Are there risks associated with helmet therapy?

Helmet therapy is generally very safe. Minor, potential risks include skin irritation and sweating. Your baby may experience extra sweating during the first few days of wearing the helmet until his or her body becomes used to it.

Cranial Remolding Wear and Care Instructions

Your child will start wearing their cranial orthosis 23 hours a day but will need time to adjust to wearing the STARband. This schedule was developed to prevent skin problems, and provides a safe way to acclimate to the STARband.
View Transcript

Speaker 1:
Your baby will eventually wear his or her STARband cranial orthosis, 23 hours a day, but needs several days to adjust to wearing the STARband. Follow the schedule on your screen to gradually increase the wearing time. Do not accelerate this program even if your baby is not having any problems. This wearing schedule was developed to prevent skin problems and to help your baby adjust to the STARband. This wearing schedule provides a safe way to acclimate to the STARband. The fifth day is considered full-time wear, and at this point, the STARband should only be removed for one hour per day. The STARband should be removed and cleaned during the baby's bath. Remove the STARband if your baby has a fever or the flu. Return to full-time wear as soon as possible.

[A bar graph titled “STARband wearing schedule program” with data depicting how long to wear the STARband cranial orthosis that reads “Day: 1 ON 1hr, OFF 1hr” NAP and NIGHT crossed out, “Day: 2 ON 2hr, OFF 1hr” NAP and NIGHT crossed out, “Day: 3 ON 4hrs” OFF 1hr, NAP and NIGHT with a check mark, and “Day: 4 ON 8hrs, OFF 1hr” NAP and NIGHT with a check mark.]

If the baby has not been able to wear the Star band for 48 hours, ramp up the wearing schedule slowly over a few days to help the baby adapt to wearing the STARband again. If your baby has been diagnosed with torticollis, the torticollis must be treated in order to achieve head shape correction. If your therapist or physician has given you neck exercises to perform, remove the STARband for the exercises and replace the band as soon as the exercises are finished at bath time each day, remove and clean the STARband. Only use unscented rubbing alcohol to clean the inside of the STARband. Other cleaners, such as soap, water, bleach or perfume, can cause skin irritation and should not be used inside the STARband.

Vigorously rub the inside of the STARband with a clean wash cloth containing the rubbing alcohol, or apply rubbing alcohol using a new soft toothbrush. Set the band upside down to dry. A fan, in addition to the rubbing alcohol, may be used to help alleviate odor that sometimes develops inside the band. Drying in the sun can also help to alleviate the odor and speed up the drying process. Shampoo the baby's head daily and reapply the STARband when both the head and the band are dry. Babies with very sensitive scalps may benefit from a mild unscented hypoallergenic shampoo. The STARband should not get wet and should be removed for swimming.

After swimming, wash your child's head with shampoo to remove chlorine, sunscreen, et cetera. Reapply the orthosis when both your baby's hair and the STARband are dry. For the first several days, your baby may perspire excessively until his or her body becomes accustomed to the STARband. This is normal. And during this time, the STARband can be removed for a couple of minutes throughout the day to dry the baby's head and band with a towel or cool hairdryer. The STARband should be reapplied as soon as the baby's hair and the band are dry. Do not use powders, lotions or wipes on the baby's head or inside the STARband. These products may contain perfumes and ingredients that can lead to skin irritation. Dress your baby in cooler clothing if the baby perspires excessively.

If the baby develops a rash, consult your doctor immediately. Also, keep the baby as cool as possible, and towel or blow-dry the baby's hair and the inside of the band throughout the day with a cool hairdryer to prevent moisture buildup. Replace the STARband as soon as the band and hair are dry. Time out of the band should be less than 10 minutes. If you need to cut your baby's hair during STARband cranial orthosis treatment, do not shave the entire head. The contact of the band against the head may cause irritation when the hair starts to grow back in, and the baby may develop skin irritation. Try to keep your baby's hair the same length throughout treatment to prevent fitting problems that may result from a decrease or increase in the amount of hair.

Skin checks should be performed every time the STARband is removed. Call your practitioner immediately if there's an area of deep redness that does not fade in one hour after removing the band. This may indicate a need for an adjustment. If there is any skin breakdown, remove the band and contact your doctor. The STARband should not be worn until the skin is healed. Excessive time out of the STARband, more than 48 hours, may create problems with the fit of the STARband since the baby's head is growing continuously. Limit the time out of the STARband and seek assistance when something prevents your baby from tolerating or wearing the band. Each time you place the STARband on the baby's head, check the chafe strap and stop gap foam insert to make sure they are secure.

Loose parts can be a choking hazard and can result in asphyxiation if the parts are swallowed. When the STARband is off your baby's head, keep the STARband away from family pets. Dogs have been known to chew the plastic and foam liner. The STARband must be worn as prescribed, 23 hours a day to constrain further abnormal growth and encourage growth in the correct locations. Even at the end of treatment, the band should be worn 23 hours a day until the physician, practitioner and caregiver agree that treatment is complete. Early discontinuation of treatment against medical advice may result in incomplete correction of the head shape.

Continued use of the STARband against medical advice may restrict skull growth and may impair brain growth and development. Explain the purpose of the STARband to other caregivers and train them in the proper application, removal and wearing schedule. Training is important for family, friends, daycare personnel and any other person taking care of your baby. If you have questions or concerns about your baby's care, contact your practitioner so that any issues can be resolved quickly. Information and resources are available for caregivers on Orthomerica's website at www.starbandkids.com. Shriners Children's and Orthomerica wishes you and your baby a most successful STARband experience.

[End Card: Shriners Children's Pediatric Orthotic and Prosthetic Services logo, Orthomerica logo, ShrinersChildrens.org]

The staff at Shriners Children's meets you with such enthusiasm, optimism and knowledge that there is no gray area to panic about.
Ellen, Erie
specialist measures baby's head while parents hold her

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Services We Provide

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Care Management

The care management team at Shriners Children's consists of registered nurses and social workers who act as resources for families throughout their plan of care.

Child Life Services

Child life professionals at Shriners Children’s take pride in focusing on the "above and beyond" aspects of medical care for our patients. From procedure support to camps, they are ready to advocate for your family.

Pediatric Orthotic and Prosthetic Services (POPS)

Shriners Children’s Pediatric Orthotic and Prosthetic Services (POPS) designs, fits and manufactures orthotics and prosthetics for children from infants to young adults.

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