Frequently Asked Questions

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Flat Head Syndrome

Over the years of treating babies with flat head syndrome, we have received referrals from doctors as well as enquiries from parents seeking treatment for their children above 2 years of age. Unfortunately, head shape would have been fully formed by age 2 – cranial helmet therapy is no longer a treatment option.

You may call us directly for an appointment as referrals are not necessary.

The current adult population was born when plagiocephaly is uncommon, as babies were placed on their stomachs to sleep. The Sudden Infant Death Syndrome (SIDS)* led to the 1994 launch of the Back to Sleep campaign in the US. Parents were informed of the importance of back sleeping and encouraged to place their babies sleeping on their backs instead of tummies. While it has successfully reduced the occurrence of SIDS, there is a significant increase in the number of plagiocephaly cases (statistics for Asia is unavailable at this point). *Sudden Infant Death Syndrome (SIDS) refers to the sudden, unexpected death of an infant under 1 year of age – a major cause of death in infants between 1 month and 1 year of age in the United States and this happens most often during sleep.

Prolonged time spent in car seats, infant carriers and slings may possibly contribute to the flattening of a baby’s head. Reduction of time spent in these devices is recommended. It is also beneficial to encourage regular supervised tummy time and repositioning techniques.

While it may be easy to identify if your baby has flat head, the best way to determine the severity is through a full evaluation including measurement. Head shape assessment is available at Orthopaedia.

There is currently no research confirming that plagiocephaly has any harmful effects on a baby’s neurological development.

Flat head syndrome often occurs due to constant pressure on one side of baby’s head during sleeping. Hence, supervised tummy time and repositioning can be very effective in correcting a baby’s flat head between 0-4 months old, as he/she is constantly in sleeping positions. However, when babies above 4 months of age reach their milestones of constant tummy time, sitting up and moving about, these methods may not be as effective anymore.

Check out our simple test guide that you can try at home. Alternatively, you may visit us at Orthopaedia for a non-obligatory free head shape assessment.

Untreated cranial asymmetries have been linked to developmental delays, visual defects, ear infections, middle ear malfunction, jaw bone changes, learning difficulties and other psychomotor delays. While we need long-term research to support if uncorrected plagiocephaly will affect a child’s neurological development, there is no doubt that cranial asymmetry can have an effect on the child’s social well-being later in life, as his/her head will remain misshapen in adulthood.

In 1994, the Back to Sleep campaign was launched in the US to encourage parents to place their babies sleeping on their backs in hope to reduce the occurrence of SIDS.

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Cranial Remolding Therapy

The cranial remoulding helmet is a customised orthosis and cannot be bought off the shelf. Once prescribed, the customised helmet will be ready for fitting approximately 2 weeks from day of scan.

Yes, most babies adjust to the band quickly in a matter of days. It is highly recommended that a baby wears the helmet on for 23 hours daily.

The results from the treatment is dependent on several factors: Helmet wearing compliance Speed of baby’s growth development The fontanelle (or commonly termed soft spot) is not closed yet The golden period for helmet treatment is between 4 to 8 months of age. The natural head growth is rapid in the first 6 months of life.

The length of treatment is greatly dependent on: Severity of flat head Growth rate of baby Helmet wearing compliance Early treatment has shown to reduce overall treatment time, as natural head growth is rapid in the first 6 months of life. Most babies generally need between 3 to 5 months of wear.

In Japan, square watermelons are grown in glass boxes to encourage the cubed shapes. For easier understanding, we liken the helmet therapy’s reshaping or correction to the concept of the square watermelon. The wearing of the cranial remoulding helmet encourages re-direction of growth towards the flattened side of head. There is no pressing against the baby’s head at all.

You may like to note that this is a medical device. If your baby has mild flat head syndrome, we do not prescribe this treatment even if you request for it. We follow strict clinical guidelines and protocols for prescription. However, if severe flat head syndrome with asymmetry is present in your baby, it is completely your decision on the best course of action. Your considerations include: Will you be happy with your child’s head shape and/or facial features when he/she is 5, 10, 20 years old? Will it affect your child’s social well-being later in life, especially if he/she has visible facial asymmetry?

Helmet therapy is not an immediate option for every baby with cranial asymmetry. There are several factors that determine if helmet therapy is an immediate prescription.

We treat babies as young as 3 months old. Early treatment has shown to reduce overall treatment time, as natural head growth is rapid in the first 6 months of life. The golden period for treatment is between 4 to 8 months old as the fontanelle may start to close up when they are approaching age 1. We have also seen babies with fontanelle closing up as early as 9 months old.

As your baby’s helmet is unique and unusual, people will generally notice. So we asked parents how do they manage this. People often ask if they are able to purchase the helmet because they think that it is for protective purpose. Parents usually take the opportunity to educate others on flat head syndrome and the true purpose of the helmet.

Let us help you today.