Flat head syndrome, or positional plagiocephaly, is a common condition where a baby’s head develops a flat spot due to sustained pressure on one part of the skull. While early intervention often leads to successful outcomes, treating older infants presents unique challenges and requires a tailored approach. This blog post delves into the specifics of cranial orthosis treatment for older infants compared to younger ones, highlighting the differences in methods, effectiveness, and expectations.
Understanding Cranial Orthosis
Cranial orthosis involves using a custom-fitted helmet to reshape a baby’s skull gently. The helmet applies mild pressure to the prominent areas, allowing growth in flattened regions. This non-invasive treatment is most effective when started early, typically between 4 and 6 months, as the infant’s skull is more malleable.
The Ideal Window: Younger Infants
When cranial orthosis is initiated in younger infants, particularly those under six months, the results are often more predictable and faster. During this period, a baby’s skull rapidly grows and is more responsive to reshaping. The helmet is worn for approximately 22 hours a day, with regular adjustments made by an orthotist to ensure proper fit and pressure distribution.
Critical Benefits for Younger Infants:
Greater Skull Malleability: The younger the infant, the softer and more pliable the skull, making it easier to correct deformities.
Faster Treatment Duration: Significant improvements can often be seen in a few months due to rapid skull growth.
High Success Rate: Early intervention typically leads to excellent outcomes, with many infants achieving near-normal head shapes.
The Challenge: Older Infants
Treating older infants, particularly those over 12 months old, introduces several complexities. By this age, the skull bones have started to harden, and the growth rate has slowed, reducing the effectiveness of helmet therapy. However, with proper management, significant improvements are still achievable, though the time spent wearing the helmet may be longer.
Key Differences for Older Infants:
Reduced Skull Malleability: As the infant grows, the skull becomes less pliable, making dramatic reshaping more difficult.
Longer Treatment Duration: Older infants may need to wear the helmet for longer, sometimes up to a year, to see desired results.
Lower Success Rate: While improvements are possible, the degree of correction might be less pronounced than in younger infants.
Modified Approach for Older Infants
For older infants, a modified approach is necessary to maximize the effectiveness of cranial orthosis. Here are some key aspects:
1. Comprehensive Assessment: A thorough assessment by a craniofacial specialist is crucial before starting treatment. This includes detailed measurements and imaging to determine the severity and type of deformity.
2. Custom Helmet Design: An orthotist must meticulously craft the helmet to accommodate the older infant’s head shape and growth patterns. Frequent adjustments are essential to ensure the helmet’s effectiveness as the skull grows.
3. Consistent Wear Time: Adherence to the prescribed wear time is vital. Parents need to ensure the helmet is worn for the recommended 22 hours a day to maximize the treatment’s impact.
4. Physical Therapy: Incorporating physical therapy can enhance treatment outcomes. Therapists can provide exercises to strengthen neck muscles and promote balanced head movement, reducing the likelihood of persistent flat spots.
5. Parental Involvement: Parents play a critical role in the success of the treatment. They must be educated in proper helmet care, monitoring for skin irritation, and ensuring consistent wear time. Regular follow-up appointments with the orthotist and craniofacial specialist are necessary to track progress and adjust.
Case Studies and Outcomes
Several case studies highlight the potential for positive outcomes even in older infants. For instance, a study published in the Journal of Craniofacial Surgery examined the effects of cranial orthosis on infants aged 9 to 18 months. The study found that while the degree of correction was less than in younger infants, significant improvements were still observed, with many infants achieving satisfactory head shapes.
Parents of older infants should maintain realistic expectations and understand that while helmet therapy can lead to substantial improvements, it may not entirely eliminate the flat spot. The primary goal is to achieve a cosmetically acceptable head shape that reduces the risk of long-term asymmetry.
As Stuart Weiner, Orthotist and Owner of Cranial Center in New Jersey, states, “Treating older infants with cranial orthosis presents unique challenges due to the reduced malleability of their skulls and slower growth rates. However, significant improvements are still achievable with a well-designed helmet, consistent wear time, and diligent follow-up care. The key is to adhere strictly to the prescribed treatment protocols, ensuring that every aspect of the therapy is optimized for the older infant’s needs.”
Cranial orthosis remains a viable option for treating flat head syndrome in older infants, though it requires a tailored approach and realistic expectations. Early intervention is ideal, but significant improvements are still possible with consistent use and comprehensive care. By working closely with healthcare providers and adhering to treatment protocols, parents can help their infants achieve the best possible outcomes, regardless of their age at the start of therapy.
While treating older infants with cranial orthosis presents unique challenges, it remains an effective method for addressing flat head syndrome. Substantial improvements can be achieved through customized helmets, physical therapy, and diligent parental involvement, offering older infants a chance at a well-rounded head shape and improved quality of life.
The Cranial Center of New Jersey is one of the first and finest cranial centers on the East Coast, specializing in early intervention cranial and helmet therapy. Cranial Center was the first to offer the STARband™ scanner and helmets in New Jersey and the third company in the world with 3-D technology. Owned and operated by Stuart Weiner, CPO, the Cranial Center is certified by the American Board of Certification in Orthotics, Prosthetics, and Pedorthics. Our facilities are conveniently located across New Jersey: Hackensack, Hazlet, and Morristown. Contact us for a complimentary consultation at 800 685 9116 or at info AT cranial center dot com
