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Cranial Molding for Plagiocephaly

What is Cranial Molding?

Cranial Molding is a technique used to correct the shape of your baby’s skull.  Since the increase in interest in the Back-to-Sleep movement there has been a dramatic rise in skull asymmetries, known as Plagiocephaly (play-jee-oh-SE-fah-lee)

The Back-to-Sleep philosophy encourages positioning infants on their backs to decrease the risk of Sudden Infant Death Syndrome.  Often babies will have a preferred side that the head rests on in bed or in car seats due to differences in neck strength or flexibility—in severe cases this neck problem is referred to as Torticollis.  Resting predominantly on one side creates a resistance to growth in that direction.  The result is a flattened area with a disproportionate increase in growth on the opposite side. 

A moderate to severe cranial vault asymmetry viewed from above showing the classic flattening of the back of the head on the right side with a prominent forehead on the opposing side.

There are other skull shape issues, include an unusually narrow skull called Scaphocephaly (skaf’o sefa lē).

and very wide heads called Brachycephaly (brak′i sefa lē).

These skull deformities are often missed or poorly understood.  For the parent it can be hard to notice this problem because there is a very slow gradual progression over months—occasionally parents first notice when they see there baby in a mirror or when someone else comments on the baby’s head shape.  Pediatricians may not be aware of the possible long term problems associated with this issue such as jaw problems (TMJ) and learning disabilities.  Many health care practitioners are also not aware of the safe, effective treatment available to correct this problem.


What to do if you are concerned 

The first step is to try to modify the child’s sleeping position to encourage time resting on the opposite side of the head.  Your pediatrician can evaluate your child to determine if there is an unequal weakness or tightness of the neck muscles.  This can often be improved with physical therapy for stretching and strengthening.  If the head shape doesn’t improve on its own, treatment with a helmet or Cranial Molding Orthosis may be indicated.  It is important before starting down this path to confirm that the head shape problem is not related to prematurely fused skull plates in the baby’s skull (Synostosis).  This can be determined by an MRI.

Some of our kids showing off their new helmets

Does my baby need treatment?  If you think your child may require treatment, don’t hesitate to speak with your pediatrician or request a referral for evaluation.  The best time to do this is between the ages of 5 and 6 months because of the rapid growth of the skull.  After 12 months the rate of growth slows significantly making treatment times much longer.  Occasionally parents wind up waiting too long because they are told “not to worry about it” or that helmets “don’t really work”—neither is true, cranial molding is safe, easy for your child and remarkably effective.  In our practice we have been 100% successful in improving skull asymmetries to within normal limits for our patients.  Keep asking until you find someone knowledgeable about this problem.  You can always contact our office for an initial consultation and suggestions about a pediatrician in your area that is familiar with this problem.

The process. The process of developing a helmet is much easier than many people expect.  First we measure your baby’s head so that we can keep track of our progress, this information will be checked at each successive visit.  We also document your child’s head shape photographically.  We’ll discuss your baby’s situation with you, your insurance coverage and answer your questions.  When you’re ready to proceed with treatment, we go through a 15 minute process to create a plaster cast of your child’s head to use in making the helmet.







Your baby will sit in your lap for the entire process.


The head is covered in cotton stocking to protect the skin. 













Ear, brow and centerline are marked.









A Binky or a bottle is often a good idea






A piece of plaster is placed behind the head.






A second interlocking piece is fit over the top.


The plaster pieces harden in just a couple of minutes and are then immediately removed and put back together to generate an exact representation of the skull.  That’s it! 

Fabrication.  The helmet must be fabricated by one of the central fabrication facilities licensed by the FDA.  The fitting will be scheduled in 10 days.  To make it seem less medical, a lot of parents chose a brightly colored transfer (coloring paper) for the helmet.  Below are a few of our most popular transfer papers.


When you return, we’ll fit the helmet carefully to your child, adjusting and modifying as necessary.  We’ll review how to care for the helmet and what the Initialization process is to allow your child to more easily get used to the new helmet.










Ongoing care. There is a 2 week follow up and then additional follow up as needed to make adjustments for  growth.  As always, additional follow ups can be scheduled at any time if you have questions or concerns.












For more information about this safe and effective treatment please call us toll free at 1-877 538 8825 or email our office.


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Treatment for Plagiocephaly
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