Why does my baby need a helmet?

- Julie Matheney

Plagiocephaly happens when a baby develops a flattened spot on their head, usually due to prolonged pressure in one area. This can result from:
• Positioning – Spending lots of time on their back (as recommended for safe sleep) or favoring one side when lying down.
• Torticollis – A tight or shortened neck muscle that causes a baby to prefer turning their head one way, leading to uneven pressure.
• In-utero positioning – Limited space in the womb (e.g., with multiples or breech positioning).
• Prematurity – Soft skulls and extended NICU stays (where babies are often positioned on their backs for medical care) increase the risk.

Why Does Early Intervention Matter?

A baby’s skull is very soft in the first few months of life, which means flattening can get worse quickly but is also easier to correct early. If caught in the first few months, simple strategies like:

✔️ More tummy time
✔️ Adjusting head positioning during sleep (while still following safe sleep guidelines)
✔️ Holding baby upright more often
✔️ Physical therapy if needed (for torticollis)

…can help round out a baby’s head naturally without needing a helmet.

When Is a Helmet Needed?

If repositioning and therapy don’t improve head shape by around 4–6 months, a helmet may be recommended. Helmets work best between 4–12 months because babies’ skulls are still growing rapidly. The helmet gently guides head growth into a more symmetrical shape over several months.

Beyond aesthetics, untreated severe plagiocephaly can sometimes impact:
• Jaw alignment – Leading to potential feeding or dental issues.
• Vision – Uneven skull shape can affect eye positioning.
• Ear positioning – Potentially impacting hearing or how glasses fit later.
• Neck mobility & gross motor skills – If linked to torticollis, limited movement can delay rolling, crawling, or sitting.

The earlier we intervene the less time baby will need the helmet! If you have any concerns about the shape of your baby’s head, speak with your pediatrician or a pediatric physical therapist!
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