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Research Spotlight: "Helmets Work For Brachycephaly"

Updated: 10 hours ago

Not only do they work, but we can prove that the sooner you start, the better.


Data exists supporting the use of helmets to correct cranial deformities and it needs to be shared with you all. In this first research update (yes, there will be more), we examine a study that is relevant, reliable, and scientifically based. Today we are addressing the misinformation out there regarding helmet therapy.



Who Are We Learning From?

Today we are specifically looking at an article in the peer reviewed journal, Global Pediatric Health. This is a recent article published 2018 and looks specifically at the treatment of brachycephaly.


Kelly, K. M., Joganic, E. F., Beals, S. P., Riggs, J. A., McGuire, M. K., & Littlefield, T. R. (2018). Helmet treatment of infants with deformational brachycephaly. Global pediatric health, 5. https://doi.org/10.1177/2333794X18805618


What Does This Article Say?

Deformational brachycephaly results in a head shape that is wider than long with posterior occipital flattening. This diagnosis can lead to movement of the mandible (resulting in underbite and sleep apnea), displaced center of mass, decreased postural control, and shorter anterior neck muscles. It is therefore considered medically necessary to treat with a helmet in moderate to severe cases. In the study by Kelly et al. (2018), they found that helmet treatment was 87.7% effective in improving the length to width ratio or cephalic index for infants beginning between 3 and 12 months of age. In addition, younger infants demonstrated better outcomes and shorter length of time in the helmet!



How Did They Prove It?

Researchers looked at a whopping 4205 infants starting treatment between 3 and 12 months of age. Participants met the criteria of moderate to severe brachycephaly by having:

  • Cephalic index (width/length ratio) greater than 90%

  • Minimal asymmetry defined as a cranial vault asymmetry of 3 mm or less

  • No confounding medical conditions (i.e., synostosis, syndromic conditions, surgical shunt)

Data was collected on age of treatment, treatment time, and pre/post cephalic index. Data was collected using a 3-dimensional imaging system and analysis was performed utilizing Statistical Analysis System (SAS) software.



What Does This Mean for My Baby?

If your child has moderate to severe brachycephaly, it is unlikely their head will correct on its own by the time they reach 12-15 months of age. Most importantly, this study shows that a helmet will work for your baby and the sooner you start, the more correction can be gained. Specifically, out of over 4,000 infants included in this study, there was not one case where head shape worsened with helmet treatment. In addition, difficulties with the helmet throughout the treatment process were revealed to be extremely rare. According to Kelly et al. (2018), skin irritation/breakdown and heat rash occurred in less than 1% of participants and 92.9% saw results with only one helmet.


What Does This Mean for Me?

We are presenting this article to demonstrate that treatment will produce results! There is a lot of misinformation out there and parents/medical experts can fall into a trap of believing that they should do nothing if they have concerns regarding their baby's head. They can also believe that helmets don't work. Well, knowledge is power and we hope to help arm you with up to date and relevant material.


Research has shown that in significant times of development, some infants are spending approximately 23 hours a day on their backs, especially because it has been proven as the safest position for sleep (Davis et al., 1998). With infants spending so much time on their backs, we continue to see a rise in brachycephaly. In short, you are not alone. Of course repositioning your infant can help and their are strategies to avoid a helmet, but if your baby needs a helmet and has been measured to have moderate to sever brachycephaly, you can be confident knowing that a helmet will work for your baby. If they are wearing it, and growing, it will work.



What Does This Mean for the Medical Community?

This study is one of three published studies demonstrating the effectiveness of helmet treatment to correct deformational brachycephaly (Graham et al., 2005; Teichgraeber et al., 2004). Given the commonality of study results, pediatricians should not hesitate to refer for consultation in order to ensure best outcomes.


It is also important for medical professionals to be aware of popular information sources for parents that are just wrong.


Parents.com is a common place for parents to look for information regarding what's right for their baby. Their article "Baby Helmets' Efficacy Called Into Question" vaguely states helmets might not work according to "studies". It is written by Holly Lebowitz Rossi, a self described freelance writer and editor specializing in holistic health, religion, and spirituality, parenting, and other lifestyle topics. The article does not even picture a cranial remolding helmet and yet parents looking for information are trusting this source.


Another article on parents.com mentions that starting helmets sooner than later is better, but again is written by someone who is not a medical expert and again has a photo of a non cranial helmet as the main picture.


Really? We can do better for our babies and patients! Let's keep the info coming current, accurate, and from the experts!



So What's Next Researchers?

There are currently articles demonstrating that babies head DO NOT correct on their own at a certain point. If these could become more mainstream and accepted, we could avoid a lot of the stigma surrounding the helmet process and get these little heads corrected!

Stay tuned and subscribe to omi-kiddos.com for more up to date information and visit our page that is dedicated to research!


More Questions?

Do you have more questions that you want answered by our staff of experts? Head on over to our Q&A brunch. That's right, we like to think of our mom forum as a friendly trendy cafe where you can connect with others about the helmet journey.




References:

Davis, B. E., Moon, R. Y., Sachs, H. C., & Ottolini, M. C. (1998). Effects of sleep position on infant motor development. Pediatrics, 102(5), 1135-1140.


Graham Jr, J. M., Kreutzman, J., Earl, D., Halberg, A., Samayoa, C., & Guo, X. (2005). Deformational brachycephaly in supine-sleeping infants. The Journal of pediatrics, 146(2), 253-257.


Kelly, K. M., Joganic, E. F., Beals, S. P., Riggs, J. A., McGuire, M. K., & Littlefield, T. R. (2018). Helmet treatment of infants with deformational brachycephaly. Global pediatric health, 5. https://doi.org/10.1177/2333794X18805618


Teichgraeber, J. F., Seymour-Dempsey, K., Baumgartner, J. E., Xia, J. J., Waller, A. L., & Gateno, J. (2004). Molding helmet therapy in the treatment of brachycephaly and plagiocephaly. Journal of Craniofacial Surgery, 15(1), 118-123.


This article was edited by Kaitlin Ploeger OTD



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