Cranial Remodelling Helmets

          Passage through the birth canal often makes a newborn's head appear pointy or elongated for a short time. It's normal for a baby's skull, which is made up of several separate bones that will eventually fuse together, to be slightly misshapen during the few days or weeks after birth.

          But if a baby develops a persistent flat spot, either on one side or the back of the head, it could be a sign of positional plagiocephaly. Also known as flattened head syndrome, this can occur when a baby sleeps in the same position repeatedly or because of problems with the neck muscles.

          Fortunately, positional plagiocephaly can be treated without surgery and does not cause lasting cosmetic problems.



About Positional Plagiocephaly

          Positional plagiocephaly is a disorder in which the back or one side of an infant's head is flattened, often with little hair growing in that area. It's most often the result of babies spending a lot of time lying on their backs or often being in a position where the head is resting against a flat surface (such as in cribs, strollers, swings, and playpens).

         Because infants' heads are soft to allow for the incredible brain growth that occurs in the first year of life, they're susceptible to being "molded" into a flat shape.

          Learn more about "tummy time" here.

Cranial Remodeling Orthosis

          The Boston Band is available only through select Orthotic centers, specifically trained in the design, fit, and treatment techniques necessary for the highest level of patient care. Its patented hinge design allows for easy application.

Protocol for Treatment

          The following guidelines are provided to ensure that the identification of Plagiocephaly and the referral for treatment, are managed to provide optimal results for each patient.

          It is recommended that at three months of age, as a standard of practice, each child be evaluated and measured for cranial symmetry. Anthropometric calipers may be used for manual measurement taking.

          If it is determined that a cranial asymmetry of 8mm or greater is present, the child needs to be referred to a trained specialist in cranial remolding for treatment, care, and tracking of progress.

Treatment with the Boston Band

          The treatment of plagiocephaly with a cranial remolding orthosis should commence at approximately 3 months of age. The Boston Band is a lightweight, plastic and foam orthosis made from a cast impression or a 3-D scan of the infant’s head. It is made of a plastic flexible shell lined with polyethylene foam. The foam can be modified over time to allow for growth and will provide a pathway for the infant’s head to grow into a more symmetrical shape. The Boston Band allows the baby to sleep in any position he or she wants, yet keeps pressure off the flat spots and constrains head growth along the axis of the prominent parts. It offers a simple and direct solution to the problem of positional plagiocephaly and brachycephaly. Correction usually occurs within 2 to 3 months for patients beginning Boston Band treatment at 3 months of age. In older patients, longer treatment time is necessary.

What do the numbers mean?

When a baby is diagnosed with Deformational Plagiocephaly, it is important to determine whether or not the baby will benefit from Cranial Remodel Band or Helmet. These numbers may seem confusing but this has proven to greatly assist in the monitoring of children with any skull shape concerns.  If you would like help determining if your child would benefit from a Helmet - contact us at or call 888.432.5488

So what is the Cephalic Index?

The Cephalic Index, also referred to as cranial ratio or cephalic ratio is the measurement that will be used to categorize your infants head shape. CI = width ÷ length x 100 or CI = (Left/Right) ÷ (Front/Back) x 100 Scale for Cephalic Index (CI)

Normal: 75 – 90 mm

Mild: 91 – 93 mm

Moderate: 94 – 97 mm

Severe: >97 mm

Scale for Measuring Plagiocephaly

Normal head shape: 0 – 4 mm Mild

Plagiocephaly: 5 – 9 mm

Moderate Plagiocephaly: 10 – 15 mm

Severe Plagiocephaly: >15 mm

Cranial vault asymmetry also referred to as diagonal difference, oblique diagonal difference, or transcranial difference.  CVA is the difference between 2 diagonal measurements.

Plagiocephaly Diagnosis: ·

CI >76% to <90%, asymmetric head shape, occipitoparietal flattening, ear misalignment

· May affect temporal, parietal, and/or frontal bones and facial symmetry

· May occur alone or in combination with brachycephaly or dolichocephaly

· May result from premature fusion of one or both coronal sutures or rarely the lambdoid sutures.

Brachycephaly Diagnosis:

· CI >90%, short skull, occiput flattened, widened

· May affect parietal, temporal, and/or frontal bones and facial symmetry

· May occur alone or in combination with plagiocephaly

· May result from the premature fusion of the coronal or lambdoid sutures

Dolichocephaly Diagnosis: ·

CI <76%, long, narrow skull, affects occiput, temporal, parietal and frontal bones,

May affect facial bones

· May be familial, often noted in premature babies, uterine breech position

· May result from premature fusion of the sagittal suture


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