Plagiocephaly is an asymmetric moulding of the head caused by external forces.

It can be caused by a number of factors including:

• extended time spent in a neonatal unit
• the birth process
• position in the womb
• the infant's preferred sleeping position
• torticollis which is an imbalance in the muscles on either side of the neck
• If the baby is less than 3-4 months of age and the asymmetry is mild, alternative positioning is recommended to get the baby to sleep with his/her head to the other side.

We always recommend that if your baby is less than 4 to 5 months old, that you reposition (see our repositioning guide (link)). If repositioning and tummy time are not having any effect after about a month, then we would recommend considering using a cranial remoulding orthosis.

If the plagiocephaly is accompanied by torticollis, this should be treated in conjunction with the orthotic treatment program.

A lightweight, plastic and foam helmet is made from a 3-D scan of your infant's head. The foam lining is made with a growth area which allows improvement in head shape and over time, this is modified to allow for continued improvement. The helmet allows your baby to sleep in any position he/she wants yet keeps pressure off the flat spots and allows growth to bring about correction. Correction usually starts after 2 or 3 weeks and we’d expect an infant between 4 and 7 months of age to need to wear the helmet for about 12 weeks. For older infants a longer treatment time is necessary.

We accept referrals in 3 ways:

• Self referrals from the baby’s parents. If you want to see us, please contact your local clinic for a free assessment appointment.
• Formal hospital referrals from consultant doctors or therapists with an official order to allow payment by the hospital.
• Informal or private referrals from doctors or therapists.

In all cases, initial and final scan reports will be sent to the baby’s doctor or consultant to allow referral back to the baby’s healthcare provider if necessary.

We receive very few referrals or payments from hospitals. Your GP may agree to try to gain an Exceptional Treatment approval from your PCT but this is very unusual. We will help all that we can, but cannot guarantee any success with this route.

Generally UK insurers do not pay for any orthosis unless it is part of an acute medical treatment or operation. Parents are very occasionally successful in receiving reimbursement for the clinical time associated with management of the orthosis. Each insurance company has different coverage and medical policy guidelines. It is best to contact your insurance company and/or employer benefits coordinator to determine the type and level of coverage for orthotics.

This varies, but we expect to start to see an improvement after only 2 weeks of treatment. Correction continues over time, and requires complete compliance to achieve the greatest degree of symmetry. Although there is often early visible improvement, the helmet must be worn by the baby for the full length of the treatment to gain the maximum benefit.

The helmet is cleaned with isopropyl alcohol (rubbing alcohol) which we provide.

Yes, your child will need regular review appointments during the course of the treatment to make sure that all is well and to adjust the orthosis. We usually need to see you at 2 - 4 week intervals depending on age and severity. We offer appointments that are frequent enough for your baby's safety but not so often that it interfers with your life too much. If you need to see us you can at any time during treatment.

There are 3 reasons for ending treatment:

• When the helmet is outgrown and there is no more room for correction.
• For older infants, when growth has stopped and no more correction is occurring.
• When, even if there is growth room available, the parents are so satisfied with the result that they are happy to end treatment.

Most infants complete the program with a single orthosis. In cases of very severe deformity in very young infant, it is possible to outgrow the helmet before all possible correction is achieved. If this happens, we will discuss whether it is appropriate to continue with a second treatment. An additional treatment is chargeable as for the initial treatment.

No. Many parents ask this and our experience is that head shapes continue to grow as they were at the end of treatment. As children get older, they spend more time sitting, crawling and walking which minimises the amount of time they spend on their backs. In fact, further skull shape improvement may occur over time. If your child was diagnosed with torticollis you must continue with the stretching program.

Orthotists are registered medical professionals. All orthotists are dual trained as prosthetist /orthotists and are educated for 4 years at degree level in all aspects of anatomy, physiology, biomechanics and orthotic manufacturing and application. After qualification there is a one year internship before an orthotist / prosthetist is fully prepared to work independently. Cranial remoulding orthotic therapy is regarded as highly complex treatment.

The ideal age to start treatment is 4 to 7 months, but remoulding can be started up to the age of 14 months. Generally, better results are achieved within a shorter time if started when the infant is younger.

• Full payment at the start of treatment when a scan is taken
• If you are fundraising, please let us know and we will help as much as we can.

If you would like us to give you an indication of whether we think that your baby would benefit from cranial remoulding treatment, please Email them to smottram@ossur.com and we will answer by return.

No. Each type of helmet is made by a different manufacturer, to its own specification. Some work only on asymmetry and tend to ignore the overall head shape. Others are more open which reduces the ability of the bones to reshape into a more natural form. When we specify the desired modifications for treatment, we are working not only to improve asymmetry, but also to improve the width to length ratio to bring about greater normality in the overall head shape. We also often specify that additional liner material is added to give us room for greater improvement where we need it. With these unique attributes, we make sure that the majority of babies treated only require a single helmet to achieve the correction required for a more normal head shape.

We do not treat babies older than 14 to 16 months as by then the majority of head growth has occurred and the treatment requires growth to bring about change. We do occasionally continue a treatment up to the age of 24 months if the baby is already with us and correction is continuing. We understand that there are other clinics in the UK which treat older infants but we regard this as unethical practice as we believe that parents are given false hopes that correction will occur.