Cranial Remodeling Treatment & Baby Head Shape Correction

Also known as: baby head shape correction, plagiocephaly treatment, cranial orthosis, cranial molding, cranial remolding.

What is cranial remodeling?

A cranial molding orthosis is a helmet-like device, used in infants under 18 months of age with misshapen heads most often caused by spending too much time laying on their backs. The orthosis is typically worn for a few months to gradually reshape the head.

Nicklaus Children's Hospital uses the STARband™ cranial remodeling orthosis. This helmet-like device will help reshape your child’s head and must be worn 23 hours each day, with an hour off for bathing and hygiene.

What happens during cranial molding treatment?

During the first five days of treatment, you will be asked to gradually increase the wearing time of the helmet as follows:

Day On Off Nap Night
1 2 hours 1 hour Yes No
2 4 hours 1 hour Yes Yes
3 6 hours 1 hour Yes Yes
4 8 hours 1 hour Yes Yes
5 23 hours 1 hour Yes Yes

Your child may experience increased perspiration during the first few days the cranial remodeling helmet is worn until his or her body becomes accustomed to it. Products such as powders and lotions should not be applied to the head or the helmet. If a heat rash appears at the base of the skin, remove the helmet every three to four hours for skin checks and wash irritated areas with a mild soap.

Skin Checks and Concerns

The skin on the head and scalp should be checked for deep areas of redness. If there is an area of deep redness that does not fade within an hour, or there are signs of skin breakage, blisters or blood, the helmet should be removed and the occupational therapist should be notified.

Neck Exercises

Some children will be asked to perform neck exercises as part of their treatment plan. The caregiver should remove the helmet for this type of treatment.

How should I care for the remodeling helmet?

Baby girl wearing a cranial remodeling helmetThe helmet should be removed daily and cleaned with 70 or 90 percent strength rubbing alcohol (pure mild soap may also be used). Any other product may burn the child’s skin. Apply the rubbing alcohol to a washcloth or use a new, soft toothbrush and clean the inside of the helmet thoroughly. Set it upside down to dry during the child’s bath time.

The helmet may develop an odor, especially in warmer climates. The helmet should always be cleaned as soon as it is removed. Setting the helmet upside down in the sun or using a fan will help to eliminate the odor and “air” the helmet.

The helmet should never get wet and should always be removed while swimming or bathing. After swimming, the child’s hair and area covered with the helmet should be washed with shampoo to remove chlorine and sunscreen. Reapply the helmet when the child’s head is completely dry.

How often are follow-up visits for head shape correction?

Families will be asked to bring the patient to visit his or her Nicklaus Children's occupational therapist at regular intervals during the course of cranial remodeling treatment. The frequency of the visits will vary depending on the child’s age and progress. In general, visits will be scheduled as follows:

Child's Age Frequency of Visits
3 to 7 months Weekly visits
7 to 10 months Every two weeks
10 to 14 months Once per month
15 months + Every 6-8 weeks

The schedule may change at any time depending upon the child’s needs.

How long does cranial remodeling treatment last?

On average, treatment with the STARband ™ is completed within three to 10 months. Older infants may require a longer treatment program because growth of the head slows after 12 months of age. The result of treatment will depend on the proper use of the helmet and family compliance with treatment protocols. If you should have any questions or concerns during the course of treatment please contact your Nicklaus Children's occupational therapist.

This page was last updated on: January 07, 2022 09:37 AM

Pediatric Craniofacial Center & Clinic

The Craniofacial Center at Nicklaus Children's Hospital is one of Florida’s leading specialty centers for children with craniofacial disorders offering comprehensive management for infants, children, and young adults with craniofacial disorders.

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