One in five infants develop plagiocephaly or brachycephaly during the first year of life.1 These asymmetric or disproportionate head shapes are often associated with prolonged periods of infants’ time spent on their backs, limited tummy time, torticollis, prematurity, or multiple birth pregnancies.2-6 In some cases, cranial asymmetry or disproportion is a result of the premature fusion of the sutures of the skull. This is known as craniosynostosis and often requires surgical intervention. Depending on the severity of the initial asymmetry or disproportion, clinicians may initially recommend repositioning therapy or physical therapy as a conservative treatment option.7 For moderate-to-severe deformations, a cranial remolding orthosis (CRO), or helmet, may be prescribed.
Early research suggests an association between plagiocephaly and motor and language development, though most infants with deformational (nonsynostotic) head shape asymmetry develop typically. Treatment with a CRO works by gently guiding skull growth toward a more symmetric shape during the critical window when an infant’s skull remains pliable and is growing quickly. This can help optimize head shape and may address concerns some families have about long-term appearance and proper fit of helmets and other safety equipment.
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