Introduction

Flat head syndrome — also called positional cranial deformation or plagiocephaly — is one of the most common conditions in babies. Parents are often advised to start with repositioning or physical therapy, but when is a cranial remolding orthosis (helmet) the better option?

A new meta-analysis published in the Journal of Clinical Neuroscience reviewed 13 studies involving 1,189 infants to compare helmet therapy with non-helmet treatments.

Key Findings

  • Helmets work better: Babies treated with helmets showed significantly greater improvement in head shape than those using repositioning alone or waiting for natural correction.
  • Proven results: Using the Cranial Vault Asymmetry Index (CVAI), the helmet group had much larger reductions in asymmetry.
  • Early treatment matters: Starting helmet therapy around 4–6 months leads to the best results, as the skull is still very flexible.
  • Consistent outcomes: Across an average 21-month follow-up, helmets provided more reliable results than conservative methods.

Why It Matters

While mild cases sometimes improve naturally, this research confirms what many clinicians already know:

  • Helmets are more effective for moderate to severe cases.
  • Repositioning and therapy may help mild cases but often take longer and may not fully correct the head shape.
  • Early action gives the best chance for complete correction.

Conclusion

This study provides strong evidence that cranial helmets are a safe and effective treatment for infants with flat head syndrome — especially when started early.

Parents should talk with their pediatrician or cranial specialist if they notice head flattening. Early evaluation helps determine whether repositioning is enough or if a cranial remolding orthosis will achieve better results.

Clinical Perspective

At GoodDay Prosthetics & Orthotics, we see these results firsthand. Helmet therapy provides faster and more reliable head-shape correction than conservative methods alone, particularly for moderate to severe cases.

Our team uses advanced 3D scanning and custom fabrication to create comfortable, effective cranial remolding orthoses tailored to each child’s needs.

Source

Gondim de Sousa Y, Lopes TLM, Soares ÁM, et al. (2025). Helmet versus non-helmet treatment in infants with positional cranial deformation: A systematic review and meta-analysis. Journal of Clinical Neuroscience, 139:111431.
Read the full study here.

✅ GoodDay Prosthetics & Orthotics provides cranial remolding orthoses to help infants achieve healthy, natural head shapes.
Contact us today to learn whether helmet therapy is right for your child.