What is Cranial Remodelling?

Posted by in flat head syndrome, infants

Flat head syndrome is a condition often seen in infants and characterised by an asymmetrical (plagiocephalic) or disproportionately wide (brachycephalic) head shape. Commonly referred to as ‘helmet therapy’, cranial remodelling aims to restore the skull to a more normal, symmetrical shape using a custom-moulded device known as a flat head syndrome helmet or cranial remodelling orthosis (CRO).

What causes flat head syndrome?

Flat head syndromeThe main cause of flat head syndrome is external pressures on the back of the head. When a baby spends a lot of time sitting and lying down with the head resting against various surfaces, this can eventually leave an impression on the soft bones of the skull.

If the neck muscles stiffen (torticollis or ‘wry neck’), this can cause the baby to experience pain when moving the head, further contributing to the problem. Other risk factors include male gender, premature birth, assisted delivery, first-born birth rank and multiple births.

Is cranial remodelling the only form of treatment?

No. During the first few months of life, a programme of repositioning is recommended to relieve pressure on the back of the head and minimise the risk of the condition occurring in the first place.

While infants must always be placed on the back to sleep to minimise the risk of sudden infant death syndrome, the baby may be encouraged to face in alternating directions by moving toys from one side of the cot to the other before bed time, for instance.

The infant can also be repositioned whilst awake and playing through what is commonly known as tummy time. Other measures include minimising the amount of time the baby spends in prams, car seats, carry cots and other carrying devices that apply pressure to the back of the head.

So, when does cranial remodelling come into it?

Cranial remodellingRepositioning is often effective in preventing the development of severe flat head syndrome during the first few months of life.

However, it’s not always successful and if an infant’s head shape has failed to undergo adequate correction by around four to five months of age, repositioning is unlikely to make much difference at all.

At this stage, if the deformity remains moderate to severe, cranial remodelling may be the only way to ensure a complete and safe correction.

Does it work?

Yes. Research has proven that cranial remodelling achieves a satisfactory correction of around 95 percent of moderate and severe cases of flat head syndrome.

Is it safe?

Yes. Cranial remodelling is not linked with developmental delay, and provided you choose a reputable provider and follow treatment protocols correctly, it is pain- and discomfort-free.

Are cranial remodelling orthoses available on the NHS?

Very rarely. The NHS considers flat head syndrome to be a cosmetic condition, so most cases are dismissed or referred to private clinics.

If flat head syndrome is cosmetic, why does it matter?

Sadly, there’s no escaping the fact that physical appearance plays an important role in our society. Children who look ‘different’ may experience psychosocial and emotional difficulties growing up and feel estranged from peers as a result of their ‘abnormal’ head shape. They may feel unable to wear certain hairstyles and headwear, instead keeping their hair long in an effort to cover the deformity.

Later in life, they might struggle to find protective headwear that fits, limiting their options for work and leisure. In addition, some studies suggest that flat head syndrome may be linked to developmental delay, although more research is needed in order to understand the nature of this link.

So, what should you do if your baby has flat head syndrome?

Your healthcare provider should be able to provide you with a repositioning programme to ease pressure on the affected area. If this has failed to make the difference that you had hoped for by four or five months of age, it may be worth booking an appointment at a private helmet clinic.

There, the clinician will assess the severity of the deformity and help you decide whether or not cranial remodelling could be of benefit to your child. If they recommend treatment and you decide to go ahead with it, you will be provided with a custom-made helmet, which should be worn for around three to six months to gently redirect growth into the flattened areas.

The window of opportunity for correction is fairly small. At around 12 to 14 months, the bony plates in the skull begin to fuse and harden and any remaining deformity becomes permanent. So, if you think your baby may require treatment, it’s worth booking an assessment sooner rather than later.


Technology in Motion is a leading provider of treatment for flat head syndrome with clinics all over the UK. They have successfully treated thousands of infants to date using their custom-made TiMband helmet, which combines a soft inner lining with a hard outer shell to ensure a comfortable, safe and pain-free correction.

Call 0330 100 1800 to book an appointment at your nearest clinic or visit www.technologyinmotion.com for more information on Technology in Motion and the treatment that they offer.