Calls for more research into flat head syndrome in babies and whether helmet therapy works

A specialist team in Bristol says more research is needed into flat head syndrome, a condition which is thought to affect up to 40% of babies.

Southmead Hospital runs the only NHS clinic offering helmet therapy for infants with flattened heads.

The advice to lie babies on their backs to prevent cot deaths is one of the most successful public health interventions, but can cause babies to develop a flat head.

Most cases are mild and self-correct over time, but babies with moderate to severe cases can be referred to experts in Bristol for cosmetic treatment.

The reconstructive science team takes photos of babies’ heads which are run through 3D software, to help create bespoke helmets with a 3D printer.

Babies usually from the age of six months are advised to wear the helmets for 23 hours a day.

The helmet corrects the condition by relieving pressure on the flat side.

It is a unique clinic; the only NHS trust in the country offering helmet therapy for babies with flat heads, known as plagiocephaly or brachycephaly.

Elsewhere, parents have to go privately, and at a cost of £2,500, it can be prohibitively expensive.

‘There’s not a lot of information out there’

We met mum Becky Darby and her one-year-old son Leo at the Bristol clinic.

Becky says she became worried about the shape of his head when he was four months old. “One side of his head was flat and the rest was perfectly round, but where he was constantly lying on it, it was getting flatter,” she said.

Becky was frustrated by the lack of guidance.

“I didn’t know what I was doing, and there’s not a lot of information out there,” she said.

Leo has been wearing his helmet for five months, and his progress is regularly monitored.

Disputed evidence

Data around flat head syndrome is scarce, and scientists at the clinic are carrying out research to investigate further.

The NHS has said the evidence that the helmets work is “not clear”, and that they can cause other problems like skin irritation and rashes.

“These helmets and headbands generally are not recommended,” according to the NHS.

Senior reconstructive scientist Amy Davey wants to increase awareness and is creating a tool to assess babies, which will help find the “right treatment pathway” for infants.

“There certainly needs to be more research into providing understanding behind when and where we can go and help with helmet therapy, and where there are alternatives,” she said.

Clinicians agree that more research is needed but warn parents should not be put off lying sleeping babies on their backs.

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Parents still advised to lie babies on their backs

Dr Joanna Garstang is a community paediatrician and adviser for the cot death charity the Lullaby Trust.

She told us that while flat head syndrome is common, “in nearly all cases it just resolves spontaneously as the baby grows and begins to sit up and crawl”.

Lying babies on their backs is a public health success story, reducing the number of sudden infant deaths by 90% since the late 1980s.

“Even if parents are worried about flat head, putting the baby on the back to sleep is by far the safest way for the baby to sleep. If they’re worried about flat head they should talk to their GP or health visitor,” Dr Garstang said.

Becky Darby says choosing helmet therapy is “the best decision” that she took.

As for Leo, his helmet is working and should be off soon.