Boston Othotics and Prosthetics
Boston Othotic and Prosthetics

Flat-Head Treatment Options Based on the Age of the Baby

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Many babies—as many as one in every five—has a flat spot on the back or side of the head. This flattening, called plagiocephaly if the flattening is on one side of the head and brachycephaly if the flattening is on the back of the head, can be caused when the baby’s head frequently rests in the same position on everyday surfaces such as a mattress or car seat, or it can even happen in the womb.

The treatment for cranial flattening in infants depends on a number of factors, but one of the most important is the age of the baby at diagnosis. At Boston Orthotics & Prosthetics, we treat more than 1,500 infants for plagiocephaly every year, and have different treatment recommendations for every stage of development. We are known as the only O&P provider that offers three distinct components: evaluation, prevention and treatment.

While we still suggest prevention methods such as repositioning and tummy time, our unique prevention and treatment program includes use of a couple of thoroughly researched and tested orthotic devices that can be used to prevent or reduce flattening of the baby’s head.

We recently sat down with Steve Slawinski, CO, Boston O&P’s Cranial Services Program Director, to provide answers to some of the most common questions we hear about plagiocephaly treatment and what options are available.

Birth until baby can roll over independently: The Perfect Noggin

The Perfect Noggin is a contoured sleeping surface for infants that encourages symmetrical head growth. It was created at a prestigious Harvard-affiliated children's hospital by pediatric plastic surgeon and renowned plagiocephaly researcher, Gary F. Rogers, M.D., and Boston O&P orthotist James Rusty Miller, CPO. In some cases, babies who use the Perfect Noggin will not need any further treatment for plagiocephaly.

Perfect Noggin FAQ

How does the Perfect Noggin work? The Perfect Noggin has a head recess that cradles the back of the infant’s head to help promote natural head shape and symmetry as they sleep.

How effective is the Perfect Noggin at addressing plagiocephaly and other cranial abnormalities? Since its creation over 15 years ago, the patented layered design has been used with unparalleled success and safety by thousands of parents to help maintain their infant's head shape while back sleeping.

Is there any scientific proof that the Perfect Noggin works? The Perfect Noggin design has been the subject of more scientific studies than any other competing product, and the results are so convincing that a smaller version is currently used in pediatric hospitals and intensive care units throughout the United States. If you’d like to lean more, read clinical studies about the Perfect Noggin.

Is the Perfect Noggin safe? The Perfect Noggin is a safe sleep surface for babies who can not roll over on their own. It has a stable, low-profile design, with an anti-slide edge and no unsafe loose pillows or cushions. All materials are biocompatible, easy to clean, and contain no lead or phthalates.

How long should a baby use the Perfect Noggin? The Perfect Noggin can be used as a sleep surface until the infant is able to roll over from their back to their stomach, at which point the use of the Perfect Noggin can only be used under direct supervision, or use should be discontinued.

Is the Perfect Noggin covered by insurance? How much does it cost? Insurance coverage varies, but our billing specialists will confirm coverage prior to your baby being fit. If you go through Boston O&P, the cost is $400. This includes all visits, scans and associated services provided.

After baby can roll over from back to tummy independently (depending on the severity of the condition): The Boston Band

The Boston Band is a lightweight orthotic helmet developed by Boston O&P that has been proven as a simple and effective solution to the problem of any head shape concerns. If your child has a cranial asymmetry and they are already rolling over, a corrective helmet like the Boston Band may be suggested.

Boston Band FAQ

How does the Boston Band work? The Boston Band acts to redirect the growth of the infant’s head, preventing further asymmetric growth and guiding the infant’s head to grow into a more symmetrical, rounded shape.

How effective is the Boston Band at preventing plagiocephaly and other cranial abnormalities? Numerous studies have proven the effectiveness of cranial remolding orthoses such as the Boston Band for the treatment of plagiocephaly, and the results Boston O&P has achieved with the Boston Band are superior to industry standards. For more information, see Boston O&P’s plagiocephaly outcomes chart.

Is the Boston Band safe? Yes, the Boston Band is perfectly safe for babies. It does not apply any pressure to the head, is very light, and does not interfere with head control development.

How long should a baby use the Boston Band? The Boston Band should be worn for 23 hours per day during treatment. The length of treatment depends on the baby's age, head circumference, and amount of growth needed, but on average, babies wear the Boston Band for 14 weeks. Beginning treatment earlier can shorten the length of time in the helmet.

Does the Boston Band require a prescription? The Boston Band does require a prescription, which you can obtain from a pediatrician or any other physician your child has seen.

Is the Boston Band covered by insurance? How much does it cost? Insurance coverage varies, but our billing specialists will relay coverage and cost information to you prior to your baby being fit.

The Perfect Noggin and the Boston Band are both excellent solutions if you are looking to ensure your child has a normal, rounded head shape. If you notice a flattening on your baby’s head and have questions or want to get your child evaluated, contact Boston O&P for a free consultation

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