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Frequently asked questions about helmets
Which is the best band?
Every member of this board whose baby has graduated from a band will be desperate to tell you why their band is the best. It's natural to want to validate our own choices by encouraging others to use the same band. What's important to remember is that ALL of the bands work. The Helmets section lists all the bands and their differences, as well as the contact details for each supplier. The main differences are cost, clinic location and frequency of review appointments. The Clinics and specialists page gives information on each orthotist and their experience.
Is my baby too old/young for a helmet/band?
Different providers band babies at different ages, but typically babies can be banded from five months onwards right up until they are about twenty-four months. The age ranges for banding for each of the three providers is given in the provider database. Very young babies (under 5 months) who are banded may be more at risk of regression after treatment. They may also have seen improvements through repositioning if not banded. It is usual for providers to encourage repositioning under this age and to recommend returning for a progress check when the baby is slightly older. Usually the optimum time for banding is from five months onwards; this is also recommended by the American Academy of Pediatrics. Older babies (10 months onwards) often benefit from banding, but their growth will be slower than 5-10 month olds. This can mean wearing the helmet for longer, and they may not see as good correction as younger babies, however this is very individual and depends on the severity and growth spurts of the child. Many older babies do see excellent improvements. Band providers will give a realistic estimate of the likely improvement before you go ahead based on the age at the start of treatment.
How long will it take my baby to adjust to the helmet?
Most babies adjust very quickly and sleep right through the first night in the helmet. Others take longer, as they have lost their comfortable flat spot and can find it difficult to settle initially at night. Keeping them cool is important, as they sweat more at night/naps. Getting a band can also coincide with the start of teething, so do check your child is not feverish or teething before concluding that there is a problem with the helmet. Some babies also dislike having the helmet taken on and off, so it is important to move to 23 hour a day wear as soon as your provider recommends. However, all babies adjust within a couple of weeks maximum and then go on to successfully complete treatment.
My baby has a lump/pressure mark - what should I do?
The following is the advice for STARband wearers. This may or may not be the same for other helmets - so please check with your provider if you are unsure, or read the advice in the question that follows after this.
Lumps:
1. Remove the band and leave it off for a day at least. This lets the skin rest and allows healing to start.
2. Wait for the lump to completely go down before putting the band back on. This may take 3 or 4 days but it has to be. Leaving it on will cause greater problems which will be more difficult to resolve, often by several weeks of not wearing the band which may then mean that the helmet will no longer fit correctly.
3. When it has gone down, go back to the day three routine of 4 hours on with a gap of one or two hours between before putting it back on again. Do not have the baby wear the band at night.
4. An urgent appointment should be arranged for the pressure area to be relieved so that treatment can continue uninterrupted.
Pressure marks:
Pressure marks that are just red but are not going after 30 minutes should be dressed with Vaseline or Sudocreme and you should seek to bring forward your next review appointment so that the issue can be addressed.
My baby is getting red patches/spots under the band - what should I do?
The first thing is to determine if they are caused by pressure or a heat rash/skin reaction. A pressure mark is usually in one discrete spot and is caused by the band pressing on this area. A pink mark is nothing to worry about, just keep an eye on it, but if it is a deep red and lasts for more than an hour after the band is removed, then the band probably needs adjusting. Contact your orthotist immediately about having an adjustment. It is quite common for babies to need an adjustment or two in the early days of having a band. It is best to leave the band off until you have seen or spoken to your orthotist if there is a deep red pressure mark, to prevent the skin breaking down. Follow the advice of your orthotist on which preparations and treatment to use and when to replace the helmet.
Heat rash is very common in the early days of wearing a band. It looks like red spots or red patches in an irregular pattern and is caused by the baby becoming too hot in the helmet. Some babies are very prone to this as they have sensitive skin or are very sweaty babies in the first place. The most important advice is again to remove the band to allow the skin to die down. You should keep your baby very cool, following the advice for how to reduce sweating, such as wearing very thin cotton clothes or one layer less, especially at night. A fan or air conditioning unit can be very helpful in really hot weather. Also remember that different places are different temperatures, so if you enter a hot shop with your baby in a winter coat, they may be too warm. Non air-conditioned cars in the heat can cause the same problem. Some parents use hydrocortisone cream (which can only be obtained on prescription) to clear up the rash which works well, but is a steroid so is not suitable for long-term use. Prevention is better than cure by keeping your baby cool and only replacing the band when the rash has died down or gone completely, checking every couple of hours to make sure it has not reoccured.
Excess alcohol use for Cranio helmets should also be avoided as this may irritate skin.
My baby has got a fever- should I leave the helmet off?
Bands and fevers do not go together, so always remove the band if your child develops a fever and only replace it when the fever has gone. Bands already increase the temperature of the baby initially, so it is not safe to leave it on. Also bear in mind that fever medication such as paracetemol or ibuprofen can wear off during the night, so make sure the fever is really gone before replacing the band. It is very frustrating to miss helmet time due to fevers, but it does not usually make any difference to the outcome and it is very important to leave it off for safety reasons.
What should my baby wear once in the helmet?
Once your baby is banded, you need to pay careful attention to his temperature. The general rule of thumb is to dress your baby in one layer less than before, and in summer months, possibly even less clothing. Some babies seem to revert back to their original levels of clothing after a while, but most, it seems, continue to need to be dressed more lightly. You will quickly learn what to dress your baby in and it will become second nature. Although all babies are different, in the first week or two your baby will most likely sweat a great deal, possibly even soaking his clothing. It is OK to remove the band for a few moments to wipe your baby’s head and the inside of the helmet. You may want to buy some new clothes that can easily be added or removed without taking the band off – for example, cardigans, body warmers, etc.
How long will my baby have to wear a band?
This varies a great deal and will depend on which condition or combination of conditions your baby is suffering from, the severity of their condition, whether or not they have facial asymmetry, their age, and their rate of growth.
Your orthotist should be able to give you a rough guide as to the length of treatment, but will not be able to give you a definitive answer, as all babies are different. Human anatomy is not a standard thing, unfortunately. As a rough guide, treatment usually takes between three and six months.
Some babies seem to reach 0mm asymmetry, whereas others get to, say, 6mm, and are happy to finish treatment. Are measurements an accurate indicator of asymmetry?
Measurements are a tricky thing. Manual measurements can never be completely accurate or consistent, because it can't be guaranteed that they are always taken in the same place. It's final head shape that matters, and this depends on volume growth, not just lineal growth. The following, from Tim Littlefield of Cranial Technologies, Inc. (DOC Band) offers a good explanation:
1. Measurements are 2-D straight lines on a complex 3-D surface. You cannot adequately convey a deformity using only linear 2D measurements. You can't describe the shape of a banana simply by stating how long it is. You also have to convey its diameter, how that diameter changes along its length, its inner and outer radius of curvature etc.
2. I can line up ten children with exactly the same anthropometrical measurements who have completely different head shapes.
3.If you buy a pool with an 80' lineal foot perimeter, that pool could be a rectangle, a circle, a kidney shape or something completely unique. There is an entire field of analytical geometry that relates to how to maximize shape and surface area for a fixed volume or measurement. The physical amount of asymmetry also depends upon where the measurements are taken. A difference of 5 mm over a length of 457 mm (18" entire head circumference) is a very small discrepancy, i.e. 1%. However, if there is a 5 mm discrepancy over a measurement that is normally only 10 mm (upper face measurement) it is very significant, i,e, 50%. Also, a 5 mm discrepancy on a 5 month-old is not the same thing as a 5 mm discrepancy on a 2 year, old whose head is larger.
How should I clean the helmet?
Use only the alcohol recommended by your provider, using a rough washcloth or a toothbrush. Leave the band to dry thoroughly.
If you are using the Cranio Helmet, be careful to only use a small amount of alcohol as it is of greater strength than that used for the DOC Band and STARband and can affect the skin, occasionally causing burns.
DO NOT use water or get the inside of the band wet.
If it is a sunny day, then leave the band to dry in the sun. Sunlight kills bacteria, and it's the bacteria that cause that smelly trainer whiff! It is also best to clean the band at the beginning of the hour off, to allow maximum drying time.
My baby has dry skin - how can I best treat this?
Vaseline is good for dry patches because it doesn't contain lanolin like E45 and some other creams do.
Where can I buy Isopropyl Alcohol (for use with the STARband)?
Many pharmacies stock this, but if you are having difficulty getting hold of some, Lloyds Chemists will order it for you. The part number is ISO0233K.
How do I get rid of a smelly head?
Shampoos that have been recommended by other parents are: -
Lane's Tea Tree Shampoo, “specially formulated for children”. It is manufactured by G R Lane Health Products Ltd., Sisson Road, Gloucester GL1 3QB, and the member bought it at a local health food shop, for £4.95 for 250ml. -
Aveeno Baby Wash and Shampoo. This particular Aveeno product is not available in the UK but you can order it from www.dermstore.com -
L’Oreal does a range of children’s shampoos that smell nice, for example: Burst of Pineapple Flash, Burst of Cherry Almond, So Strawberry, Burst of Cool Melon, Burst of Tropical Fruit, Splash of Sunny Orange. Unlike the others, above, they do not necessarily combat bacteria or alleviate scalp irritation, they just smell nice! -
Is the STARscanner laser safe?
The laser used in the STARscanner is of a lower intensity even than a supermarket scanner. It is a Class 1 laser - like those in CD players and laser printers - and is fanned and pulsed, meaning that it doesn't shine a direct light all the time. The scanner is a CE marked product, which means it conforms to certain mandatory health and safety requirements as set out in the European Directives. The laser used in it has been cleared to shine into the eye for up to 10 hours before any damage is caused, but the laser is actually only at the eye level for about half a second. The laser used is specifically designed to gather data - it is not a therapeutic laser like the ones used in eye operations and such like - and are perfectly safe.
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