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Plagiocephaly and Cranial Remolding Orthoses (Cranial Helmets for Infants/Babies)

Before and After the treatment with a Cranial Remolding Helmet/Orthoses from Nobbe Orthopedics
Before and After the treatment with a Cranial Remolding Orthosis/Helmet from Nobbe Orthopedics

What is Plagiocephaly?

Deformational Plagiocephaly, also known as “flat head syndrome”, is the abnormal shape of a baby's head caused by external forces. The baby's head may appear misshapen with areas that protrude or are flat immediately after birth, or the abnormal shape may become noticeable in the first few months of life.

If your child is between the ages of 3 and 18 months old, your pediatrician or specialist will refer you to a practitioner, such as Nobbe Orthopedics, Inc., that specializes in providing cranial remolding orthoses.

Before and After quantifiable results with a Cranial Remolding Orthosis/Helmet from Nobbe Orthopedics Brachycephaly results with a Cranial Remolding Orthosis
Outcomes shown in Cranial Symmetry Assesment

News Item: STARband Cranial Helmets from Nobbe Orthopedics Making a Difference in the Lives of Children

Happy baby with Cranial Remolding Helmet/Orthoses



What are the causes of deformational Plagiocephaly?

There are a number of causes of plagiocephaly:
  • Restricted space in the womb, twins or multiple gestation, large infants with small mothers, or low amniotic fluid.
  • Suction or vacumm assisted births
  • Tightening in the neck-also know as Torticollis, leads a child to prefer a certain position.
  • The “Back to Sleep” program began in the early 1992 reduced Sudden Infant Death Syndrome by 40%. Sleeping our babies on their backs in combination with the use of the carriers to hold and position during waking hours may result in undue pressure on the head.

What can I do if my baby has an unusual head shape?

Visiting your pediatrician for any concern, is always advisable. Your doctor will most likely recommend tummy time and repositioning off the flattened area. A referral for an assessment with a head shape specialist, such as Nobbe Orthopedics, may be given.

What happens at your baby's first appointment at Nobbe Orthopedics?

The certified, licensed practitioner will conduct a thorough evaluation that includes questions about your baby's history, examination and calliper measurement of your baby's head, clinical photographs, and a STARscan. Cranial remolding, also know as helmet treatment, will be thoroughly explained. During this appointment, parents will have an opportunity to have all questions answered. Most parents feel much better with the knowledge gained during this hour.

What is the Starscanner™?

The Starscanner is a 3-D scanning system that allows us to SAFELY obtain an image of your infants head in less than 2 seconds! This information is used to review your baby's head shape, make clinical decisions, AND manufacture the Starband. Cranial remolding orthoses made from this stable scanner offer the best outcomes available!

What is the Starband™?

The STARband™ cranial remolding orthosis, or helmet, manufactured by Orthomerica derives its name from its purpose – Symmetry Through Active Remolding.  The custom orthosis is fabricated from a model of the infant’s head to obtain optimum fit and function. The STARband is FDA approved.

How does Cranial Remolding (with the STARband) Work?

The STARband™ is a plastic and foam device designed to gently correct your baby’s head shape. The orthosis, or “helmet,” redirects head growth to improve proportion and symmetry.  They are designed to provide total contact over prominent or bossed areas of the baby’s head to discourage additional growth. An opening inside the helmet where the head is flat encourages growth.

What happens next if my baby begins treatment?

  • Your baby will be fitted with the orthosis within 2 weeks of the scanning date.
  • Within 5 days your baby will progress to wearing the orthosis 23 hours a day with one hour off for bathing and cleaning.
  • Once full time wear is achieved, you will see your practitioner for a check of the fit and to address any questions you may have.
  • After that, visits are usually every 2-3 weeks depending on how fast your baby grows. 
  • At the two month mark or Mid-Treatment, another scan is completed. This scan is compared to the one taken to order the helmet. All the progress is readily visualized in the overlay. This is a fun appointment! A copy will be provided for your child's baby book.
  • Three to four months into treatment, another comparison scan will be completed. This comparison shows all progress to date and provides insight on when treatment will end.
At each appointment the orthotist will check the fit and function of the orthosis, document changes in head shape, and make adjustments necessary to direct growth into the flattened areas.  You are encouraged to contact us immediately if you have concerns about the fit, skin problems, have any questions, or feel that your baby needs an adjustment before the next scheduled appointment.

How long will my baby wear an orthosis?

Most babies wear a cranial remolding orthosis for 3-6 months if they are between the ages of 4 and 7 months at the beginning of treatment.  Older infants may require a longer treatment program because head growth slows.  Research indicates that the greatest symmetry can be attained before the baby is 12 months old, although correction is possible in babies up to 18 months.

Nobbe Orthopedics can supply custom graphics for your baby's cranial remolding orthoses / helmet.

How will I know when my baby is done with treatment?

Typically, the decision to discontinue treatment is made at the time the baby starts to outgrow the helmet.  At that time, the orthotist will schedule an End- of-Treatment evaluation for parents to visualize the growth and correction. Together, the parents and the orthotist determine if correction is to a point where treatment is no longer necessary. Treatment may be discontinued even if the head shape is not fully corrected since some mild asymmetry or disproportion is normal in all individuals.

Will my insurance cover a Cranial Remolding Orthosis?

Most Insurance companies cover cranial remolding treatment if the child meets their criteria. During the initial appointment, you will learn whether your child meets criteria. Nobbe Orthopedics staff will contact your insurance carrier regarding coverage for your child. We are contracted with most major insurance carriers. We are proud to offer a military discounts. TriCare does not offer cranial remolding as a benefit.


This process takes about 30-45 minutes.  The procedure is not painful, but may cause a child to be fussy or frightened.  A cotton stockinet is placed over the baby’s head with an opening for the face and ears.  A series of plaster strips are applied from the eyebrows to the base of the neck, along the sides of the head covering the ears, and along the sides of the face.  Distraction with a toy, bottle, or music is beneficial.  Once the plaster has cured, the negative mold is removed.  The child is then cleansed to remove plaster residue.  The cast is shipped to Orthomerica for fabrication.
While casting has been in use for many years, it has the potential to distort during removal from the child or during shipping to the lab. With the casting technique, approximately 10-12 working days are required for fabrication, further increasing the potential for fitting and tolerance problems, due to infants’ rapid growth.

Non Contact laser digital SCANNING
Obtaining data with the use of the STARscanner™ takes about 1.5 seconds!  A cotton stockinet is placed over the baby’s head with an opening for the face and ears. Parents assist the baby to lie on their back in the scanner. The specialist positions the child accurately. While holding a toy above the baby to attract his/her attention, the specialist presses a foot pedal to obtain the scan. In less than 1.5 seconds, a 3-D image of the baby is obtained! This information is electronically transferred to Orthomerica for manufacturing. Fabrication time is reduced to 5 working days resulting in markedly improved fit and comfort.

Nobbe Orthopedics is the 7th practice in California to obtain a STARscanner™ and is the only location in the Tri-Counties area! Nobbe Orthopedics utilizes only Orthomerica, the world’s largest manufacturer of FDA approved cranial remodeling orthoses.