Infant skull growth and why the first 6 months is so important.

It has now been more than 6 months since I started working at Cranial Technologies, a cranial remolding orthotics company. Over the past few months, I have gotten to know hundreds of babies. I meet new ones every day with a very specific condition: positional head shape change (plagiocephaly and brachycephaly). This condition can be due to a variety of reasons (to be covered in an upcoming blog). What amazes me is that while the condition has been around since the 1990s and pediatricians have known about it for years, I still meet with new parents every day that had no idea their babies’ heads could change so drastically in such a short period of time.

Many pediatricians do a wonderful job of referring babies to physical therapy or craniofacial specialists before 6 months of age. Yet so many others are waiting until the babies turn one year old, hoping that they would normalize by that point. And in mild cases, they do round out on their own. But for most of the very severe head shape deformities we encounter, the best time to treat is actually before 6 months.

Why? Because newborns have softer skulls that will take time to harden and fuse together as they grow. A majority of their brain growth (and therefore skull growth) happens in the first 6 months of life. This is a time in their life when they are the most susceptible to forces that may change the shape of their head.

I have encountered many frustrated parents who come to us with babies older than 18 months, whose faces and ears are completely out of alignment.  At that point, the helmet is no longer effective to change the shape of a baby’s head.

The best time for treatment with a cranial remolding orthosis and repositioning is between 4-6 months. The baby’s head control is much better at that point. The treatment process is actually much quicker because the baby is changing faster. Beyond 6 months, and head growth slows down significantly. This can be seen in the following infographic. The blue is the newborn head size, the green is how much it grows and changes within the first 6 months, and the yellow is how much it grows for the next 6 months.


Infant Skull Growth Infograph


With such a time-sensitive condition on our hands, if you have any reservations or concerns about your baby’s head shape and head growth, please bring it up with your pediatrician!

About PT4Peanuts

Judy is the proud owner of Lil' Peanuts Physical Therapy, P.C. She is a board certified pediatric specialist who has worked with children all across the country, from NICUs to outpatient day rehabilitation centers. She is an avid blogger and full proponent of APTA’s 2020 vision for physical therapy. Her passions lie in educating children, parents, teachers, clinicians, and future therapists so that they can best reach their full potential.
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