From the YummyYucky team, founded by Nancy Nash

Life with a baby helmet: the day-to-day

This page is for families whose baby wears a cranial remolding helmet (also called a cranial orthosis or band) for a flat head, whether plagiocephaly or brachycephaly. You have just left the fitting with the helmet and a sheet of instructions, and this covers the everyday part: the hours, the break-in days, cleaning, skin checks, sleep, heat, car rides, stickers, comments from strangers and the adjustment visits. It is built from the care handouts of children's hospitals and helmet clinics in the US, Canada, the UK and Australia, and where they disagree, it says so.

Throughout, “orthotist” means the person who makes and fits the helmet.¹² At some hospitals that is an occupational therapist.³

A day in the helmet

Most helmet programs aim for about 23 hours a day, with an hour off for bath and cleaning.¹³⁴⁵⁶⁷ Children's Healthcare of Atlanta puts it at about 22 to 23.⁸ Your clinic gives you your baby's number, and theirs is the one to follow.¹⁷

Bath time is the usual time for the hour off: the helmet comes off, your baby's hair gets washed, and the helmet gets cleaned while it is off.⁴⁷⁸ Hanger says the hour can be split up across the day,⁷ and Gillette suggests two 30-minute breaks.⁹

The helmet also comes off for swimming and for playing in sand,³⁵⁸ and for neck exercises if your baby has them, going back on as soon as they are done.³⁵

Shampoo your baby's hair every day.⁵¹⁰ If a haircut comes up, don't shave the whole head, because hair growing back under the helmet can irritate the skin, and try to keep the length about the same so the fit does not change.⁵¹⁰ If your baby has cradle cap, Gillette suggests gently brushing the scalp at each shampoo, and calling the pediatrician about redness, tenderness or drainage there.⁹

Each time it goes back on, check that the strap and the foam pieces are secure, because loose parts can be a choking hazard.⁵¹⁰ While it is off, keep it away from pets: dogs have been known to chew the plastic and foam.⁵¹⁰

Leave the fit to the orthotist rather than adjusting it at home.² Lurie warns that grinding away foam to ease a rub can make the rubbing worse.¹¹

Anyone who looks after your baby, from a grandparent to the daycare room, needs to know how to put the helmet on, take it off and keep to the schedule.⁵¹⁰¹²

The break-in days

The first days usually build up slowly. Follow the schedule your orthotist gave you, even if things are going well.¹⁵⁷⁸⁹ Clinics differ, so your orthotist's schedule comes first. A few published examples:

• Hanger Clinic's published schedule reaches full time on day 7. It starts with 1 hour on and 1 hour off, with naps from day 3 and overnight from day 6.⁷
• Gillette Children's published schedule reaches full time on day 5. It starts with 1 hour on and 1 hour off, with naps and overnight from day 4.⁹
• Nicklaus Children's published schedule reaches full time on day 5. It starts with 2 hours on and 1 hour off, with naps from day 1 and overnight from day 2.³

Children's Atlanta and Shriners describe five days of building up,⁵⁸ and the Royal Children's Hospital in Melbourne a week.⁶ Check your baby's skin at every break during these days.⁹¹³

Most babies get used to the helmet quickly.²⁴⁷⁸ The first days can be harder on the parents: Hanger's handout says so, and Alder Hey calls them a time of adapting for all of you.⁷¹⁴

The helmet can feel a little loose or shift in the first weeks, which Sainte-Justine and Alder Hey both call normal.¹³¹⁴ If it moves around a lot or keeps sliding, call your orthotist.²¹³

In YummyYucky's free helmet tracker, you can pick one of these published schedules or type in your orthotist's, and the Today screen shows each day's step.

Cleaning the helmet

The handouts agree on cleaning it at least once a day,³⁶⁸⁹¹¹ and on letting the inside dry completely before it goes back on.^5678911 A soft toothbrush or a washcloth gets into the foam.³⁵⁷⁸ Past that, they differ:

• What to clean with. Some say rubbing alcohol only, because other cleaners can irritate the skin.⁵⁸ Others use a mild baby soap or shampoo,⁶⁷ alcohol first and then soap,¹¹ or alcohol mixed half and half with water.⁹
• Drying. Children's Atlanta and Shriners allow a hair dryer on cool;⁵⁸ Lurie says never use one, because it can melt the foam.¹¹ Setting the helmet upside down in the sun or by a fan helps it dry and air out.³⁵
• Water. Several handouts say never to soak or submerge it.¹¹¹⁴
• How often. Hanger suggests twice a day in the first few weeks,⁷ and Children's Atlanta adds a clean whenever it is dirty or after time outside.⁸

So the short version is the one the tracker shows: Use what your orthotist recommended, and make sure it's fully dry before it goes back on.

Skin checks, fevers and when to call

Most programs ask for a quick skin check each time the helmet comes off.⁵⁷⁹ Many programs say mild redness that fades within about an hour is expected, especially early on or after an adjustment.⁶⁹¹¹ Marks or small dents for a few minutes after it comes off are normal too.²

Redness that hasn't faded after about an hour is a reason to call your orthotist. They can tell you whether to keep the helmet off for now.³⁵⁶⁹¹¹ Programs differ on what to do in the meantime. Several say to take the helmet off and call,³⁶¹¹ while Gillette has families put zinc oxide cream on the spot, keep the helmet on and check again in 2 to 3 hours.⁹ Ask at your fitting which your clinic wants.

Call your orthotist about redness lasting past an hour, a blister, broken skin, or a poor fit. For a rash, check with your baby's doctor too.³⁴⁵⁶ Cleveland Clinic adds signs of infection (warmth or tenderness under the helmet, pus, a bad smell), a helmet that slides around or feels too tight, and fussing or crying with the helmet on that you can't settle, or trouble eating or sleeping.² The AAP says skin irritation, discomfort and a bad smell should not happen, and that the specialist who made the helmet should adjust it if they do.⁴

On smell, though, the handouts don't agree: some say a helmet can pick up a smell even with good cleaning, and that airing it in the sun or by a fan helps.³⁵¹²¹³ If cleaning doesn't fix it, or the smell seems to come from your baby's skin, call your orthotist.²¹²

Ask before putting anything on the scalp. Some handouts say no powders, lotions or wipes on the head or in the helmet,³⁵ while others suggest a moisturizer or a barrier cream for dry or rubbed skin.⁶⁹¹¹¹³

Most programs say to take the helmet off during a fever. If it's off for two days or more, ask your orthotist how to ease back in.^56891114 Where they draw the line differs: 100°F at Children's Atlanta and Gillette, above 100.5°F at Lurie, above 38°C at Alder Hey.⁸⁹¹¹¹⁴ Ask which number your clinic uses. Easing back in differs too: Shriners has families build back up over a few days after 48 hours out of the helmet,⁵ while the Royal Children's goes straight back to full time once a fever is over.⁶

Sleep

Once the break-in is over, the helmet stays on for naps and overnight, as part of the 23 hours.⁵⁸⁹ Babies in helmets still sleep, play and cuddle like any other baby.¹⁵

Safe sleep stays the same: on the back for every sleep,¹²¹⁶ on a firm, flat surface, with no pillows or other soft things in the crib.¹⁶ Keep the room cool and the layers light, since the helmet adds warmth.^11121416

Clothes, heat and sweat

Expect a sweaty head at first. The handouts call it normal in the first days or weeks of full-time wear, and it settles as your baby gets used to the helmet, often within about two weeks.⁵⁷⁸⁹¹¹ When the head gets damp, take the helmet off, dry the head and the inside of the helmet, and put it back on.⁵⁶⁸ Shriners keeps these breaks under 10 minutes.⁵

Count the helmet as a layer and take one off your baby: lighter clothes, and a onesie works well.^5681114 For sun or cold, a hat goes over the helmet, big enough to fit, and comes off in the car so your baby doesn't get too hot.¹³ Skip hats or liners under the helmet.¹²

Outside, keep an eye on how long your baby is in the sun with the helmet on: Children's Atlanta warns it can cause a heat rash.⁸ A fan and air conditioning help on hot days, and in real heat the helmet may need to come off to avoid heat stroke.¹¹ After swimming, wash your baby's hair to get the chlorine and sunscreen out before the helmet goes back on.³⁵ After the beach or the sandbox, clean the helmet once you are back inside.⁸

Car seats

The handouts we read say little about car seats. What they do say is about heat: be careful with hot cars, and take your baby's hat off in the car.¹¹¹³

The AAP's car seat basics apply to every baby: a harness snug enough that you can't pinch any slack at the shoulder, and nothing added to the seat that didn't come with it or isn't approved by the seat's maker.¹⁷ If the helmet seems to change how your baby sits or how the harness lies, ask your orthotist, and have a certified child passenger safety technician check the fit. Some technicians have extra training in transporting children with special needs.¹⁷

Decorating the helmet

Many clinics are fine with stickers or decals on the helmet,²¹² and some have you pick a color or pattern when it is ordered.¹⁸ Hanger says some families decorate it to reflect their baby's personality.¹⁵

Before you paint it or try a wrap, ask your orthotist. None of the handouts we read covers paint, and several warn that heat can damage the foam or the shell.¹¹¹²¹³

Comments and questions from strangers

People will ask. It is a common worry, and Hanger says many parents find the helmet becomes a conversation starter.¹⁵ It helps to decide ahead of time how you will answer, and to keep it short and friendly.¹² A few answers that don't get into anything medical:

• “It's a helmet for her head shape. She wears it for a few months.”
• “He's used to it by now. Thanks for asking!”
• To someone who keeps pushing: “We're following our orthotist's plan, thanks.”
• To a curious kid: “It's a special hat she wears for a while. Want to see the stickers?”

You don't owe anyone more than that. If you would like to talk with families who have been through it, ask your orthotist: Hanger's clinicians offer to connect parents with others in their area.⁷¹⁵

Adjustment appointments: what to bring

Your baby's head keeps growing, so the orthotist checks and adjusts the helmet at regular visits.⁶⁷¹⁸ How often varies a lot: weekly for the youngest babies at Nicklaus,³ every two weeks at Children's Atlanta,⁸ every two to four weeks at Lurie after a first check 7 to 10 days in,¹⁸ and about every four to six weeks at the Royal Children's.⁶

One helmet provider's guide suggests keeping a simple log of wear time, skin notes and photos, and sharing it at each visit.¹² It helps to bring:

• The hours worn, day by day, including any days it was off for a fever or a red spot.
• Notes on red spots: where they were, and whether they faded within about an hour.
• Photos of anything you weren't sure about, taken when you saw it. One clinic asks families to text or email a photo of a red spot between visits.¹⁰
• Your questions, written down. The places this page says the handouts disagree make a good start: what to clean with, which creams if any, the fever number, and how to ease back in after time off.

Everyone caring for your baby can add to it: ask them to note red marks, sweaty spells or unusual fussiness.¹²

When treatment ends

Treatment usually runs for a few months, and how many varies: three to five on average at Children's Atlanta and Shriners, three to six at Lurie, three to four at the Winnipeg program, and up to ten at Nicklaus.¹³⁵⁸¹⁸ The AAP notes that some children may benefit from more time and a second helmet.⁴

The clinic decides when it is done, using the measurements or scans from the last visits.¹⁷¹⁰ Until then, Shriners keeps babies at full time,⁵ while another provider's guide talks about a gradual taper planned with your clinician,¹² so follow your own clinic's plan for the last weeks. Hanger's handout calls the final visit a graduation, with before and after scans.⁷

How YummyYucky's free helmet tracker helps

The helmet tracker is free, and it stays out of sight until you turn it on, under Care extras on your baby's page or from the line at the bottom of Health. Then a card on the Today screen shows whether the helmet is on and the hours worn today against the goal your orthotist gave you, with one tap for when it comes off and when it goes back on.

For the break-in, pick the Hanger Clinic, Gillette Children's or Nicklaus Children's published schedule or type in your orthotist's, and Today shows each day's step and when the next break is due. Tick the daily clean, log a skin check with a photo if you want one for the orthotist, and the helmet page shows the last 14 days at a glance, keeps every day back to the first, and prints a page of the last week or two to bring to appointments. It works offline, and everyone logging for your baby sees the same helmet on their own phone. Ending treatment in the tracker keeps the hours, cleanings and skin checks logged so far.

Related reading

• Baby rash: when to worry
• Cradle cap: what it is and how to treat it

Sources

1. Rehabilitation Centre for Children, Winnipeg: Helmet Therapy for Plagiocephaly, Frequently Asked Questions (June 2024)
2. Cleveland Clinic: Why Do Babies Wear Helmets? (medically reviewed January 12, 2026)
3. Nicklaus Children's Hospital: Cranial Remodeling (updated January 7, 2022)
4. American Academy of Pediatrics (HealthyChildren.org): Baby Helmet Therapy, Parent FAQs (updated August 31, 2020)
5. Shriners Children's: Helmet Therapy, with its STARband wear and care video
6. The Royal Children's Hospital Melbourne, Orthotic Prosthetic Unit: Helmet Therapy information sheet
7. Hanger Clinic: Cranial Helmet Wear & Care Guide (June 2023)
8. Children's Healthcare of Atlanta: Helmet 101, Wear and Care of Your Child's Cranial Remolding Band
9. Gillette Children's: A Caregiver's Guide for the Talee Cranial Remolding Orthosis
10. Steinmann Prosthetics & Orthotics, Las Cruces: Cranial Helmet Wear and Care Instructions
11. Lurie Children's: Helping Baby Adjust to a Helmet
12. OrthoPediatrics Specialty Bracing (OPSB): Parent Guide to Cranial Helmet Therapy, What to Expect (2026)
13. CHU Sainte-Justine, Montreal: Cranial orthosis, a brochure for parents (2016)
14. Alder Hey Children's NHS Foundation Trust: Helmet therapy for craniosynostosis (revised January 2023; for helmets after surgery)
15. Hanger Clinic: 10 Common Questions Before Starting the Cranial Helmet Journey (August 7, 2025)
16. American Academy of Pediatrics (HealthyChildren.org): How to Keep Your Sleeping Baby Safe, AAP Policy Explained (updated September 11, 2026)
17. American Academy of Pediatrics (HealthyChildren.org): Car Seats, Information for Families (updated April 16, 2026)
18. Lurie Children's: Treatment of Head Shape Anomalies, Cranial Remolding (Helmet Therapy)

Last updated September 2026. Next review December 2026. How we write these: built from current published guidance from the AAP, CDC, FDA/EPA, NIAID, WHO, and other pediatric and public-health authorities, with sources cited on the page. See our editorial and medical policy for how we research, source, and update these, and how we double-check the food advice.

This is general information, not medical advice, and is not individualized for your baby. Always talk to your pediatrician about your baby's diet, introducing allergens, and any reaction. In an emergency, contact emergency services.

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