Customised 3D-printed helmets are being used by the KK Women’s and Children’s Hospital (KKH) to treat very young babies with flat-head syndrome, a misshaping of the skull that can occur when babies sleep in one position for long periods.
The helmet, which is worn almost all the time, gently guides the skull to grow into a more rounded and symmetrical shape.
A growing number of parents are seeking treatment to correct this head shape abnormality in their babies, pushing up the number of cases at KKH by 36 per cent in the last two years.
With the cases of flat-head syndrome or cranial asymmetry rising from over 800 in 2022 to more than 1,000 in 2024, the hospital has launched a specialised clinic dedicated to treating the condition.
At the KKH PlagioCentre, babies are managed by a multidisciplinary team made up of doctors who specialise in the care of newborn infants, physiotherapists and experts in the designing, making and fitting of artificial devices.
“The doctors make sure that there are no developmental issues that cause the flat head,” said Dr Kavitha V. Sothirasan, who heads the centre.
Flat-head syndrome is a relatively common condition in which an infant’s head becomes misshapen or flattened due to constant pressure on one side of the skull.
One form of the syndrome is plagiocephaly, where the head is flattened on one side. Another type is brachycephaly, where the head is flattened at the back, resulting in a wider-than-usual head shape.
Globally, the condition affects up to 22 per cent of infants by the sixth week of life, and nearly 30 per cent by the fourth month.
Mild cases often resolve naturally as babies start to crawl and move their heads independently.
Parents can help by increasing tummy time – when babies lie on their stomachs while awake – to enable them to develop strength in the neck, arms and back. This will make it easier for them to move their heads and shift positions.
“More than just a cosmetic concern, babies with moderate to severe conditions (who)… are not treated early can develop uneven jaw. Facial development is affected. When they get older… they will have problems wearing protective headgear or glasses,” said Dr Kavitha.
Another risk is torticollis, a condition where the head is tilted to one side.
“When there is torticollis, it affects their vision as well because they end up holding their head in a particular manner. It would also restrict their head movements,” she added.
Flat-head syndrome often stems from everyday habits during babies’ early months, when they are constantly lying on their side or on their back.
Placing babies to sleep on their backs to reduce the risk of sudden infant death syndrome may have contributed to the increase in cases of flat-head syndrome, according to reports in the US.
Babies who spend long periods in strollers or rockers without moving their heads regularly may also face higher risk of developing the condition.
“When the child sleeps in the same position all the time… by the third month, you will see that the head shape is flatter on one side,” said Dr Kavitha.
Parents are becoming more aware that they can get help for their baby’s misshapen skull.
Helmet therapy is the main treatment, while the other options are exercise and physiotherapy.
Previously, babies with flat heads used helmets customised using a plaster mould of the head. Orthotists adjusted the mould to ensure a symmetrical shape before fabricating the helmet from polyethylene plastic, Dr Kavitha said.
Now, KKH PlagioCentre is the first public clinic to offer 3D-printed helmets as part of its treatment options.
The helmets, made using a 3D scan to capture the shape of the head, offer a more precise and customised fit.
“Made from a perforated material, these 3D-printed helmets are lightweight and breathable for better ventilation and comfort, even during long hours of wearing,” Dr Kavitha noted.
She declined to give the prices of the 3D-printed helmets or the conventional ones.
“As the costs can vary very widely if helmet therapy is required, the medical team will discuss them with the parents or caregivers. Subsidies are also available for eligible families,” she said.
Dr Kavitha said that comparing the 3D-printed helmets with conventional ones “is not simply about which one costs less”.
“The real value in 3D-printed helmets lies in the precision and the breathability it provides for infants who are compliant in their treatment. (They need) to wear them for 23 hours a day,” she added.
During helmet therapy, a baby undergoes a monthly review to assess the growth and development of the head shape. The helmet is adjusted accordingly to ensure effective reshaping and comfort as the head grows.
“The advanced technology also enables a more efficient and consistent production process, compared with the conventional method of using plaster moulds. This allows KKH to provide the customised treatment at scale, and meet the growing demand for flat-head syndrome therapy.”
The first baby to be custom-fitted with a 3D-printed helmet at KKH PlagioCentre was Ng Pei Xuan, now 13 months.
One of a set of triplets, she was nearly six months old when she was diagnosed with very severe flat right plagiocephaly and moderate brachycephaly, a result of her continuously sleeping on one side.
“Initially, we noticed that her head was flatter than her brothers’, but we did not think it was serious. When we took the babies for their check-up, the doctor mentioned she needed to go for therapy and referred us to Dr Kavitha,” said Pei Xuan’s mother, Ms Janice Chen, who declined to give her age.
Pei Xuan’s condition was classified as severe, and she was recommended to have helmet therapy.
“She started wearing the helmet for 23 hours a day since December. We remove it only when we bathe her or when she has a fever,” said Ms Chen, who works in the finance industry.
Her husband Ng Han Siang, a 41-year-old assistant vice-president at a bank, said: “Pei Xuan struggled when we tried the exercises taught to us… but she did not struggle as much when we put her 3D-printed helmet on.”
At the daycare that Pei Xuan and her brothers, Jie Rui and Jie Le, attend, she keeps the helmet on.
After four months of consistently wearing the helmet, her cranial measurements showed exceptional progress.
“Pei Xuan’s condition has improved significantly. The flat right side of her skull had been reduced to just mild severity, while the flat part of the back of her head was resolved,” Ms Chen said.
“It is only when she is older and starts trying to remove the helmet on her own that we will totally rid her of it.”
