Cranial Remolding Orthosis - Guide to the Boston Band

The active design of the Boston Band ensures contact with the bulging areas of your child’s head, leaving the flat areas free to grow. This enables your child to lie in any position they want.  How long your child may need to wear the Boston Band depends on how flat the head is and the amount of growth remaining. To achieve the best possible results for your child, it is important to follow these instructions. If you have any questions, please do not hesitate to contact your orthotist.



Wearing Schedule

Children adapt easily to helmets. After a short break-in period, your child will wear the Boston Band for 23 hours a day. A break-in period is necessary to ensure that the Boston Band is fitting well and to give your child a chance to adapt. This will take approximately three days. Break-in periods may be different depending on the child. Please follow the schedule below.


To begin your break-in period, your child should wear the Boston Band for one hour. After the hour, remove the band for thirty minutes and check the skin. Repeat this process, increasing wear time by one hour each time.

Full time wear is 23 hours a day. With full time wear the Boston Band should be removed twice a day, morning and evening. Ideally, the band should not be removed for more than one hour a day.



When to Take It Off

There are a few times when it is important to remove the Boston Band:

  •   When redness does not go away after 30 minutes
  •   When the child has an unexpected fever
  •   If any kind of surgery is performed
  •   At bath time
  •   For swimming. After swimming, wash your child’s head with shampoo to remove chlorine, sunscreen, etc. Reapply the Boston Band when both your child’s hair and the Band are dry.
  •   As needed during physical therapy

Checking Your Child’s Skin

Skin checks should be done each time the Boston Band is removed. Irritation or pink spots along the cheeks and the back of the neck are very common. This irritation usually improves as the child’s skin adapts to the Boston Band. Any irritation or redness should go away within 30 minutes. If any redness does not go away by the end of the 30 minute break, leave the Boston Band off until the redness goes away.  If redness does not go away or skin breakdown occurs, stop wearing the Boston Band and immediately contact your orthotist to schedule an appointment.  It is important to always wear the Boston Band at least 20 minutes prior to your appointment. This will help your orthotist to evaluate the fit of the Band and to see any red spots that you may have noticed.


Cleaning Your Child’s Head

You should clean your child’s head once a day while using the Boston Band. If you begin to notice excessive dryness of your child’s skin, please discuss this with your orthotist . Do not change shampoos prior to beginning treatment with the Boston Band. You may use any mild baby shampoo to which your child does not have an allergy. To avoid skin irritation, make sure that all the shampoo is fully rinsed from your child's hair. Your child's hair should be fully dry before placing the Band back on.

Cleaning Your the Boston Band

Your child’s Boston Band needs to be cleaned every day to remove any sweat or skin cells that may discolor the inside of the Band and/or cause an unpleasant odor. Some discoloration of the foam is normal and should not be a cause for concern.

Your child’s Boston Band can be cleaned with a mild soap and water, such as your child’s shampoo. It is important to rinse the Band well. You can also clean the Band with rubbing alcohol. Use any percentage rubbing alcohol greater than 70%.

The Boston Band should be fully dry before placing it back on your child’s head. Do not use a hairdryer or other heat source to dry the Boston Band as this can damage the foam. If your child’s band begins to smell, first try placing the band outside in the sun to dry. This may help with the odor. If your child’s band continues to smell, please discuss this with your orthotist.



Frequently Asked Questions

If my child has a red spot, what should I do?

Remove the Boston Band for 1 hour and reapply if the red spot goes away. You may also try applying a light dusting of cornstarch-based baby powder. If the spot does not lighten or go away, leave the Boston Band off and call to schedule an appointment with your orthotist.

My child has long hair. Should I cut it?

No — It is not necessary to cut your child’s hair; although, longer hair may lead to shifting of the Band. If your child has long hair, we recommend that you pull your child’s hair up to the top of the head. Your child should not wear braids, barrettes or rubber bands anywhere under the Boston Band.

Will it be difficult for my child to sleep in the Boston Band?

Most children do not have a difficult time sleeping in the Boston Band, although some children may require additional time to adjust to the Band.

Can I take the Boston Band off if the weather is too hot?

Yes — When the weather is warm use your full hour off. Try breaking your hour off into six ten minute durations. Ensure that your child is not overheating by removing the helmet or moving your child to a cooler area.

My child is sweating a lot. Is there anything I can do?

For the first several days, your child may perspire excessively. This is normal until your child’s body becomes accustomed to the band. You can also try a light dusting of cornstarch-based baby powder.

Will my child’s head shape become flat again once I stop using the Boston Band?

It is possible, but not likely. The risk decreases as the child ages and head growth slows. When stopping Boston Band use, it is important that your child is sitting independently and not spending lots of time in one position. Spending time in one position can affect the head shape.


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