FAQs

A baby’s head grows very quickly to accommodate a fast-growing brain, and as it grows it conforms to any external constraints or pressures. A baby with torticollis will lie continually on the same side of his or her head, discouraging growth on that side. As a result, growth that should happen evenly on both sides is redirected to the side on which the baby does not lie, creating an asymmetry. In a baby who cannot move their head to either side comfortably, flattening will develop at the back of the head. This may be accompanied by overgrowth on both sides (creating a wide head with a flattened back) or overgrowth at the top of the head (termed turricephaly) which appears overly tall.

There is no association between tongue or lip tie, and torticollis or head flattening. Tongue tie is a developmental anomaly arising from failure of programmed cell death; torticollis is a neck muscle imbalance that arises from constraint in utero. These two processes have no relationship.

There are only two options to offset this developing problem. The first – repositioning – is unpredictable and largely ineffective in babies with congenital muscular torticollis (which is almost every infant with flattening). It is impractical to expect exhausted parents to wake up every few hours to alter their infant’s head position. This is the reason parents turn to solutions which alter the surface on which the baby rests their head, since the head cannot become flat if it grows on a rounded surface. There are many pillows sold for this purpose, but they are largely ineffective and can actually cause flattening because they do not accommodate head growth and are not shaped like an infant’s head. They also pose a safety risk because they violate safe sleep recommendations against soft, loose items in the crib, and all pillow designs create dangerous neck flexion, which can restrict the baby’s airway. The Perfect Noggin was designed to overcome all of these limitations. Its patented, adjustable, soft foam liners are anatomically shaped to fit your infant’s head shape, and the platform design maintains the safest and most ergonomic head-neck-torso alignment. But the best feature of all is that it really works!

The Perfect Noggin is a mattress, formed of a solid ABS plastic base measuring 30 inches long by 14.5 inches wide. On top of the base sit four (six for the Perfect Noggin 2.0 Plus) IXPE foam layers. The foam is firm, in order to mould the growing head shape, but is soft and delicate to the touch, so comfortable for your baby’s skin. The IXPE foam is closed-cell so it can be easily wiped down and sterilized, so the product can be used over and over again. The foam does not absorb liquid. The largest foam liner goes to a head circumference of 19 inches.

The Perfect Noggin started in Boston Children’s Hospital as a custom-moulded foam block called the “cup”. It was clinically shown to reduce head asymmetry significantly better than the traditional treatment recommendations of repositioning and physical therapy. However, the cup required weekly contouring by a licensed orthotist and this created hardship for many families. The team set out to create a more user-friendly design, and the result was the most extensively studied product of its kind; the PlagioCradle. This design added a torso support for better head-neck-torso alignment, and incorporated a patented system of removable layers that permitted parents to adjust the fit as the infant’s head grew. The PlagioCradle was successfully used for over a decade to maintain and improve head shapes in thousands of infants throughout New England, and the clinical benefits are documented in multiple peer-reviewed scientific investigations (referenced below).

The Perfect Noggin incorporates all the best features of its parent product (the PlagioCradle) but in a more ergonomic design. As a testimony to its effectiveness, a smaller version of the Perfect Noggin is currently used in a number of pediatric intensive care units around the United States to offset deformational head shape changes that commonly occur in premature infants. Quite simply, the Perfect Noggin is the most ergonomic and clinically effective sleep surface available to maintain a natural head shape in your infant.

But don’t just take our word for it - let the clinical evidence, results and parent testimonies convince you.  

1. Rogers GF, Miller J, Mulliken JB. Comparison of a modifiable cranial cup versus repositioning and cervical stretching for the early correction of deformational posterior plagiocephaly. Plast Reconstr. Surg. 2008 Mar;121(3):941-7.
2. Seruya M, Oh AK, Sauerhammer TM, Taylor JH, Rogers GF. Correction of deformational plagiocephaly in early infancy using the plagiocradle orthotic. J Craniofac Surg. 2013 Mar;24(2):376-9.
3. DeGrazia M, Giambanco D, Hamn G, Ditzel A, Tucker L, Gauvreau K. Prevention of deformational plagiocephaly in hospitalized infants using a new orthotic device. J Obstet Gynecol Neonatal Nurs. 2015 Jan-Feb;44(1):28-41.
4. Knorr A, Gauvreau K, Porter CL, Serino E, DeGrazia M. Use of the Cranial Cup to Correct Positional Head Shape Deformities in Hospitalized Premature Infants. J Obstet Gynecol Neonatal Nurs. 2016 Jul-Aug;45(4):542-52.
5. Knorr A, Giambanco D, Staude MV, Germain M, Porter C, Serino E, Gauvreau K,DeGrazia M. Feasibility and Safety of the Preemie Orthotic Device to Manage Deformational Plagiocephaly in Extremely Low Birth Weight Infants. Adv Neonatal Care. 2019 Jun;19(3):226-235.

The Perfect Noggin creates the exact opposite conditions to the flattened mattress on which the asymmetry is developing. The head rest is fully contoured and anatomically correct, meaning that whichever way your baby turns his or her head, it rests within a curved surface. This means that growth is discouraged in areas of overgrowth via contact with the foam of the head cup. Flattened areas have no contact with the foam (due to the contour of the head cup) and therefore new growth is redirected there.
Unlike other products, the head rest is curved in all 3 dimensions, and the layer system ensures an effective fit as your baby grows. While lying in the Perfect Noggin, no flattening can develop, because no flat surfaces exist! The neutral head-torso alignment also creates the best airway position for breathing.

Once your baby can roll, and begins to sleep on their stomach (approx. 6 months of age) only a properly fitted helmet will improve head shape.

The Perfect Noggin promotes a natural head shape by redirecting growth. It is not magic, and growth can be slow. Short periods of time spent in the Perfect Noggin are not enough to redirect sufficient quantities of growth, so will yield no change. The best results are seen in young babies (more growth available, and faster growth) who sleep in the Perfect Noggin overnight. 

Yes! It does not matter which way your baby turns his or her head. The Perfect Noggin was designed to be effective in babies with torticollis - that is to say, an active head turning preference. The head cup is fully contoured, so regardless of how the head is turned, there are no flat areas with which the head can come into contact, and no contact is made with any already flattened parts, encouraging new growth there.

Head flattening (plagiocephaly, brachycephaly, scaphocephaly) is purely cosmetic. No scientifically robust studies exist which link head flattening to an increased incidence of ear infections or dental malocclusion, or to delayed motor or cognitive development. There is no truth to the claim that children will be unable to wear glasses, swimming goggles or protective headwear later in life, or that they are certain to suffer bullying as a result of the shape of their cranium. How do we know this? As many as 12% of adults have “irregular” shaped heads – but have you ever noticed this in an adult? Babies are more frequently viewed from above and in combination with little to no hair coverage, an asymmetry can be obvious. In contrast, only a hairdresser may regularly see young people and adults from this angle.

On the other hand, what is also not true is the claim often made by health professionals that the head flattening will “resolve itself”, or that the flat spot will “pop out” once the baby can sit or roll. In some cases there may be a small amount of natural improvement, but some degree of flattening will almost certainly persist for life – with no medical repercussions for the child. The issue is more immediate and is purely related to you – the parent – and how you feel about the aesthetic of your baby’s head. For many parents, the visual appearance is distressing and they simply do not want to wait until the child is grown and the asymmetry is no longer noticeable. These parents may choose to helmet their child, as the right helmet (fitted and monitored by a competent orthotist) can produce a great result, especially if started early. However, we believe a far better path is to avoid, halt or reverse any flattening which could occur within the first 5 months of life, and potentially avoid the need for a helmet entirely. This is the purpose of The Perfect Noggin.

The Lullaby Trust recommends that babies are put to sleep on their backs, in their own beds, in the absence of soft furnishings and on a flat (ie non-inclined) surface. Sleep positioners, devices that restrict the baby’s movement, and pillows are all advised against. The Perfect Noggin is a firm mattress on which the baby sleeps on his or her back, and is placed into your Moses basket or cot. There are no loose or soft components and the baby is completely unrestricted, able to move their head in any direction they wish. Therefore, it is entirely safe.

The Perfect Noggin should only be used under supervision once the child is able to roll over. This milestone is reached by different babies at different ages, but will occur around the age of 5 or 6 months. Once they are able to roll, it is likely the baby will choose to sleep on his or her stomach, removing the forces contributing to head flattening, and the baby can resume sleeping on a standard flat mattress. From this point onwards, any existing flattening will not worsen and over the following years will become less and less obvious.

The Perfect Noggin was flammability tested by an independent UK lab to EN 597-1:1994 and EN 597-2:994 (from BS 7177:2008+A1:2011 Low Hazard) and achieved a classification of “NON IGNITION”. 

The Perfect Noggin was invented by Dr Gary F. Rogers M.D., J.D., LL.M., M.B.A., M.P.H.
Dr Rogers is a practicing paediatric plastic surgeon, based in Virginia, USA.

That depends on the degree and type of flattening, the age of the baby and how much time the baby spends in the PerfectNoggin. With pure Plagiocephaly, results are seen faster than with brachycephaly - this is also true when using a helmet. In younger babies (2 - 3 months) growth is so fast that change can be seen in less than a week. 

In general, after 4 - 6 weeks of overnight use, you should see improvement in the shape. 

If your baby has brachycephaly, progress will be slower. It is important to take good quality photographs before starting, so you can monitor change. Pictures should be true laterals (side views) with the baby looking straight ahead, not down, so their eyes are level with the top of their ears. Do not expect significant change in brachycephaly in only a few weeks.

For delivery within the UK or EU, order here

For the rest of the world, please visit www.theperfectnoggin.com

The Perfect Noggin can be used until your baby can roll. Once your baby starts to roll back to stomach, it should only be used under direct supervision. Most babies learn to roll between 5 and 7 months.

If your baby is too old for The Perfect Noggin, you have two choices; you can use a cranial remolding helmet to re-direct growth to the flat side, or over time you can let general growth, hair coverage and perspective change render the flattening less obvious.

The Perfect Noggin is supplied with full instructions, and a measuring tape. The tape is a guide and will give you an idea of which layer to try. However, just like with shoes, sometimes the final fit differs a little, depending on the shape of your baby’s head. There should be only a few millimetres of room either side of your baby’s head, just above the ears. It should be snug but not tight. Babies with wider heads (eg as a result of brachycephaly) may have to go up a layer, as you may find the layer indicated by the tape measure is too tight. Babies with scaphocephaly (longer, thinner heads) may have to size down a layer. If you are unsure, send us pictures of your baby in the layer(s) – by email, WhatsApp or via Facebook. Always use the smallest layer in which your baby’s head comfortably fits – too large and it will not as effectively redirect growth to the flat area.

We dispatch every working day. For orders within Great Britain, these are sent with Next Working Day delivery. For Northern Ireland, it is 48 hour delivery. For the EU, we aim for no more than 4 working days where possible. Delays to EU deliveries are usually caused by Customs so we advise you to keep an eye out for an email from the shipping agent who will inform you of the procedure for paying this.

Once your shipment is booked, you will receive a tracking number.

If you are in Romania, please email for details of how to complete a faster purchase.

Yes, we can send PayPal invoices and accept direct bank transfers. Please email us with your specific request and we will do our best to work with you on a solution. 

We would love to chat about your baby’s head! Please drop us an email ( sales@contourimports.co.uk ) or head over to the Noggin Doctor’s Plagiocephaly & Torticollis Parent Discussion Board on Facebook.