Summary: Finding a helmet for a child with hydrocephalus is not just a simple matter of finding one large enough.

Parents of children with hydrocephalus contact us looking for a helmet for their child, having found that normal toddler helmets are much too small, and in some cases even adult helmets do not fit the oversized head. But fit is only one question, and perhaps not the most important one.

First, you should be aware that bicycling may not be a good activity for a child with a tender brain. It must be difficult as a parent of a child with hydrocephalus to balance the need for the kid to lead a fairly normal life with the fact that almost everything these kids do is risky if it involves possible blows to the head. Walking, running, swimming, dancing, aerobics, and others seem like better sports, but who are we to judge. You should know that even wearing a bike helmet will not necessarily protect them from an injury. Bike helmets are designed to protect the average brain against catastrophic injury. In a hard knock they do not attempt to soak up all of the energy. A person with a normal brain may experience a concussion and be knocked out during a bike crash with a helmet on. A person with a brain affected by hydrocephalus and perhaps associated disorders may die in the same crash.

We are not aware of any extra-extra-large toddler helmets on the market, since there would be very little demand for them and no manufacturer wants to produce a helmet that will not pay for itself, much less make a profit. The same applies to a helmet specifically designed for anyone with hydrocephalus. Manufacturers must also be concerned about lawsuits if the helmet made it appear safe for a child with hydrocephalus to ride, and then the child were injured or killed.

The best advice is always to ask your pediatrician for advice before putting a helmet on your child. If you get the green light from your physician, you may have to use an adult helmet to find one that fits. The only difference defined by US standards between the protection of an adult helmet and a toddler helmet is that the CPSC standard requires more head coverage for toddlers under five, so toddler helmets come further down on the head. This difference can be minimized by choosing a "skate style" bike helmet: a helmet that is made in the classic skate helmet configuration but certified to the CPSC bike helmet standard. These helmets generally have about the same coverage as a toddler helmet. They are available as skate helmets in many mass market retail stores. There are some comments on them in the July, 2002 Consumer Reports article. If a normal adult helmet is still too small, see our page on helmets for big heads for more ideas.

In Canada, there is a different energy management requirement for toddler helmets. A helmet meeting the Canadian toddler standard should provide a softer landing. We don't know of any that do meet all requirements of that standard without any waivers for the energy management requirement at present and are labeled as meeting the Canadian child helmet standard. If you know of one, please email us. Even if you find one of those, it may or may not be protective for a child with hydrocephalus.

If the physician confirms that biking is ok for your child, the best helmet for a child with hydrocephalus would probably be one with a round, smooth exterior and a thicker, moderately dense foam liner. You generally find helmets like that in discount stores at low prices, not in bike stores at prices above $100. Do not spend more on a super-vented, fashionable helmet, since it will have harder foam to make up for those vents.

Remember that the blow that might only stun another person can be fatal for someone with a brain disorder. Helmets are not magic, and they may or may not work for your child. Only your physician can say for sure.

This page was last revised on: September 10, 2007.

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