My baby has a preferred head position, What now?

What Causes This?

The increase in preferred head positions among infants is partly due to modern advice: parents are encouraged to place their babies on their backs to sleep, which helps prevent SIDS (Sudden Infant Death Syndrome). However, this means babies spend more time lying on their backs than previous generations.

Often, the cause of a preferred head position is unknown. In that case, its called idiopathic positional preference. This can reinforced by habits such as always feeding or approaching your baby from the same side.

In some cases, there may be an identifiable cause. That is why the child health clinic or pediatric physiotherapist will always carryout a thorough assessment to rule out any underlying medical issues.

What Are the Consequences for My Child?

Fortunately, a flattened or asymmetrical head is usually only a cosmetic issue and typically does not affect your baby’s health. Still, it is important to try to correct the head preference. If it persists too long, it can impact the development of the neck muscles and even delay motor milestones. Once the head position corrected and your baby starts turning their head to both sides, the flattening will often reduce on its own. At this age, your baby’s skull is still soft and flexible — the sutures and fontanelle have not fully closed yet — so the head shape can still return to normal.

What Can I Do at Home? Some Tips:

• If you are bottle-feeding:

Alternate the arm you use — sometimes feed on your right arm, sometimes your left, also try placing your baby on your lap, facing you, with your feet supported.

• For sleeping:

Position your baby in bed so their head turned alternately to the left and right. If your baby turns back during sleep, gently reposition their head toward the non-preferred side.

• In the nursery or bedroom:

Pay attention to your baby’s environment. There may be a reason they always turn to one side — for example, a light source or noise. If your baby sleeps in your room, make sure they are not always facing toward you.

• Tummy time:

Encourage frequent tummy time — always under supervision. Try placing your baby on their tummy 6–7 times per day and play with them in this position. In the beginning, your baby might tolerate this only for short periods, but you can gradually increase it each day.

Is Pediatric Physiotherapy Necessary?

If you suspect your baby has a preferred head position, feel free to contact one of our pediatric physiotherapists. They can offer personalized tips and guidance to support your baby’s motor development.

PCM Measurement

We can perform a PCM measurement to determine the degree of flattening. This involves gently measuring your baby’s head with a soft band. Based on this, we can assess whether further treatment is needed.

If the preference is mild and you are comfortable following the advice, the physiotherapist will continue monitoring your child’s development — usually up to around 6 months of age.

Helmet Therapy

Many parents worry whether their child will need a helmet. Opinions on this treatment vary. Research has shown that in healthy babies with a flat head, pediatric physiotherapy is more effective than helmet therapy.

Currently, helmet therapy only considered if your baby still has a severe flattening with positional preference at around 6 months of age. Even then, the decision — in consultation with your pediatrician — is up to you as the parent.