Head shape and positioning

A baby's head is soft and can flatten when it rests in the same spot for a long time. Tight neck muscles (torticollis) can make a baby turn the same way again and again, which adds to the flat spot. Changing your baby's position during awake time is one of the best ways to help.

Safe sleep comes first

• Always lay your baby down to sleep on the back, for naps and at night.
• Use a firm, flat sleep surface with a fitted sheet and nothing else.
• No pillows, positioners, wedges, bumpers, loose blankets or toys in the sleep space. Ever.
• Never use a head-shape or positioning pillow for sleep, not even for a short nap.

A safe sleep space

On the back, on a firm, flat mattress, in an empty crib or bassinet. A wearable blanket (sleep sack) keeps your baby warm without loose bedding.

About positioning pillows

Some pillows are sold to help with head shape. They are not safe for sleep. Use one only if your therapist recommends it, and only during awake time on the floor while you are right there watching. Put it away when your baby gets sleepy, and stop using it once your baby starts to roll.

Tummy time every day

Start with a few minutes at a time, several times a day, while your baby is awake and you are watching. Add a little more time as your baby gets stronger. Get down face to face, or try tummy time on your chest.

Change things up

• In the crib: switch which end of the crib your baby's head goes each night, so your baby turns both ways to look out at the room. Your baby still sleeps on the back.
• On the changing table: change which side you stand on, so your baby turns both ways to see you.
• At feeding time: switch arms for bottle feeds, the way you would switch sides to breastfeed.
• At playtime: put toys on the side your baby turns to less, and talk to your baby from that side.
• When carrying: hold your baby in different positions, as your therapist showed you.

Limit time in baby gear

Car seats, swings, bouncers and loungers all press on the back of the head. Use the car seat for car rides, and take your baby out of gear when you are not on the go. If your baby falls asleep in a car seat, swing or bouncer, move them to a safe sleep space as soon as you can.

When to ask your pediatrician about a helmet

• The flat spot is not getting better after a few weeks of position changes.
• One ear or one side of the forehead looks pushed forward.
• Your baby still has trouble turning the head both ways.

Some babies need a special helmet to guide head growth. Helmets work best while the head is growing fast, so ask early. Your Oaklin Lane physical therapist can also show you neck stretches and positions for your baby.