Colin Snow
A newborn's head should be placed in a way that it is facing the head of the crib one night and the foot of the crib the next night. This is because babies tend to turn their heads towards the door or a window, and this practice will give them the flexibility to turn their heads equally in both directions. It is recommended that babies are always placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). However, this can cause flat head syndrome, which is when a baby's head develops a flat spot due to prolonged pressure on one side of the head.
| Characteristics | Values |
|---|---|
| Safest sleeping position | On their back |
| Risk of sleeping on their back | Flat head syndrome |
| Alternative sleeping position | On their side or front |
| Risk of alternative sleeping position | Sudden infant death syndrome (SIDS) |
| How to prevent flat head syndrome | Alternate the baby's head position each time they sleep |
| How to encourage head movement | Use toys or mobiles |
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What You'll Learn
The safest position for a newborn to sleep in
Babies should sleep on their back until they are old enough to roll over by themselves. Sleeping on the back can cause a baby's head to become flattened due to the prolonged pressure on the same area of the head. This is known as flat head syndrome or positional plagiocephaly. It is quite common, affecting about 1 in 8 healthy infants under the age of one. The condition is easily treated and prevented with some simple practices.
To prevent flat head syndrome, it is recommended to alternate the baby's head position in the crib each day. For example, place the baby's head towards the head of the crib one night, and towards the foot of the crib the next night. This will encourage the baby to turn their head in both directions. You can also try placing toys or mobiles on the side of the crib to encourage head movement and more even pressure on the baby's head.
Additionally, it is important to provide supervised "tummy time" for newborns when they are awake. This can be done for 10 to 15 minutes, at least three times a day. This helps to give the baby's head a break from pressure and allows them to move their head freely.
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How to prevent flat head syndrome
Flat head syndrome, or positional plagiocephaly, is a common condition in newborns, affecting 1 in 8 infants under the age of one. It is caused by a baby's soft skull being affected by pressure from lying in the same position for many hours a day, often with their head turned constantly to the same side. While it is easily treated and preventable, it can be linked to problems with the infant's ability to turn their head properly, suck correctly, develop their spine, and experience delays in motor development.
Alternate sleep positions
A simple way to prevent your baby from developing a flat head is to change their sleep position daily. Alternate the position of their crib or cot in relation to your bed, so they don't always have to turn to the same side to look at you. You can also place them in their crib with their head towards the head of the crib one day, and towards the foot of the crib the next day.
Supervised "tummy time"
When awake, babies should spend supervised time on their tummies for at least 30 to 60 minutes a day, in short segments. This helps develop strong neck and shoulder muscles and prevents flat spots. It is best to do this after a diaper change or when the baby wakes up from a nap.
Reduce time spent with their head against a flat surface
Apart from sleep, babies also spend a lot of time in car seats, swings, strollers, and bouncy seats, which put added pressure on the back of their heads. Reduce the time your baby spends in these devices, and take them out of their car seat as soon as a journey is over.
Repositioning
You can gently reposition your baby's head during naptime and bedtime, from right to left, and left to right. You can also influence which part of their head they lie on by changing the positioning of toys hanging above their crib.
Holding your baby
Holding your baby or using a baby carrier is much better than having them constantly lie down. When holding your baby, alternate the use of your right and left arms. You can also use a breastfeeding pillow, which can help prevent plagiocephaly and make both mother and baby more comfortable.
Physical therapy
Most babies with flat head syndrome also have some degree of torticollis, or tight neck muscles, which can be treated with stretches and physical therapy. A physical therapist can teach you exercises to do with your baby, involving stretching their neck to the side opposite the tilt.
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How to treat flat head syndrome
It is recommended that newborns sleep on their backs to prevent sudden infant death syndrome (SIDS). However, this can sometimes cause flat head syndrome, or positional plagiocephaly, due to the baby always turning their head to the same side. This condition is caused by pressure applied to the soft and malleable skull, and it can also occur before birth or in babies who spend a lot of time on their backs due to their medical needs.
If you notice a flat spot on your baby's head, you should consult a paediatric physiotherapist, chiropractor, or osteopath. These professionals can assess your baby for conditions like torticollis and recommend treatments such as tailored exercises to improve neck mobility and encourage symmetrical head shape development. Most babies with flat head syndrome also have some degree of torticollis, which is characterised by tight neck muscles that limit the baby's ability to move their head freely. Simple stretches at home and physical therapy can help improve neck mobility over time.
To treat flat head syndrome, it is important to vary your baby's sleep position and provide plenty of "tummy time". You can do this by placing your baby with their head towards the head of the crib one day, and then alternating towards the foot of the crib the next day. This allows your baby to have the same view while still changing their head position. You can also encourage your baby to look in a different direction by placing a mobile on the side of the crib.
In more severe cases of flat head syndrome, a doctor may prescribe a helmet to help redirect skull growth to the flatter areas. This treatment is most effective when started between 4-6 months, but it can still be effective up to 18 months old. Overall, flat head syndrome improves with time and natural growth, and in most cases, it will not affect a baby's brain growth or development.
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How to encourage your baby to sleep on both sides of their head
It is recommended that babies are always placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). However, this can cause a baby's head to flatten on one side, known as flat head syndrome or positional plagiocephaly. This is because a baby's skull is very soft, and they have weak neck muscles, so they tend to turn their heads to one side when placed on their backs.
To encourage your baby to sleep on both sides of their head, you can try alternating the side of the crib that you place your baby's head on. For example, place your baby with their head toward the head of the crib one night, and then with their head toward the foot of the crib the next night. This will give your baby the practice of turning their head equally in both directions. You can also alternate your baby's head position every 2-3 hours during awake hours, such as feeding time or diaper-changing time.
Another strategy is to use toys to encourage head movement and more even pressure on the whole head. For example, you can place a mobile on the side of the crib facing the room to encourage your baby to look in that direction. You can also try rubbing your baby's head in a circular motion to help shape it.
In addition, it is important to provide supervised "tummy time" when your baby is awake. This can be for 10 to 15 minutes, at least three times a day. This will give your baby's head a break from pressure and allow them to strengthen their neck muscles.
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The link between baby head shape and sleeping position
A baby's skull is very soft and malleable, which is necessary for it to pass through the birth canal. This softness also allows the baby's head to grow after birth and remains flexible throughout childhood, gradually hardening as the child grows. As a result, a baby's head shape can be affected by external factors, including its sleeping position.
Sleeping on the back is the safest position for babies as it opens the airways and minimises the risk of choking. It is also linked to other health benefits, such as a reduced likelihood of developing an ear infection, stuffy nose, or increased body temperature. Research has also shown that sleeping on the back reduces the risk of sudden infant death syndrome (SIDS), where a seemingly healthy baby dies suddenly in their sleep.
However, a side effect of placing babies on their backs to sleep is an increased likelihood of developing a flattened head, or positional plagiocephaly, due to continued pressure on the same area of the head. This is more common in premature babies, whose skulls are softer than those of full-term babies, and who spend a lot of time on their backs due to their medical needs. Flat head syndrome can also develop before birth, due to pressure on the baby's skull from the mother's pelvis or a twin.
To prevent flat head syndrome, it is recommended to change the baby's sleep position each day. For example, placing the baby with its head towards the head of the crib one day, and towards the foot of the crib the next day. Supervised "tummy time" when the baby is awake is also recommended, for 10 to 15 minutes, at least three times a day. These practices can help to improve flat head syndrome even if it has already developed.
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Frequently asked questions
It is recommended that newborns sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).
Flat Head Syndrome, or positional plagiocephaly, is a condition in which part of a baby's head becomes flattened, either on one side or the back of the head. It is caused by a baby sleeping in the same position most of the time or because of problems with neck muscles.
To prevent Flat Head Syndrome, you can alternate your baby's head position each time they sleep. You can also try placing toys on either side of their head to encourage head movement and more even pressure on the skull.
