Why does my baby always turn their head to one side?

A baby who always seems to look in one direction is something our osteopaths regularly see in practice. Often a parent will tell us that their baby has a definite favourite side when sleeping, feeding or lying on their play mat. Sometimes the first thing that draws their attention to it is noticing that one side of the back of their baby's head has started to look a little flatter.

We recently received a lovely review from the parents of a 7-week-old baby who came to The Waterside Practice for exactly this reason. They had noticed that their son favoured lying on one side and were beginning to see a change in his head shape.

So, why do some babies develop a favourite side, when should parents be concerned and what do our osteopaths actually look for?

Why might my baby prefer turning their head one way?

Sometimes it can simply be related to positioning after birth. Babies naturally turn towards things that interest them: faces, voices, light and movement. How they are fed, carried and positioned can all influence the directions they spend most time looking towards.

As osteopaths, we are also interested in a baby's position before they were born. Towards the end of pregnancy, space becomes increasingly limited and some babies will have spent a considerable amount of time tucked or bundled into one side of the uterus and pelvis.

We can't say that a baby's position in the womb is necessarily the cause of a later movement preference, but clinically it is something we are interested in when taking a history. Parents will sometimes tell us that their baby seemed to spend much of the latter part of pregnancy on one side, and after birth they notice that the same baby appears more comfortable turning or curling in one direction.

This is why our osteopaths ask about pregnancy and birth as part of an assessment. We may ask about the baby's position towards the end of pregnancy, whether they were breech, transverse or head down, how labour progressed and whether assistance was required during delivery. It helps us build a picture of their early physical history rather than simply looking at their neck in isolation.

What about torticollis?

Sometimes there is a more defined difference in how comfortably a baby can move their neck.

Congenital muscular torticollis is a recognised condition involving the sternocleidomastoid muscle in the neck. A baby may consistently hold their head tilted or rotated and find it more difficult to turn fully in the opposite direction.

Not every baby with a favourite side has torticollis, however, which is why assessment is important.

When our osteopaths assess a baby, we're not simply looking at which direction their head is facing. We look at how freely they move in both directions, whether there is a consistent preference, how the soft tissues of the neck feel and how the rest of their body is moving.

Why can a flat area develop?

A young baby's skull is naturally soft and mouldable. If they repeatedly rest with pressure on the same part of their head, over time this can contribute to positional flattening.

When this predominantly affects one side it is commonly referred to as positional plagiocephaly. When there is more generalised flattening across the back of the head it is known as brachycephaly.

This does not mean parents should change how their baby sleeps. Babies should always be placed on their backs to sleep in accordance with safer-sleep guidance.

Instead, during awake and supervised periods, there are ways of encouraging babies to spend time in different positions and explore movement in both directions.

What is cranial osteopathy?

Cranial osteopathy is not a separate form of osteopathy but a particularly gentle approach that some osteopaths incorporate into their treatment.

The cranial approach originated with American osteopath William Garner Sutherland in the early twentieth century. Sutherland was a student of Andrew Taylor Still, the founder of osteopathy, and began developing what became known as osteopathy in the cranial field.

Today, osteopaths using a cranial approach work with very light contact and subtle manual techniques. This gentle style of treatment is one reason it can be incorporated into osteopathic care for babies.

Despite how subtle cranial techniques can look, our osteopaths who use them are often pleasantly surprised by the changes in movement and function they observe in some babies following treatment. These are clinical observations rather than a guarantee of a particular outcome, and every baby is assessed and managed individually.

How do osteopaths treat a baby's neck?

Understandably, parents often want to know exactly what we are going to do before allowing someone to treat their young baby.

Treatment of a baby's neck is extremely gentle. It is quite different from some of the stronger techniques people may associate with osteopathic treatment in adults.

Rather than taking a baby's neck and trying to stretch it into a position, our osteopaths work within the movement that the baby comfortably gives us. We can gently follow the soft tissues into their available range and, where appropriate, use gentle inhibitory techniques on the small and delicate muscles of the neck to encourage them to relax.

There should be no forcing of the baby's neck through resistance.

Everything is slow and controlled, with the baby's comfort and safety at the centre of the treatment. If a baby doesn't want to move in a particular direction, we don't force them to.

Guiding the body towards better function

One of the reasons babies are such a rewarding age group for our osteopaths to work with is that their bodies haven't had years to establish the patterns we so often see in adults.

An adult may come into the practice with a movement pattern that has developed over months or years. Their body may have adapted around previous injuries, prolonged desk work, repetitive movements, stress and longstanding muscular tension.

A 7-week-old baby doesn't have that same history of chronic muscular change.

From our clinical experience, this can sometimes mean that changes in movement are seen relatively quickly. Rather than trying to force a change, we think of treatment as gently guiding the body towards more comfortable function rather than allowing it to remain stuck in a restricted pattern.

It is one of the things that makes this age group such a pleasure to treat. Treatment itself can be exceptionally gentle, and seeing a baby begin to explore their movement more freely can be incredibly rewarding for both the osteopath and their parents.

What can parents do at home?

Treatment is only one part of the picture. There are simple things parents can do at home to encourage their baby to explore movement and reduce the amount of time spent resting on the same part of their head.

Supervised tummy time is particularly useful. It gives babies time away from pressure on the back of their head while helping them develop their neck, shoulder and upper-body control. For young babies, several short periods throughout the day can often be much more manageable than trying to achieve one long session.

We also encourage parents to think about their baby's environment. If your baby always looks to the right, for example, where are you when you approach their cot or changing mat? Where is the light coming from? Which side do you tend to feed or carry them on?

Placing yourself, toys or other interesting things towards their less-preferred side during awake time can give them a reason to explore movement in that direction. Alternating feeding and carrying positions can help provide variation too.

The important thing is that we're encouraging movement rather than forcing it.

When should I get my baby checked?

If your baby consistently favours one direction, seems unable or reluctant to turn comfortably the other way, persistently holds their head tilted or you notice their head shape changing, it is worth discussing this with your health visitor, GP or an appropriately trained healthcare professional.

There are other, less common reasons for an unusual head shape that require medical assessment, so significant or progressive changes shouldn't automatically be assumed to be positional.

Assessment is an important part of what our osteopaths do. If we see something that we don't think is appropriate for osteopathic management, or something that warrants further investigation, we will refer your baby to the appropriate healthcare professional.

For our osteopaths who regularly work with babies, this is an incredibly rewarding area of practice. Sometimes the treatment itself can look like very little is happening because the contact is so gentle, but that is precisely the point. With such small and delicate patients, treatment is about working with their bodies, not against them.

If you've noticed that your baby has developed a favourite side, isn't turning equally in both directions or you're concerned about changes in their head shape, you can contact The Waterside Practice to discuss whether an osteopathic assessment may be appropriate. We also have a free Osteopath consult call if you would like to speak directly to one of our paediatric Osteopaths: https://thewatersidepractice.janeapp.co.uk/#/discipline/1/treatment/96

The Waterside Practice

01487 209 084

reception@thewatersidepractice.co.uk