Flat head and torticollis

Why do some babies get a flat head?

A baby’s skull is still soft. When a baby often rests on the same spot, the back or one side of the head can flatten: this is called a positional head deformity, or plagiocephaly.

It has become common since babies are put to sleep on their back, which remains essential to prevent sudden infant death. According to the French National Authority for Health, it has a good outlook and usually improves by around two years of age.

How can osteopathy help?

A baby who always turns their head the same way rarely does so by chance. Tension in the neck, a cramped position in the womb or a difficult birth can make one side more comfortable than the other. The baby then always rests on the same spot of the skull, which flattens.

What I look at

• neck mobility: does your baby turn and tilt their head equally to both sides;
• the shape of their skull and the symmetry of their face;
• their overall posture: back, pelvis, how they lie on their back and on their tummy;
• how they feed, often easier on one side.

What I work on

With gentle techniques suited to infants, I release the tension in the neck, shoulders and back that limits head rotation, and work on overall posture. The aim is for your baby to turn their head freely to both sides.

What you can expect

A baby who moves better varies where their head rests, which lets the head shape improve over time. I also show you simple techniques for home: sleeping set-up, carrying, tummy time, stimulation from both sides. For torticollis, the session complements physiotherapy, which I encourage you to start early if the doctor prescribes it.

And infant torticollis?

A baby who always turns their head the same way may have torticollis: stiffness in the neck that stops them turning their head freely. Torticollis encourages a flat head, since the baby always rests on the same spot.

The French National Authority for Health recommends seeing a doctor promptly if your baby struggles to move their neck, so that physiotherapy can be prescribed early if needed.

My baby always turns their head one way: what should I do?

This is common in the first weeks. Most often it is a positional preference, which fades as the baby becomes more mobile. A few steps to take:

1. Watch them. Do they turn their head both ways when you call them or show them a toy? Do they always tilt their head to the same side? Is the back or one side of their head starting to flatten?
2. Talk to your doctor or paediatrician. Don’t wait for the next check-up if they struggle to move their neck: the doctor checks for torticollis and prescribes physiotherapy if needed.
3. Encourage them on the side they turn less. Talk to them, offer toys and light on that side, and alternate the side you pick them up from and the way you lay them down.
4. Give them tummy time too, while awake and supervised.

Osteopathy can work alongside, to release the tension that makes them prefer one side.

What can I do day to day?

The recommendations rely on freedom of movement:

• always put your baby to sleep on their back, on a firm mattress, with no head wedge, pillow or cot bumper;
• limit time in the bouncer, car seat or swing outside of journeys;
• during awake time, and while you supervise, place them on their tummy and on their side too;
• vary the stimulation: talk to them and offer toys from both sides.