When your baby is born, labour can often cause their head to appear pointy or elongated for a short time. This is normal and usually settles within the first few weeks after birth.

If you have noticed that your baby is developing a flat area on the back or side of their head, it may be due to a head-turning preference and could be a sign of plagiocephaly.

Plagiocephaly is a condition where one side of a baby's head becomes flattened. It occurs when a baby spends a lot of time lying in the same position. As babies' skulls are soft, they can be moulded into a flatter shape. The ear on the flattened side may be pushed forwards and the face may appear asymmetrical.

What causes it?

Tight neck muscles

Your baby may have tight neck muscles and need stretches. These will be taught by your physiotherapist.

Sleep position

Babies spend a lot of time asleep. If your baby always lies in the same position, this can cause flattening on one side of the head.

Prematurity

Babies born prematurely have softer skulls, which are more prone to moulding. They may also have been too unwell initially to be moved frequently.

Lack of tummy time

Although all babies should sleep on their backs, it is important that they spend time on their tummy when awake every day.

Car seats

Prolonged use of car seats means that babies are unable to move freely and may be more likely to develop head moulding.

Try to limit the use of car seats to travelling in the car.

What can I do?

It is helpful to encourage your baby to use different positions so that their head is not always resting in the same position.

Please note: The examples below are for a baby who prefers to turn their head to the right. If your baby prefers to look to the left, reverse the instructions.

• turn your baby's cot so that they need to look to the left to see you approaching
• place interesting toys or a mobile on your baby's left side to encourage them to look that way
• when your baby is on the floor, think about which way they turn to look at the television, window or lights and position them so these are on their left side
• try gently turning your baby's head to the left when they are asleep. They may turn it back again, but any time spent with their head turned to the left is helpful
• set aside time every day to play with your baby on their tummy. Encourage them to look up and especially to the left
• make sure their elbows are underneath their shoulders so they can support themselves. If they are struggling, place a rolled towel under their chest to help
• try not to use a car seat for anything other than travelling in the car. You can place a small rolled towel behind the head support on the right to encourage your baby's head to stay more central
• your baby will benefit from any time spent avoiding pressure on the right side of their head. Try placing them on their left side when they are awake. You may need a cushion behind them to stop them rolling back and an interesting toy in front of them
• when holding your baby against your shoulder, place them on your right shoulder so they need to turn to the left to look around. Your cheek will help stop them turning to the right
• use a baby sling instead of a car seat or buggy where appropriate. This provides a different position and helps reduce constant pressure on one side of your baby's head
• if your baby is bottle-fed, hold them with their head on your right arm and encourage them to look to the left towards their bottle and to see you.