Head preference in newborns

Have you noticed that your newborn prefers to turn their head in one direction more than the other? Maybe it's a tilt, where the ear drops toward the shoulder or head turn, when the chin drops towards the shoulder. Chances are one or both of those things are present and I want to take a moment today to talk about how we can help support and strengthen their necks so it doesn't turn into a bigger issue.

So, why do babies tend to turn their head to one side or another? It's simply because they're not strong enough to support the weight of their head in the center of the body and because of gravity it will flop to one side or another. As your baby gets stronger they are able to keep their head more centered, this usually happens around 3 months. If this isn't resolving it can be a red flag for Torticollis. Aside from it turning into something more serious like Torticollis, it is also be the cause of a flat spot or flat head. It's estimated that around 20% of babies will develop a mild flattening while a shocking 47% will develop a flat spot. A flat spot can develop anywhere where your babies head is in constant contact with the floor. Developmental specialists are seeing more and more flat spots in babies because parents are using baby containers (rock and plays, bouncy chairs, swings, etc) more than ever before. I have a feeling this is because with the "Back to sleep" movement parents are worried about SIDS. But babies need floor time desperately! Thats how they discover their bodies. So even once your baby has gained control of their neck (usually around 3 months) a flat spot may still develop because of the overuse of baby gear. A safe time period would be no more than 2 hours a day. 

One thing most therapists and developmental teachers know is interconnectedness, this means unaddressed head preference can lead to so many other things. It may lead to decrease use of one arm, decreased visual scanning, unbalanced motor skills and so much more. So what can we do to help our little ones? First its to simply be aware. Look back at pictures and pay attention and see what side your baby prefers. The next things is....tummy time!! You know in My Big Fat Greek Wedding where the Dad puts Windex on everything? Tummy Time is my Windex. There are so many different strengths that are developing during tummy time and this big one here is practicing lifting the head against gravity which builds neck strength. While we're at it why not add in some colorful objects (scarves, toys) and/or sounds (shakers, bells, rattles) in front of their eyes (keep objects 8-10 inches away from face so they don't get overwhelmed) so they can track the objects moving side to side and practice not only working against gravity to lift but to turn their whole head in one direction. Tummy time work is the best and fastest way your baby will discover, learn and get feedback about their body. 

Aside from Tummy Time (check out my post for tummy time tips!) I have a few other tips that can help strengthen the head and neck muscles:

Remember appropriate play is a babys work and these moves should be apart of your everyday actives. While working it's best to have TV/Radio off and be attentive, encouraging and mindful of the work your baby is doing. 

+Rolio - This is a lovely PT move that really allows the baby to freely move their neck from side to side. Baby begins on their back. Bring arms and feet into Happy Baby pose. Guide baby all the way over to one side. You'll wait until baby turns their head and their check touches the floor. Repeat rolling side to side. It's normal to see the head lag in the beginning but the more this is practiced the better baby becomes. Eventually head and torso will move as one. 

+Side Plank/Spinal Twist - Baby begins on back. Lift one leg straight up, then across the midline of the body. Move your hands to their hips to help the stabilize on their side. Baby should be laying on the right or left side. Your hand isn't there to be a weight, but to keep them from rolling to their back. Baby may stack their shoulders (side plank) or they may drop the top shoulder back to the floor (spinal twist). Repeat on both sides and allow baby to stay in this position for as long as they are content. 

+Lay them the other way in cot/bassinet or move bassinet to a new location in the room. Babies like to look at fixed objects so moving them around the room or laying them "upside down" in their bed may stimulate them to move their head. Moving the bassinet next to windows or paintings is especially stimulating.

+Lay them the other way on the changing pad. Babies love to look at you and interact on the changing pad. A great way to strengthen head and neck is to place them the other way (upside down). They'll have to turn the other way to get a look at you. This is also a great mental exercise for you! You place them the same way each time because it's easiest for you to change a diaper, this new way will force your brain and body to talk.

+Change sides when bottle feeding. We naturally change sides during breast feeding but don't usually think about it when bottle feeding. Take the opportunity to feed from your non dominant hand. This will be sure to stimulate both sides of your babies body and give you another mental workout as well! 

Hopefully these are some easy and helpful tips that you can start practicing right away! Feel free to reach out if you feel as though there are larger issue at hand, have any questions or need more support in this area and I can help guide you in the next direction.

Photo: Dr. Monica Wonacott