Many parents feel as though their baby went to sleep with the most beautifully round head and then woke up the next morning to discover that their baby’s head was no longer perfectly round but a little flat on one side. This can understandably cause concern, but it is actually very common. Of course, it does not happen overnight but develops gradually over time.
Some babies may have experienced pressure while in the womb or may have been delivered with the assistance of a vacuum extractor, resulting in an asymmetrical head shape from birth. This can lead to uncertainty about whether their head shape will ever become more symmetrical.
So, what is an asymmetrical head shape? What should you look out for, and how can you gently support your baby using insights from research and clinical practice to encourage healthy head shape development? We will explore that in this article.
Why Do Some Babies Develop an Asymmetrical Head Shape?
In most cases, this is what is known as positional plagiocephaly. It typically develops when a baby’s head is exposed to uneven pressure or positioning over time, or due to tension and tightness in the muscles and fascia (the body’s connective tissue) that connect the body and head.
A baby’s skull is incredibly soft and mouldable, which is completely natural and allows the head to pass through the birth canal during delivery. Afterwards, this flexibility remains important because the brain grows rapidly during infancy and requires space within the skull to expand and develop.
However, this also means that the shape of the head can change depending on how the baby lies and moves.
There is rarely a single cause. Instead, several factors often contribute:
- A preference for looking to one side
- Tension in the neck or body
- Limited variation in positions throughout the day
- Spending a lot of time lying on the back in the same position
- Premature birth
- Twins sharing the tight womb space
What Should You Look Out For?
Many parents worry that their baby either has or is developing an asymmetrical head shape. Some even invest in apps to monitor their baby’s skull development, but there are several signs you can look for yourself.
Signs of an asymmetrical head shape may include:
- Your baby frequently looks to the same side
- Your baby usually sleeps with their head turned to the same side
- Your baby is easiest to carry in one particular position or on one specific arm
- During tummy time, your baby mostly looks, tilts, or rolls towards one side
- Your baby becomes upset, cries, or resists when their head is gently turned to the opposite side
- Your baby quickly returns to their preferred side after you reposition their head
- Your baby consistently chooses to look away from the side where you attract their attention with light, sound, or toys
- Flattening on one side of the back of the head
- Uneven ear positioning
- Mild facial asymmetry, where one eye may appear larger than the other, or the forehead protrudes more on one side
Can I Check My Baby Myself?
In addition to observing the signs above, you can gently turn your baby’s head when they are in a deep sleep to see whether there is any resistance to movement, even while they are relaxed.
When your baby is awake, you can actively encourage them to turn from side to side by talking to them and gently stroking their cheek, first from one side and then the other.
You can also take photographs of your baby:
- From above: to see whether the head is equally rounded on both sides at the back, whether the ears are aligned, and whether the forehead protrudes equally on both sides. You may find it helpful to place your index fingers beside the ear openings when taking the photo, as a young baby’s ears can be difficult to see.
- From the sides: to compare the profile on both sides.
- From below: to see whether the cheeks and forehead protrude equally (this can be a little more difficult).
If your baby is a newborn, you may repeat this once a week. For older babies, once a month is usually sufficient.
Five Quick Things You Can Do Yourself
1. Create Variety Throughout the Day
- Alternate sides when carrying your baby
- Vary your baby’s positions throughout the day
- When picking your baby up, roll them gently onto their side first, then lift them. Remember to do this from both the right and left sides.
2. Limit Prolonged Time in One Position
Allow your baby to spend as little time as possible in car seats, bouncers, or other baby equipment where they cannot move freely and where pressure is placed on the back of the head.
3. Prioritise Floor Time and Tummy Time
Daily tummy time helps strengthen your baby’s body, supports motor development, and reduces pressure on the back of the head.
Remember to encourage your baby to look in both directions, especially when they are very young. As your baby grows and becomes more interested in faces and toys, you can actively encourage them to turn towards both sides.
Floor time allows your baby to move freely. If your floor is cold, use an insulating mat and, if possible, place your baby in a draught-free area.
If your baby dislikes tummy time, try offering it more frequently but for shorter periods. You can roll your baby onto their tummy during each nappy change, alternating sides each time. You can also place your baby on your legs, across your forearm, or on your chest.
Remember: anything is better than nothing. Find what works best for your family.
If needed, seek guidance from a paediatric physiotherapist, osteopath, or chiropractor.
4. Encourage Activity from Both Sides
Talk, play, and position toys on the side your baby does not naturally prefer.
5. Alternate Sides During Breastfeeding or Bottle Feeding
This naturally creates variation in movement patterns and helps vary pressure and tension around your baby’s head and neck.
When Should You Seek Professional Advice?
- If your baby’s head shape is asymmetrical from birth and does not noticeably improve within the first 2–4 weeks
- If the asymmetry becomes more pronounced over time
- If your baby clearly prefers or only uses one side
- If, despite your efforts, your baby cannot comfortably turn their head to both sides
- If your baby becomes distressed or uncomfortable when you gently turn their head
In these situations, it may be helpful to have your baby assessed by one of Q Clinic’s paediatric practitioners. We have extensive experience and specialised training in working with babies and children.
How Can Osteopathy Help?
The aim of treatment is to support your baby’s freedom of movement so that the skull is exposed to less one-sided pressure and tension.
By improving mobility throughout the body, your baby is given the opportunity to move more freely and develop greater symmetry. This may support more varied movement patterns and help reduce uneven loading of the skull.
Q Klink’s paediatric osteopaths provide gentle, individualised treatment tailored to each child and can offer practical strategies for everyday life if you feel your own efforts are not enough.
An Important Point
Recent research shows that positional plagiocephaly is a common condition during infancy and that early intervention through varied positioning and movement may have a positive effect on head shape and overall function.
You are not to blame if your child has an asymmetrical head shape. In most cases, it is harmless and temporary, and small changes in daily routines can make a significant difference over time.
Written by Didde Thorsted as part of a collaboration with Tuttelu nappies.
