10 Pediatric OT + PT Approved Tips to Help Prevent Flat Head Syndrome in Babies
By Kelsey Baker, MS OTR/L, CLC, CST
As a pediatric OT, I’ve worked with many families concerned about flat head syndrome (also called positional plagiocephaly or brachycephaly). While it’s common and treatable, prevention is key—and thankfully, there are simple ways you can help your baby build a beautifully round head and strong motor foundations from day one.
Flat head syndrome—medically known as positional plagiocephaly or brachycephaly—is a common condition in infants characterised by flattening of one part of the skull due to prolonged pressure on that area. While placing babies on their backs to sleep is crucial for preventing SIDS, it can also increase pressure on the same part of the head, especially if that position is maintained for long periods.
Here are 10 tips to help you keep your baby’s head shape healthy:
In the majority of cases, cranial molding can be prevented with early movement at home, and therapy if needed!
1. Prioritize Tummy Time—Early & Often
Tummy time places your baby in a supervised prone position while awake, encouraging strengthening of neck, shoulder, and trunk muscles, both are critical for both head shape and developmental milestones.
Research suggests that targeting a cumulative 30 minutes of tummy time per day (broken into short, engaging sessions) helps decrease the risk of flat spots forming.
Tip: Begin right from the newborn period with just a few minutes at a time, using playful interaction and safe surfaces.
Why this matters: Adequate tummy time supports overall motor growth, feeding readiness, and reduces flattening caused by sustained supine pressure.
Related: Learn more about why movement is essential for your baby’s brain development to understand how early motor experiences shape the nervous system.
2. Switch Up Head Positions During Sleep
While babies should always sleep on their backs (per safe sleep guidelines), you can gently turn their head to alternating sides at each nap or bedtime to avoid pressure on the same spot. Supervised tummy time naps are also SO helpful for nervous system regulation, digestion, and neck mobility!
Passive tummy time with baby’s head turned fully to the side, sucking on a pacifier has more benefit than you’d think as well — just be sure you’re alternating sides and of course, using a cylindrical (think Avent Soothie) or Ninni Co. pacifier!
The key is to get their head turned fully to the side, and next opportunity make sure they’re getting equal mobility to the opposite side.
Tip: Place a visual cue (like a black-and-white card or interesting toy) on the opposite side of the crib to encourage head turning.
3. Limit Time in “Containers”
Car seats, swings, and bouncers are helpful in moderation—but extended time in them can increase pressure on the back of baby’s head.
OT Tip: Try to balance “container time” with more floor time throughout the day.
Ideally, we want equal amounts of time on their back, belly, right side, and left side throughout the day!
4. Use Babywearing to Free the Head
Wearing your baby in a carrier gives them closeness, promotes sensory development, and keeps pressure off the head. Just don’t forget to help them turn their head to alternating sides so they don’t develop a preference for just one position.
Bonus: It also helps reduce fussiness and supports bonding!
5. Alternate Sides During Feeding
Whether you’re breastfeeding or bottle-feeding, switch arms regularly. This not only supports symmetrical muscle development—it also encourages head turning to both sides.
Elevated side-lying and other guided feeding positions support both feeding efficiency and head turn practice.
Note: It’s also the preferred bottle-feeding position for infant feeding therapists, and we wish everyone would adopt it.
6. Encourage Visual Tracking
Use toys or high-contrast cards to help your baby follow with their eyes and turn their head side to side.
This builds neck strength, supports visual development, and helps avoid favoring one direction.
7. Provide Supervised Side-Lying Play
Side-lying is a wonderful position for babies! It encourages midline awareness, reduces pressure on the back of the head, and prepares babies for rolling.
Tip: Use a small rolled-up towel or nursing pillow to support behind their back.
8. Watch for Favoring One Side
Does your baby always look to the right? Or prefer turning their head one way? Or are always curved to one side when you lay them down? This could be an early sign of torticollis, which can contribute to head shape differences.
If you notice this, reach out to your local OT or PT as soon as you can — the sooner we get started the less time intervention is typically needed! The longer you wait, the longer it will take to help get their bodies and heads back to symmetry.
Head shape concerns are usually fairly easy to address in the first 3 months of life, doable in month 3-4, and more challenging beyond that and a helmet may be required around 6 months if the head shape difference is significant (while also participating in therapy to address the tension and movement patterns that led to the flattening in the first place!) so please don’t wait if you’re having concerns!
9. Rotate Crib and Changing Table Orientation
Babies often turn their heads toward light, people, or stimulation.
By occasionally switching their sleeping or diapering direction, you’ll help them turn their heads evenly to both sides.
10. Trust Your Instincts—And Seek Help Early
If you’re concerned about your baby’s head shape or movements, you are not alone. Early intervention makes a big difference. Specialized Pediatric OTs and PTs are trained to support you with head shape, positioning, and early motor development.
Remember: You’re not doing anything wrong—babies are just little creatures of habit and have their preferences from in-utero positioning, fascial strain, and birth impact.
With a few small tweaks, you can support their growth and development beautifully.
If your baby does need a helmet, please seek therapeutic support alongside the cranial molding process for best outcomes!
In Summary:
Small, consistent changes in your daily routines can have a big impact on your baby’s development and head shape. Prevention is about balance—giving baby a variety of positions and opportunities to move, turn, and explore.
If you’re ever unsure, don’t hesitate to reach out to a pediatric OT or PT near you.
