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.

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

Start tummy time from day one (even if just for a few minutes at a time). Tummy time strengthens neck, back, and shoulder muscles—and gives the back of the head a break.

Try: Tummy time on your chest, a rolled towel, or a tummy time pillow.

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 is also the preferred bottle feeding position for infant feeding therapists and we wish everyone would do 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. We’re here to help!