Plagiocephaly and Torticollis management for babies in Perth

What to Do if Your Baby Only Turns One Way

As a physiotherapist who has worked exclusively in pediatrics for over 20 years, I see a lot of newborns. If I had to name the two most common reasons families visit me at the Walky Talky Hub in Perth, it would easily be plagiocephaly and issues with head turning.

When you notice your baby always looking to one side, or you spot a flat area on the back of their head, it is completely natural to worry. You might even find yourself looking at them while they sleep, wondering, "Is my baby's head shape normal?"

First, take a deep breath. Don't panic! It is incredibly common, very easy to miss in those hectic first few months, and highly treatable. Let's break down exactly what is happening, what to look for, and how early physical therapy can get your little one back on track.

Torticollis and Head Turn Preference in Babies

• Congenital Muscular Torticollis: This is a structural tightness present at birth or shortly after, involving the neck muscle (specifically the sternocleidomastoid muscle). It restricts a baby's physical capacity to turn their neck, meaning they are mechanically blocked from moving their head fully to one side.

• Head Turn Preference: This is a strong habit where a baby prefers to look to one side, but they still have the physical ability to turn the other way when properly motivated. This can be caused by mild muscle imbalances, how they were positioned in the womb, or environmental factors like where the light enters their nursery and how they are carried by parents.

The link to a flat spot: Both conditions mean your baby spends the majority of their time resting on the exact same spot of their skull. Because a newborn’s skull bones are soft, and flexible, that continuous, one-sided pressure quickly leads to Positional Plagiocephaly (asymmetrical flattening).

The Most Important Thing to Know: Plagiocephaly is a purely cosmetic condition. Plagiocephaly does not affect your baby’s brain development.

How to tell if your baby has a flat spot

Sometimes these asymmetries develop quickly in the first 6 to 8 weeks as babies build their head control. To check your baby’s head shape and neck movement, look at them from a bird’s-eye view (looking straight down at the top of their head while sitting behind them). Look out for these subtle shifts:

• A distinctly flat spot on one side of the back of the head.

• Ear misalignment: One ear sitting further forward toward the face than the other.

• Facial asymmetry: One side of the forehead or cheek appearing to push slightly forward, or a subtle shift in the appearance of their eyes.

• The Neck Tilt: When their head is in the midline, their ear tilts down closer to one shoulder (often opposite to their preferred turning side). You might also notice they struggle to comfortably latch on one side during breastfeeding.

Can You Prevent or Improve a Flat Spot at Home?

Yes! If your baby has mild plagiocephaly, it often improves naturally as they grow, gain gross motor skills, and spend less time on their backs. The key is repositioning to take the pressure off that flat spot.

Here are four simple, everyday habits we recommend to Perth families:

1. Alternate Sleep Directions: Always place your baby safely on their back to sleep (following safe sleep guidelines). However, try alternating the direction their head faces each night. If they always turn toward the bedroom door or a window light, try placing them at the opposite end of the cot.

2. Supervised Tummy Time: Supervised floor play on their stomach is the ultimate tool. It completely relieves pressure on the skull while strengthening the neck, shoulder, and back muscles your baby needs to roll, sit, and crawl. If your baby cries or struggles to push up on their arms, start with just a couple of minutes several times a day.

3. Mind the "Baby Containers": Car seat capsules, bouncers, swings, and rockers are incredibly convenient, but overusing them can keep continuous pressure on the back of the head. Swap container time for flat floor play or side-lying play using a playpen to keep them safe from pets and siblings.

4. Change Your Carry Habits: As adults, we are creatures of habit! We tend to hold, feed, and carry our babies the exact same way every day. Intentionally alternate the arm you hold them in so they are forced to turn their neck both ways to look at your face or their toys.

When to Seek Professional Support

If you have tried repositioning and your baby still strictly resists turning their head the other way—or if they genuinely cannot physically turn it—their neck muscles need specialised attention.

Be sure to see a physiotherapist experienced in infant development if:

• The flat spot or head turn preference hasn't started improving when you try these simple tips at home.

• Your baby has tightness, tilting, or cannot physically turn their head completely to both sides.

• You notice your baby is missing milestones, like struggling to lift their head during tummy time.

With 20 years of hands-on experience guiding Perth families through early childhood movement, I know how beautifully these conditions respond to early intervention. A tailored plan involving gentle stretches, targeted play exercises, and expert positioning changes usually resolves both issues beautifully.

Join Our Free Torticollis & Plagiocephaly Information Group

You do not have to navigate this alone, and you definitely shouldn't feel guilty. We know how stressful it is to constantly worry about your baby's development, which is why we’ve launched a brand-new, completely Free Parent Information Group.

This group is a one hour information session where you can connect with other local families, and get direct, practical tips from our physiotherapist.