Baby Head Preference and Torticollis: A Parent's Guide

Many parents notice it around the second or third month: the baby always looks to the right, feeds more easily on one side, or the head seems to be turning toward the same shoulder in every photo. It is very common, and in most cases it is not a sign of anything serious. Still, it is worth understanding what you are seeing, because noticing it early gives you more options.

This guide explains head preference in plain language, how it differs from torticollis and a flattened head, when to speak to your pediatrician first, and what you can do at home. It is general information and does not replace a medical assessment of your own baby.

What Is Head Preference and How Do You Notice It?

Head preference means that a baby rests or turns the head toward one side much more than the other. Signs parents often describe include:

• The baby turns the head to the same side when lying on their back, and resists turning to the other side.
• Feeding is easier on one breast, or with the bottle held on one side.
• The baby tracks a toy or a face easily to one side but stops at the middle line on the other.
• One side of the back of the head looks flatter, or one ear seems pushed forward when you look from above.
• The baby fusses when placed in a position that forces a turn to the less comfortable side.

Newborns spend most of their day lying down, and their skull is soft and still growing. If the head rests on the same spot hour after hour, that spot can gradually flatten. That is why a small preference can become more visible over weeks.

Congenital Torticollis, Positional Preference and Flat Head: What Is the Difference?

These terms are often used together, but they describe different things:

• Positional head preference: the baby simply favors one side, often because of how they lay in the womb, how they are held or how they are placed to sleep. The neck can usually still move fully in both directions.
• Torticollis: the neck muscles on one side are tighter or shorter, so the head tilts to one side and turns to the other, and the movement is limited. Sometimes a small firm lump can be felt in the neck muscle. It is sometimes present from birth.
• Positional plagiocephaly (flat head): a flattened area on the back or side of the head that develops from prolonged pressure on the same spot. It can follow either of the above, and the two often appear together.

Telling them apart needs a physical examination. A parent cannot reliably do it at home, and that is exactly why a professional look is useful. Pediatric hospitals describe flat spots as common and usually harmless to the baby's development, and they stress that early attention to neck movement matters.

When to See the Pediatrician First

The pediatrician is always the first stop. Please book a visit, and do not wait for the next routine check, if you notice any of the following:

• A lump or firm swelling in the neck muscle.
• The asymmetry of the head or face seems to be getting worse over time.
• The baby cannot turn the head to one side at all, or the neck looks stiff or tilted all the time.
• Delays in development, such as not holding the head up, not following with the eyes, or not using both arms equally.
• Fever, unusual sleepiness, floppiness, poor feeding, or difficulty breathing. In this case, go to a doctor or the emergency room right away.
• Any other concern. Your instinct as a parent counts.

The pediatrician can rule out other causes, decide whether the baby should see a pediatric physiotherapist, and follow growth and development. Bringing the baby's health booklet from the well-baby clinic (Tipat Halav) to any other consultation is always a good idea.

What You Can Do at Home

Most of the helpful steps are simple everyday habits. They are generally considered low risk, but if you are unsure, ask your pediatrician or well-baby nurse first.

• Tummy time, only while awake and supervised: a few short sessions a day, starting from the first weeks, on a firm surface with you next to the baby. It reduces pressure on the back of the head and strengthens the neck and shoulders. Pediatric guidance, such as the Royal Children's Hospital Melbourne guideline on positional plagiocephaly, notes that regular tummy time helps develop head control. Stop if the baby becomes upset or sleepy. Never leave a baby to sleep on the tummy.
• Safe sleep always comes first: the baby sleeps on the back, on a firm flat mattress, with nothing soft in the crib. Do not use pillows, wedges or positioners to hold the head in place. Within these rules you can vary the direction the baby lies in the crib, for example by changing which end the head is at every few days, so that the baby looks toward the room from different sides.
• Hold and feed on both sides: alternate the arm you carry with, and the side you feed from. Place toys, mobiles and your own face on the side the baby turns to less, to invite gentle turning.
• Vary positions during the day: hold the baby upright, carry them on your shoulder or in a carrier, and limit long stretches in car seats, bouncers and swings while at home.
• Side-lying play while awake: with you present, a few minutes of play on the side can take the pressure off the flat area.

These habits are part of the same simple routine many parents already know from the well-baby clinic, and they are worth doing even if everything looks normal.

Gentle Chiropractic Care for Babies: What It Includes and What Is Not Yet Known

At Dr. Victor Duani's clinic, infant care is built around conversation, a gentle examination with the parents next to the baby all the time, and a plain-language explanation at the end. You can read more about how a visit looks on the page about chiropractic care for babies. The clinics are in Ramat Aviv, Tel Aviv, and in Tuval, near Karmiel.

In a baby with head preference, the examination looks at how freely the head and neck move, how the baby holds their body, and how feeding and positioning are going. Treatment, when it is recommended, is very light and slow, and it aims to help the baby move more comfortably. The first step in the clinic is also to check whether the baby should be seen by the pediatrician before anything else.

It is important to be honest about what we know. The research on chiropractic care for infants is limited and of mixed quality, and no one can promise a particular result. Care may help some babies, and it is not a replacement for medical assessment. It is not presented as a treatment for colic, reflux, sleep problems or any other condition, and no outcome or number of visits is guaranteed. If anything at the visit calls for medical attention, you will be told so.

Working Together with Pediatric Physiotherapy

When torticollis is suspected, a pediatric physiotherapist is usually a central part of the plan. Pediatric guidelines recommend early physiotherapy referral for torticollis, where parents are taught stretching, handling and positioning that fit their baby. Many parents ask whether chiropractic care replaces this. It does not. It can sit alongside it, with the pediatrician and physiotherapist leading, and with everyone informed.

If a physiotherapist, lactation consultant or doula has already suggested a consultation, we are glad to work in that direction and to keep your pediatrician updated, if you would like that.

Frequently Asked Questions

Will the flat spot go away by itself? In many babies it improves as they grow, begin to sit and spend more time upright, but this is not certain, and it is better to ask early. Early attention gives more options.

Is it caused by something the parents did? No. Position in the womb, birth and normal lying time all play a part. Parents are not to blame.

Is it safe to put the baby on the side to sleep? No. For sleep, the baby is always on the back. Side-lying and tummy time are for awake, supervised play only.

Do I need a referral? A referral is not required, but we are glad when parents also update their pediatrician.

How long does a visit take? You can feed or soothe the baby during the visit, and nothing is decided on the spot.

A Note for Expecting and New Mothers

Many mothers who come with a baby are also dealing with their own aches after pregnancy and birth. If this is you, our articles on back pain during pregnancy and pelvic pain in pregnancy may be useful too. Caring for yourself is part of caring for your baby.

If you have noticed that your baby prefers one side and would like to talk it through, you are welcome to message us on WhatsApp. This article is general information and is not a substitute for medical advice. In an emergency, contact a doctor or go to the emergency room.