You notice your baby always looking to the same side. Or you see their head tilted. Perhaps one side of the back of their head has even become a bit flatter. These are signs of a preferred position, something many parents experience. Fortunately, this is usually treatable, especially if caught early.
In this blog you can read all about positional preference in babies: what it is, how to recognize it, what you can do about it yourself and when pediatric physiotherapy can help.
What is a preferred position?
A preferred position means your baby has a strong preference for turning their head to one side. It feels like your baby is "stuck" in one direction. Even if you try to encourage your baby to look the other way, their head often quickly turns back to their preferred direction.
How does a preferred posture develop?
There are several reasons for a preferred posture:
During pregnancy:
- Little space in the uterus (for example with a large baby or little amniotic fluid)
- Long-term posture in the same position
- Multiple pregnancy
During labor:
- A difficult or prolonged labor
- Use of forceps delivery or vacuum pump
- Breech or other abnormal position
After birth:
- Baby lies in the same position a lot
- Stimulation comes mainly from one side (e.g. light, sound, or where parents are standing)
- Tension or tightness in the neck muscles
The most common medical term you may encounter is torticollis, also called "crooked neck." This means that one or more neck muscles are shortened or tight, making it difficult for the baby to move their head freely.
How do you recognize a preferred posture?
As a parent you can quite easily notice signals that indicate a preferred position:
Clear signals
- Headstand: The head is often tilted, with one ear towards the shoulder
- Viewing direction: Baby almost always looks to the same side
- Resists: Baby cries or resists when you try to turn his or her head to the other side
- Flattened back of the headOne side of the back of the head is flatter (plagiocephaly)
- FeedingWhen breastfeeding, your baby may prefer one breast or have difficulty with the other.
Less obvious signals
- Baby always turns to the same side during tummy time
- The face looks asymmetrical
- One eye seems less open than the other
- Baby turns the whole body instead of just the head
NB: If your baby exhibits these signs, make an appointment with the child health clinic or your GP. The sooner a preferred position is addressed, the better.
Why is timely treatment important?
You might be wondering: won't this just go away on its own? While some minor preferences do indeed improve on their own, it's important not to wait too long for this.
Possible consequences of an untreated preferred posture
In the short term:
- Flattened back of the head (plagiocephaly) that can become permanent
- Asymmetry in the face
- Feeding problems (especially with breastfeeding)
- Limited freedom of movement
In the longer term:
- Delayed motor development (rolling, crawling, sitting)
- Posture and coordination problems
- Eye problems (strabismus/crossed eyes)
- Jaw abnormalities
- Neck complaints in later life
Fortunately, these consequences can be prevented if the preferred position is treated promptly. The first few months are crucial, because your baby's head is still soft and malleable, and the muscles are still developing.
What can you do yourself? Tips for home use
If your baby has a slight preference for a certain position, you can do a lot before professional help is needed. Your child's health clinic can advise you on this.
Positioning tips
1. Switch sides on everything
- Place your baby alternately with his or her head on the left and right sides of the bed
- Switch sides when changing
- Carry your baby alternately on your left and right arms
- Switch breasts when breastfeeding, even if one side is more difficult
2. Encourage the “difficult” side
- Place toys to the side where your baby is less likely to look
- Stand on the “difficult” side yourself during care
- Hang a mobile or music box on the side where the baby is less likely to look
3. Provide sufficient tummy time
- Start with short tummy time moments (1-2 minutes) from day one
- Build this up to several times a day, 10-15 minutes at a time
- Only do this under supervision and when the baby is awake
- Make it fun: lie down on the floor yourself, use toys
4. Avoid lying in the same position for long periods of time
- Limit the time in car seats, bouncers and maxi-cosi
- Change your position regularly
- Carry your baby in a baby sling or ergonomic baby carrier
Gentle exercises
With the approval of the child health clinic, you can also do gentle stretching exercises:
- Viewing exercise: Lure your baby to the difficult side with a toy or your face
- Massage: Gently massage the tense side of the neck
- Passive stretch: Place your hand gently on the baby's head and gently move to the other side (stop if there is resistance!).
Important: Only do this after consulting a professional and stop immediately if your baby cries or if it seems painful!
When is pediatric physiotherapy necessary?
Not every preferred posture requires physiotherapy, but in many cases it can make a big difference. Your child health clinic or GP can refer you to a pediatric physiotherapist.
Signs that professional help is needed
- The preferred position persists after 6-8 weeks, despite home exercises
- The back of the head is becoming increasingly flatter
- The baby cannot turn its head to one side at all
- Your baby is in pain or cries a lot
- There is no progress or it is getting worse
- You are unsure about what you can do yourself
How does pediatric physiotherapy work for posture preference?
A specialized pediatric physiotherapist is trained to treat babies with a preferred posture. This is what a treatment plan typically looks like:
First visit: examination and diagnosis
The physiotherapist:
- Reviews medical history (pregnancy and childbirth)
- Examine the mobility of the head and neck
- Checks for tension or tightness in the muscles
- Look at the shape of the head
- Observes how the baby moves and lies
Based on this research, a treatment plan is drawn up, specifically tailored to your baby.
The treatment
Pediatric physiotherapy for preferred posture consists of several elements:
1. Manual therapy
- Gentle mobilizations to loosen the neck muscles
- Stretching shortened muscles
- Stimulating weaker muscles
2. Exercise therapy
- Targeted exercises to increase mobility
- Stimulating motor development
- Work on strength and coordination through play
3. Advice for home use
- Positioning tips specifically for your baby
- Home exercises you can do daily
- Tips for feeding, carrying and sleeping
4. Parental information
- Explanation of the condition
- Instructions on how to perform exercises
- Advice on ergonomic aids if necessary
How long will the treatment take?
The duration of treatment depends on several factors:
- How serious the preferred position is
- At what age should treatment start (the sooner, the faster the results)
- How consistently the home exercises are done
- Whether other factors play a role
In many cases, you'll see significant improvement after just 4-6 weeks. Some babies only need a few treatments, while others require longer-term support. The average treatment duration is between 2 and 6 months.
Results: What can you expect?
The good news is that position preference in babies is generally easy to treat, especially if caught early.
What you can expect:
- Gradual increase in mobility
- Less preference for one side
- Improvement of head shape (in young babies)
- Better motor development
- Less crying and more satisfied baby
- Easier feeding
Tip: Take photos from the side and above at the beginning of the treatment. This way you can easily track progress!
Finding a pediatric physical therapist
Do you want your baby treated for a preferred position? It's important to find a pediatric physiotherapist who specializes in babies and preferred positioning.
What should you pay attention to?
- Specialization: Find a physical therapist with experience with babies and preferred positioning
- Location: A practice nearby is useful for regular visits
- ApproximationThe physiotherapist must handle your baby calmly and patiently.
- Communication: You need to be well informed about what is happening
On Kindenzo.com You'll find an overview of qualified pediatric physiotherapists in your area who specialize in treating babies with a preferred position. You can easily search by postal code, read reviews from other parents, and contact them directly to schedule an appointment.
Reimbursement: will it be reimbursed?
Good news for parents: pediatric physiotherapy is fully covered by basic health insurance for children up to 18 years old. There is no deductible for children.
What do you need:
- A referral from the GP or the child health clinic
- Health insurance (basic insurance)
- Please check whether the physiotherapist has a contract with your insurer.
Frequently Asked Questions
From what age can you start physiotherapy? You can start pediatric physiotherapy immediately after birth. The sooner you start, the faster the results.
Does it hurt my baby? No, pediatric physical therapy for posture preference isn't painful. The physical therapist works very gently and pays close attention to your baby's signals.
How often should I take my baby to the physiotherapist? Initially, this is often once a week, but later this can be reduced. The physiotherapist will determine this based on your progress.
Should I do exercises at home? Yes, home exercises are crucial for success. Your physiotherapist will instruct you in this thoroughly. It doesn't have to take up much time – you can often incorporate exercises into your daily routine.
Can it go away on its own? Some slight preferences do indeed improve on their own, but waiting carries risks. When in doubt, it's always best to seek advice.
What if we are too late and the head remains flat? The first six months are the most important because the head is still malleable. After about a year, the skull hardens more. In severe cases, helmet therapy may be necessary, but this is rare if treated promptly.
Prevention: avoid a preferred posture
Besides treatment, prevention is, of course, even better. Here are some tips to prevent a preferred posture:
- Vary from day one: Change sides consistently at all care times
- Sufficient tummy time: Start immediately and build it up gradually
- Limit time in chairs: Do not stay in a maxi-cosi, car seat or bouncer for too long
- Carry your baby: In a baby sling or carrier with good support
- Be alert: Pay attention to signals and discuss concerns with the child health clinic in a timely manner
Need help? Here are your first steps.
Do you think your baby has a preferred position? Here's what you can do:
- Observe and document: Pay close attention and take photos if necessary
- Discuss it at the child health clinicThey can advise you and, if necessary, refer you.
- Request a referralAt the GP or child health clinic
- Find a specialized pediatric physiotherapist: For example Kindenzo.com Can you find pediatric physiotherapists in your area who have experience with positional preference in babies?
- Start with exercises: Both in practice and at home
- Be patient but consistent: Improvement takes time, but consistency pays off
Conclusion: A preferred posture can be treated well
A baby's preferred position can be a cause for concern, but it's important to know that in most cases, it's easily treatable, especially if you catch it early and practice the exercises consistently.
The combination of professional guidance from a pediatric physiotherapist and daily exercises at home provides the best results. This allows your baby to develop optimally without any lasting consequences from their preferred position.
Don't hesitate too long The sooner you start treatment, the faster and easier the results. The child health clinic and a specialized pediatric physiotherapist are ready to help you and your baby.
Are you looking for a pediatric physiotherapist near you? Then look at Kindenzo.com For an overview of childcare specialists. This way, you can give your baby the best start!