Repositioning Therapy for Babies: Techniques to Improve Head Shape
Repositioning therapy involves changing a baby's lying and sitting position to reduce head shape deformity. Learn practical techniques and tips for parents.
Repositioning for Babies: Techniques to Protect Head Shape
Quick answer: Repositioning means regularly changing the direction and position of the baby's head during the day and night to prevent constant pressure on the same spot. It is most effective in the first 4–6 months for mild cases. If noticeable asymmetry is increasing, helmet therapy assessment is recommended.
If you have a newborn, you have probably received this golden rule from your doctor: "Always place your baby on their back to sleep." This is unquestionably the safest sleep position because it reduces the risk of Sudden Infant Death Syndrome (SIDS).
However, this safety measure comes with a small side effect: Positional Plagiocephaly (Flat Head Syndrome). If a baby consistently lies on their back with the head turned in the same direction, flattening begins at that point. How can we protect head shape without compromising safe sleep? The answer lies in the art of Repositioning. At CranioWell Orthopedic & Prosthetic Centers, we have compiled techniques you can easily apply at home.
What Is Repositioning?
Repositioning means regularly changing the direction the baby's head faces and varying body position throughout the day (and night) to prevent constant pressure being applied to the same spot on the skull.
The goal is simple: distribute the load. If you share the pressure at the back of the skull equally among right, left, and centre, the head stays round.
The 4 Most Effective Repositioning Techniques
If you try to manually turn the baby's head, they will most likely resist and return to their preferred position. Instead, use the baby's natural curiosity and attraction to light.
1. The Cot Direction Technique (Light and Interest)
Babies naturally love to look toward light (the window) or toward where sound comes from (parents' bed, door).
Situation: If the window is on the baby's right while lying in their cot, they will consistently turn their head to the right.
Solution: Every night (or every other night), place the baby at the other end of the cot (head where the feet usually go).
Result: With the window now on their left, they will naturally turn their head left to see the light — you have changed the direction without forcing it.
2. Feeding Position
Head shape is affected not only during sleep but also when the baby is in your arms.
Breastfeeding: You already alternate breasts, which naturally changes the baby's orientation — this is excellent.
Bottle feeding: Parents typically use their right hand, so they tend to hold the baby in their left arm — consistently pressing the same side of the baby's head. When bottle feeding, switch arms as if you were breastfeeding.
3. Nappy Changing Table Game
Where you stand during nappy changes matters for encouraging head turning.
Do not always approach the table from the same side.
During nappy changes, step to the non-flattened side so the baby turns their head in that direction to make eye contact with you.
4. Carrying Methods (Arms and Baby Carrier)
When carrying your baby at home or outdoors, minimise use of hard plastic "container" devices (bouncers, pushchairs) as much as possible.
Baby carrier / sling: "Babywearing" removes pressure from the skull entirely and is one of the best preventive approaches.
What Repositioning Cannot Do
Repositioning is most effective in the early weeks for mild flattening. However:
If asymmetry is moderate or severe (bone has already changed shape), repositioning alone will not return the skull to a symmetrical form.
If torticollis is present, the baby physically cannot turn their head to the other side — physiotherapy must be added to the plan.
If noticeable asymmetry is persisting or worsening despite 4–6 weeks of consistent repositioning, a head shape assessment at CranioWell is recommended.
