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Tummy Time, Flat head & Torticollis

Tummy time is one of the key elements to a baby's day that sets them up for motor milestone success. In the first month of life, tummy time typically occurs while lying on mom or dad's chest but at some point making that transition to floor time is important. Within the first two months, babies will lift their head off the floor when lying on their tummies and then they start to explore, look around, and even turn from their side to their back, leading with their head. If your child is having difficulty moving his head around to look at the room or presents with a tilt such as the one pictured below, you may be dealing with torticollis. This presentation of head tilt is rarely typical and if caught early is often easy to treat. When children stay in this tilted position for long periods of time and across environments (car seat, pack and play, crib, etc) it can lead to flat head deformities, more formally known as brachycephaly or plagiocephaly.

The bones of a newborn baby's skull are soft and flexible with soft spots you can feel when you touch the top of your baby's head. These spaces between the bones allow the baby's head to change shape and also allow the brain to grow inside the skull bones. They will close as the brain reaches its full size.

There has been some debate over the years if head shape is just cosmetic, meaning that correcting it is only for looks. If these shapes become severe enough, it can lead to ear shifting, permanent skull changes in the forehead, asymmetries in eye shape, and possible face and jaw problems such as TMJ as the child ages. There is some information suggesting increased ear infections as well.

Physical & Occupational Therapists use many strategies to encourage your child's development and to prevent and resolve issues associated with torticollis and flat head deformities.

Treatment strategies your PT and OT will help you and your child with:

1. Massage

2. Passive and Active Range of Motion

3. Strengthening Exercises

4. Positioning and Handling Guidelines

5. Visual Exercises

6. Righting Reactions/Postural Education

7. Environmental Adaptations

Please email Dr. Kim, PT ( with any questions you may have regarding this topic or to set up a free developmental screening.

NEXT UP: Toy and equipment recommendations from birth to 5

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