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Repositioning Techniques for Infants

The American Academy of Pediatrics' "Back to Sleep" campaign, initiated in 1992, has been successful in reducing the occurrence of sudden infant death syndrome (SIDS) – the unexpected and unexplained death of an infant less than 1 year of age. Although lying on their backs is the safest way for babies to sleep, keeping babies on their backs during most of their awake hours can lead to positional plagiocephaly, also known as "flattened head syndrome."

When a baby always lies with his or her head in the same position, or on the same side of the face, the pressure of the head's weight can push the soft bones of the skull against a flat surface – such as the crib or car seat – causing the skull to flatten. Some babies have neck muscles that contract (shorten), causing them to turn their heads to one side when placed on their backs. This condition, called torticollis, also can contribute to the development of flat spots on the head.

Fortunately, by using some simple repositioning techniques, you can help prevent "flattened head syndrome"--and help promote your infant's neuromuscular development.

What is repositioning?

Repositioning involves changing the position of your baby's head while he or she is sleeping and during activities while your baby is awake. Repositioning keeps your baby from always resting on the same area, allowing for a more even distribution of your baby's head weight and helping to prevent flat spots. Changing head positions also helps strengthen the muscles in the neck, which are important as babies begin to hold up their heads and sit up on their own.

Here are some simple tips for repositioning your infant:

While sleeping in a crib, cradle or playpen
  • Infants should be placed on their back for every sleep. Side sleeping is not as safe as lying on the back and is not advised. However, you can change your baby’s sleeping position by alternating your child’s direction in the crib. For example, place the baby’s head at the top of the crib one night and toward the bottom the next night. You also may try changing the baby’s head position — placing the infant to sleep with the head to one side for a night and then changing to the other side the next night.
  • Consider moving your baby's crib to different areas of the room; but be sure not to have your baby's crib always facing a wall. Babies are attracted to light and will try to turn their heads toward a window.
  • Once your baby is asleep, gently move his or her head to the non-preferred side (away from the flattened area).
  • Try placing a mobile on the side of the crib or playpen to encourage your baby to look in that direction.
During playtime
  • Be sure your baby gets plenty of supervised "tummy time" when he or she is awake. Tummy time gives your baby's head a rest, and encourages the use of arm, leg and neck muscles, which helps to strengthen them. The more time your baby can spend playing on his or her tummy, the better.
  • Try to reduce the amount of time your baby spends in car seats, carriers, swings, high chairs and other devices that allow your child to rest on the back of his or her head.
  • If your baby has torticollis, your doctor may teach you some home exercises that can help stretch and massage your baby's contracting neck muscles.
While feeding
  • Alternate the arm you use to hold your baby while bottle or breastfeeding.
  • When feeding, encourage your baby to turn his or her head away from the preferred side.
Additional tips:
  • You can use soft pillows or rolled-up towels to hold your baby's head in position while in a car seat or carrier. Some companies make specially designed pillows to help hold the baby's head in the preferred position. Be sure to first ask for your doctor's advice.
  • Change your baby’s diapers from the side. This encourages the baby to turn his or her head to look at you.
  • Try using a front carrier rather than a car seat/carrier when you go out with your baby--and even around the house. Babies enjoy being held.
References

American Academy of Pediatrics.
Healthy Children. Ages & Stages. Your Baby’s Head.
www.healthychildren.org/English/ages-stages/baby/pages/Your-Babys-Head.aspx.
Accessed 10/5/2010

National Institutes of Health.
Eunice Kennedy Shriver. National Institute of Child Health and Development.
Questions and Answers for Professionals: Questions and Answers for Professionals on Infant Sleeping Position and SIDS.
www.nichd.nih.gov/sids/sids_qa.cfm.
Accessed 10/5/2010

© Copyright 1995-2010 The Cleveland Clinic Foundation. All rights reserved.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/5/2010...#10691