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Safe sleep and how to prevent neck muscle and head shape problems

In what position should my baby sleep?

The safest way for a baby to sleep is alone, on their back, in a crib. Do not put anything in the crib with your baby. This is the best way to help reduce the risk of Sudden Infant Death Syndrome (SIDS). Some babies may have health problems and need to sleep in a different position. Talk to your baby’s doctor or nurse about the sleep position that is best for your baby.

How will sleeping on the back affect my baby?

Babies are born with a habit of turning their head to one side. During the first few weeks of life, a baby’s head may be flatter on one side or at the back. This may go away on its own if you turn your baby’s head during sleep and put them on their tummy when awake.

Neck muscles can also get tight if babies do not turn their head to the right and left. Changing the position often will help the head to be a more even and round shape. Turn your baby’s head to the left on one day and to the right on the next day.

If it is hard to turn your baby’s head from side to side or if your baby really likes one side over another and this lasts over a month, talk to your baby’s health care provider. Your baby may need physical therapy to help their head be more rounded or help balance the use of their neck muscles.

Why is tummy time important?

Your baby may develop a flat head and tight neck muscles if too much time is spent on their back. Careful positioning helps keep your baby from resting on the back of their head too much. Babies need tummy time every day starting the day they are born. This will help develop back, neck, and shoulder muscles in order to roll, sit, crawl, and walk. Tummy time also helps babies use their eyes and hands together to play and learn. How can I make tummy time happy? Supervise tummy time when your baby is awake and ready to play. Start tummy time on baby’s first day of life. Time spent on tummy should be happy. Start with 2 to 3 minutes at a time. Slowly work up to a total of at least 60 minutes per day by the time your baby is 4 months old.

Tummy to tummy: Sit in a comfortable chair so you are leaning back a little. Put your baby on your chest so you are face to face and talk, sing, and smile at your baby.

Smiles face to face: Lay down on the floor so that you are face to face with your baby. Talk to and play with your baby. You can also use a mirror or bright colored toy to make tummy time more fun.

With a little help: Use a small blanket as a roll and put it under your baby’s chest and arms.

Tummy carry: Hold your baby on their tummy across your cradled arms. Snuggle your baby close.

Remember your baby should always be supervised when on their stomach!

How do I keep my baby from getting a flat head and tight neck muscles?

Babies up to 4 months of age have softer heads. Their heads may get flat from too much time spent on their back or in baby equipment such as a car seat, swing, bouncy seat, etc. Look at your baby’s head from the top down to check for any flatness. Use car seats only for riding in the car. Use swings and bouncy seats for short periods of time. If you notice your baby’s head seems flat or their neck is tight, talk to your baby’s doctor. You may be referred to a pediatric therapist who specializes in treating babies with tight neck muscles.

ALERT: Call your child’s doctor, nurse, or clinic if you have any concerns or if your child has special health care needs not covered by this information.

This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up