Is Your Baby Always Looking One Way? Here’s Why: Understanding Torticollis and Plagiocephaly
Have you noticed your baby always tilting their head to one side, or seeming to look in the same direction most of the time?
If so, they might have a very common condition called torticollis.
As paediatric physiotherapists, we see this often in young babies — and the good news is that with early support, it can be treated really effectively.
What Is Torticollis?
Torticollis happens when the muscles on one side of your baby’s neck are a little tighter or shorter than the other side.
This can cause your baby’s head to:
Tilt toward the tight side
Turn their face toward the opposite side
There are two common types:
Left-sided torticollis: head tilts left, face turns right
Right-sided torticollis: head tilts right, face turns left
It can happen in both boys and girls and is often noticed within the first few weeks or months.
What Causes It?
Sometimes the exact cause isn’t clear, but a few things can make torticollis more likely, such as:
Limited space in the womb (for example, breech position or twins)
A difficult or assisted delivery (forceps or vacuum birth)
Muscle strain or positioning during birth or early newborn life
What Are the Signs?
You might notice your baby:
Tilts their head to one side most of the time
Prefers looking in one direction
Finds feeding easier on one side
Gets upset when you try to gently reposition their head
Seems frustrated when they can’t turn fully
If any of these sound familiar, it’s a great idea to chat with your paediatric physiotherapist or GP.
How Physiotherapy Can Help
Physiotherapy is the first and most effective treatment for torticollis.
We focus on:
Gently stretching the tight neck muscles
Encouraging movement and strength on the other side
Helping your baby develop more even head control and symmetry
This is important not only for neck movement, but also for preventing a flat head.
The Link Between Torticollis and Flat Head (Plagiocephaly)
Babies with torticollis often prefer resting with their head turned the same way.
Over time, this can lead to extra pressure on one area of the skull, which may cause plagiocephaly — a flattening on one side of the head.
By improving your baby’s ability to turn and move their head freely, we can support healthier, more even head shape as they grow.
What Might a Home Program Include?
Your physio will give you simple strategies that fit easily into everyday routines like tummy time, nappy changes, feeding, and play.
Gentle Stretching and Positioning
For left-sided torticollis, we encourage turning the head left and tilting right
For right-sided torticollis, we encourage turning right and tilting left
These are always done gently, often during play or cuddles.
Time Off the Back of the Head
Spending less time lying flat on the back is really helpful for both torticollis and plagiocephaly.
Great options include:
Tummy time
Skin-to-skin time on your chest
Side-lying play
Sitting supported on your lap
Babywearing or being held upright
Basically — any time your baby is off their back helps build strength and reduce pressure on the skull.
Everyday Handling Tips
A few small changes can make a big difference:
Place toys or your face on the side your baby avoids turning toward
Adjust feeding positions to encourage looking both ways
Change the way your baby lies on the play mat
Limit time in car seats, bouncers, or swings (aim for no more than 15–20 minutes at a time when possible)
These simple strategies help your baby move more freely and allow their head shape to develop evenly.
The Bottom Line
Torticollis is very common, and with early, consistent physiotherapy, most babies improve really well.
Early support helps:
Improve neck movement
Encourage symmetrical development
Reduce the risk of ongoing flat head shaping
If you’ve noticed your baby has a head tilt or turning preference, reaching out for an assessment is a great next step.
Early help makes a big difference — and you’re doing the right thing by noticing it.
References:
Torticollis (Infant Congenital Muscular Torticollis)
Rodríguez-Huguet et al. (2023) – Effectiveness of Physiotherapy Treatments in Congenital Muscular Torticollis: A Systematic Review (RCTs included).
Systematic review of randomized controlled trials examining physiotherapy interventions (stretching, manual therapy) for infants with CMT showing benefits for cervical range of motion and neck function.American Physical Therapy Association Academy of Pediatric Physical Therapy (APTA) Clinical Practice Guideline (2024) – Physical Therapy Management of Congenital Muscular Torticollis.
Evidence-based guideline outlining assessment and intervention strategies including positioning, stretching, and activity-based care.
Plagiocephaly & Positional Head Shape
van Vlimmeren et al. (2008) – Randomized Controlled Trial: Pediatric Physical Therapy for Positional Preference and Deformational Plagiocephaly.
RCT showing a standardized pediatric physical therapy program reduced severe plagiocephaly prevalence at 6 and 12 months compared with usual care (JAMA Pediatrics).Lamberta et al. (2024) – Systematic Review: Helmet Therapy for Positional Plagiocephaly.
Comprehensive review of diagnostic tools and treatment outcomes in plagiocephaly; identifies limited high-level evidence and few RCTs in helmet use.Dalla Corte & Rohde (2025) – Systematic Review: Orthotic Helmet Therapy in Plagiocephaly and Brachycephaly.
Recent systematic review showing physical therapy and repositioning strategies often outperform or complement helmet use, with better outcomes when initiated earlier.MdPI Systematic Review (2023) – Effectiveness of Conservative Treatments for Positional Plagiocephaly in Infants.
Physical therapy (including manual therapy and caregiver education) is considered first-line intervention for non-synostotic head shape asymmetry.
Clinical Practice Resources
Royal Children’s Hospital (RCH) Clinical Guidelines – Congenital Torticollis & Positional Plagiocephaly
Expert-endorsed guidelines recommending caregiver education, positioning, and early referral for physiotherapy.