What Lies Behind Your Baby’s Positional Preference

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You may have already noticed it: your baby almost always lies with their head turned to the same side. While sleeping, feeding, awake. When you gently turn the head to the other side, it comes straight back, like a compass searching for its north. Your first thought: is this normal? Will it sort itself out? And what does it mean for my child?

What Is a Positional Preference?

A positional preference, also known as a neck tilt or, in medical terms, torticollis, means that a baby has a clear favourite side. They prefer to turn their head in one direction and avoid the other. This is more common than many people think. And it almost always has a physical cause.

Newborns spend months in a tight, often asymmetrical position in the womb. Then comes the birth itself: pressure on the skull, traction on the neck, sometimes a very fast or very long labour or an intervention such as vacuum or forceps extraction. All of this leaves traces in the tissue; in the neck musculature, in the joints of the cervical spine, in the fascia that holds everything together.

The baby does not turn their head to one side out of habit. They turn it to where they feel less resistance.

What the Research Shows

It is now well established that births involving obstetric interventions can cause functional disorders in newborns. The University Clinic for Gynaecology at the Inselspital Bern recognised this early and became one of the first clinics in Switzerland to develop a targeted programme: Wellcome.

Newborns who came into the world via vacuum or forceps extraction, or secondary caesarean section, and who showed signs of pain, restlessness, feeding difficulties or restricted neck mobility, received manual therapy during their hospital stay. The results of the pilot study were encouraging: parents reported improvements in their children’s feeding behaviour, digestion, mobility and general ability to settle. The programme was experienced by both parents and clinical staff alike as a valuable form of support.

These findings confirm what I observe every day in my practice.

What I See in My Practice

When parents come to me with a baby that clearly prefers one side, I first look at the bigger picture: how does the baby hold their whole body? Do they pull one shoulder up? Do they lie in a slight banana shape? Do they only turn to one side when feeding?

Because a positional preference is rarely isolated. It is often the visible expression of a chain: tension in the neck musculature pulls on the shoulder, the shoulder influences the diaphragm, the diaphragm affects abdominal pressure and suddenly it becomes clear why the baby always prefers the same side when sleeping, feeding and kicking.

I then look at: how freely do the upper cervical vertebrae move? What is the tension like in the sternocleidomastois, the muscle connecting the neck and shoulder? How does the tissue respond to gentle contact?

Why Acting Early Matters

A baby that consistently turns their head to the same side in the first weeks and months is placing one-sided strain on their body. Every day, for many hours. This can have consequences that are initially invisible:

The skull deforms: When a baby always lies on the same side, the pressure creates a flattening, the so-called plagiocephaly. The skull is still very malleable in the first months of life. What becomes established now may need to be corrected later.

Oral motor development becomes uneven: A baby who always turns in one direction also trains the jaw, tongue and swallowing pattern one-sidedly. This can later affect speech development and chewing.

The spine and motor development follow a one-sided path.
What begins in the neck continues downward, into the thoracic spine, the pelvis, the hips. The baby trains one side of the body more strongly than the other, which influences the entire course of motor development: rolling, crawling, standing. All of it builds on a symmetrical foundation.

This may sound like a lot, and I say it not to cause alarm. But because I know: the earlier you look, the more gently and quickly something can be changed. Often a few simple exercises at home and a little therapeutic support are all it takes.

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Newborns spend months in a tight, often asymmetrical position in the womb. Then comes the birth itself: pressure on the skull, traction on the neck, sometimes a very fast or very long labour. All of this leaves traces in the tissue; in the neck musculature, in the joints of the cervical spine, in the fascia that holds everything together. Your baby does not turn their head to one side out of habit. They turn it to where they feel less resistance.

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