Babies may exhibit a preference for turning their head to one side, with a number of potential influencing factors, some of which include:
The womb is a tight place! Add complications like atypical positioning (i.e., breech, or OP/sunnyside up) and this may cause baby to have their head turned in the womb, and a tight neck upon delivery.
Birth trauma, use of medical interventions. Any time there are interventions, such as forcepts or vaccuum-assisted delivery, there is an increased risk of head turn preference.
Limited opportunities for baby to move their body freely. This may be due to parents not receiving adequate education for the benefits of floor time and risk factors with extensive container use (e.g., carseat, infant swings, swaddling).
Positioning and habits. If baby is always held in the same arm, or fed on the same side, or always placed in the bassinet or on the changing table with their head in the same direction- this can lead to side preference.
In some cases, babies will overcome a head turn preference as their neck becomes strong and they gain control over their movements. However, other times the asymmetry becomes more and more severe, and starts to interfere with feeding and development.
Prolonged time with the head rotated to one side can impact reflex patterns, muscle tone, and movement for later function (Dunsirn et al; 2016).
Where to Start if you notice your baby has a side preference.
Be mindful of holding baby in each arm.
If bottle feeding, alternate with hand you feed with.
Alternate positioning on the changing table and when laying baby in their bassinet.
Provide daily floor time while encourage head lifting and turning to each side.
Impact of Head Turn Preference on Breastfeeding
When babies have a side preference, they often prefer the breast that accommodates the head turn. When nursing on the non-preferred breast, mothers may experience challenges with latching, such as baby crying or refusing to latch, shallow latch, maternal pain, nipple trauma, recurrent plugged ducts, or decreased milk supply on that side. Baby may have poor mechanics for the non-preferred side, exhibiting more "chompy" feeding behavior.
As a temporary solution, exploring different breastfeeding positions can significantly improve comfort for both mother and baby while nursing on the non-preferred breast. For instance, using a cradle hold on the preferred side, and then sliding baby into a football hold on the non-preferred side. However, it is important to also seek help to address the root cause and not only compensate.
Effects of Head Turn Preference on Oral Function & the Body
When babies favor turning their head to one side, the muscles linked to the back of the head, neck, jaw, and throat are all drawn in one direction, including the tongue. This tension not only hinders proper muscle function for feeding, but can also compress nerves that direct feeding reflexes. This is a concern, because reflexes are paramount to babies learning how to breastfeed in the early months. Additionally, consistently turning the head to one side results in uneven muscle development throughout the entire body, affecting baby's posture, trunk stability, strength, and more. The ability to move the entire body freely- head, neck, hips, and extremities- is vital for feeding skills (and development, but you already knew that!)
Therapeutic Approaches and Bodywork
If a baby displays a head turn preference, and simple at-home activities are not helping, you may require more support. Often, the root of the tension lies somewhere further down baby's trunk, which tells us that treatment will involve more than neck exercises. Therefore, a comprehensive assessment and treatment plan addressing the entire body are essential. Therapy and bodywork collaborate to lengthen and strengthen muscles, promote body symmetry, and engage the sensory systems and body reflexes to promote a better movement repertoire that will help baby sustain their newfound range of motion. Early intervention is key if your baby shows a side preference, as prompt action can shorten the treatment duration. Adopting a wait-and-see approach may lead to further complications, such as changes in head shape.
Nourish Therapy is based in Poulsbo, Washington and providers in-home services across Kitsap County and Gig Harbor. We specializes in holistic and integrative whole-body feeding therapy. While our primary aim is to support families in feeding their babies, we understand that oral motor therapy has to be paired with bodywork and body therapy for best results. We also collaborate with other healthcare providers when complex symptoms warrant it. Schedule a free phone consult if you have questions about
References
Dunsirn S, Smyser C, Liao S, Inder T, Pineda R. Defining the nature and implications of head turn preference in the preterm infant. Early Hum Dev. 2016 May;96:53-60. doi: 10.1016/j.earlhumdev.2016.02.002. Epub 2016 Apr 8. PMID: 27064959; PMCID: PMC4867076.
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