Positioning Tips for Your Newborn Baby

When babies are in-utero their entire bodies remain in a flexed position with both their legs and their arms pushing against their mother’s uterus as they continue to grow to full term. Once a baby is born we can help babies to feel more secure and continue to develop their strength and muscle tone needed for later motor skills by mimicking this in-utero positioning. This type of positioning is great for all new babies, but is especially important for premature babies.

What should you look for when positioning your newborn baby?

• Keep your baby’s head in the center of his body and his neck in neutral position.
• Don’t let your baby keep his head constantly turned towards the left or right shoulder
• Your baby’s shoulders should be softly rounded
• Your baby’s hips should be in good alignment and gently flexed
• Your baby’s knees, feet and ankles should also be aligned and gently flexed
• Your baby’s elbows can be gently flexed encouraging his hands to touch his face and mouth

Cautions when positioning your new baby

• Do not use pillows, blankets or towel rolls to position your baby unless he is awake and supervised
• Always place your baby to sleep on his back in a basinet or crib free of soft bedding, toys, pillows to prevent SIDS
• Only when your baby is awake and supervised encourage tummy time on a flat surface as well as on your chest to build neck and trunk strength. Do not place your baby to sleep on his tummy to prevent SIDS.

Some positioning ideas for your baby as you supervised his play/awake time during the day:

• Side Lying Position: Alternate placing your baby on his left and right side when he is awake and alert and place a small rolled towel or receiving blanket behind his back to keep him from rolling onto his back. His arms and hips can be gently flexed with his top leg resting over his bottom leg. This position promotes him bringing his hands together and also bringing his hands to his mouth to self-soothe, which are two important newborn developmental skills.
• Nesting: Place your baby on his tummy with his arms and legs tucked under him, hands forward and toward his mouth. You can place a rolled blanket around him for comfort. His head should alternate being turned to the left and right sides and you can gently talk or sing to him as he begins to work on lifting and turning his head and sucking on his hands. Baby must be fully awake and supervised.

• Swaddling: You can find instructions on the internet for different techniques for swaddling your new baby. This means wrapping him very tightly into a blanket which restricts the movement of his arms and legs. You can use swaddling throughout the day to make your baby feel secure and to help soothe him if he is upset, sleepy or crying.
• Containment: Place your baby on his back with towel rolls or receiving blankets on either side of him and under his hips. Or you can place him on his back him in a Boppy donut shaped pillow.

What does my newborn baby like?

• Newborn babies prefer your face and the sound of your voice over most toys at this age so engage with your baby in singing, reading, or cooing face to face with him in these positions
• You can attract his attention with lighted toys, shiny toys and high contrast black and white pictures or objects as well

Be sure to alternate your baby through several different positions during his supervised awake periods during the day so that he is not spending all his time in one position (on his back) with pressure on one spot on his head. This will help to prevent your child from developing a condition called “positional plagiocephaly” which means “flat head” and can lead to infants needing to wear re-shaping helmets in infancy to correct their head shape.

As always, if you have concerns about your baby’s development or especially if your baby was born pre-term you should speak to your pediatrician and also contact your local Early Intervention provider for a developmental evaluation to assess your newborn baby’s skills. If you live in Pittsburgh, PA or the surrounding counties you can contact TEIS for more information 412-271-TEIS.

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