Newborn Concerns

Physiotherapists can help newborns with a range of positional, musculoskeletal, movement and developmental concerns. Some are common and relate to a baby’s position before or after birth, while others are less common and may require closer monitoring or referral.

1) Common positional and musculoskeletal concerns

Some newborn musculoskeletal concerns arise from sustained positioning or limited space in the uterus, sometimes referred to as “packaging” effects. These may be more likely in larger babies, first pregnancies, low fluid, or certain uterine shapes.

• Plagiocephaly (flat head shape)
  Positional plagiocephaly is an asymmetry of the skull, often associated with a preferred head position. A physiotherapist can assess head shape, neck movement, positioning and motor development, and provide practical strategies to support more symmetrical movement and positioning.
  In some babies, further developmental assessment may be recommended where there are persistent asymmetries, movement differences or a higher-risk birth history.

• Congenital muscular torticollis
  Tightness or asymmetry of the neck muscles can cause a persistent head tilt or preference to turn the head in one direction. Physiotherapy may include stretching, strengthening, positioning for play, carrying strategies and parent education.

• Positional talipes and clubfoot
  A baby’s foot may appear turned in or out. Flexible positional foot postures often improve with growth, movement and stretching, while true clubfoot requires orthopaedic assessment and specific treatment.

• Developmental dysplasia of the hip (DDH)
  DDH describes a hip joint that is shallow, unstable or not developing normally. Physiotherapists may support early identification, positioning advice, developmental monitoring and collaboration with orthopaedic services where required.

• General positional asymmetry
  Some babies show a consistent preference to look, rest or move more to one side. Early assessment can help determine whether this is simply positional or whether further monitoring or treatment is appropriate.

Role of physiotherapy:
Early identification, parent education, positioning and movement strategies, maintaining joint range of motion where needed, supporting symmetrical development and helping prevent secondary problems such as persistent asymmetry or delayed motor skills.

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2) Early developmental concerns

Occasionally, newborns or young infants show movement patterns that suggest they may benefit from broader developmental assessment and ongoing monitoring.

These may include:

• persistent whole-body asymmetry

• delayed or atypical early motor patterns

• differences in muscle tone or movement quality

• reduced spontaneous movement or movement variability

• postural or coordination difficulties

• feeding or positioning difficulties where posture, tone or motor control may be contributing

Early assessment can help determine whether development is progressing as expected and whether monitoring, physiotherapy or referral to another health professional may be helpful.

Role of physiotherapy:
Assessment of early movement and postural development, identification of emerging asymmetries or delays, parent guidance, developmental monitoring and timely referral where required.

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3) Less common birth-related nerve or movement concerns

Some newborns present with more significant weakness or movement asymmetry following birth. These concerns are less common but may benefit from early assessment and close monitoring.

Examples include:

• Obstetric brachial plexus palsy (OBPP)
  OBPP can occur when the brachial plexus nerves are injured during birth, sometimes in association with shoulder dystocia. It may present as weakness or reduced movement of part or all of one arm.

  Physiotherapy may help to:

  • maintain joint range of motion

  • prevent stiffness and contracture

  • support recovery of movement and strength

  • guide safe handling and positioning

  • promote symmetrical gross motor development

  • support longer-term function where recovery is incomplete

• Other unusual or asymmetric movement patterns requiring further assessment

Not sure whether your newborn needs physiotherapy? An initial assessment can help clarify what you’re noticing and whether treatment, monitoring or referral is needed. Learn more about our assessments