Prevailing head position to one side in early infancy—A population‐based study

Abstract Aim To determine the prevalence of prevailing head position to one side (PHP) in young infants and to evaluate its associations with reaching performance, neurological condition and perinatal and socio‐economic factors. Methods Observational study in 500 infants (273 boys) 2‐6 months corrected age, representative of the Dutch population (median gestational age 39.7 weeks (27‐42); birthweight 3438 g (1120‐4950). Prevailing head position to one side and reaching performance were assessed with the Infant Motor Profile; neurological condition with the Standardized Infant NeuroDevelopmental Assessment. Socio‐economic information and perinatal information were obtained by questionnaire and medical records. Associations were analysed with uni‐ and multivariable statistics. Results Prevailing head position to one side was observed in 100 infants (20%), and its prevalence decreased from 49% at 2 months to 0% at 6 months. Only in infants aged 4‐5 months PHP was significantly associated with worse reaching and an at‐risk neurological score. Prevailing head position to one side was weakly associated with prenatal substance exposure, post‐natal admission to a paediatric ward and paternal native Dutch background. Conclusion Prevailing head position to one side at 2‐3 months is a frequently occurring sign with limited clinical significance. Yet, PHP at 4‐5 months is associated with a worse functional and neurological condition. Therefore, PHP at 4‐5 months could serve as a red flag indicating possible challenges in later development.