Tips and Tricks- Increasing neck strength and head control

This post is a follow up to my milestone post regarding development of head control.   So here are my tips and tricks on working on head control, but make sure your child is at the appropriate stage of development when you work on increasing their head control and neck strength.

baby head strength

Head rotation

0-2 month olds should be able to turn their heads side to side while lying down.  If you notice your child isn’t looking both ways, encourage them to rotate their head by slowly moving a light-up toy or brightly colored toy within their line of vision to each side to encourage them to turn their heads to follow it.

Neck strength

it’s never to early to start tummy time! :)  A great tummy time activity for newborns is also a great skin to skin activity- simply being on their parents chest on their tummy.  You can alter the angle that they are on their tummy to make it easier or harder.  This position also places your face close enough so they have something interesting to look at while they’re on their tummy.

Neck strength- Pull to sit

As your baby’s neck strength improves, I recommend beginning practicing pulling to sit–>

baby with full head lag and not enough strength to hold head up with pull to sit

I wouldn’t recommend pulling up all the way initially, but begin by pulling up just enough to lift their shoulders a little off the bed to get your child used to the feeling of being pulled up, then gradually pull up higher as you see their neck strength improve.  In other words, don’t pull all the way up if their head continues to lay back on the bed like the baby on the left.

You can make pulling to sit a little easier by trying to pull up to sit with your baby sitting up at a slight angle.  This will give them less gravity to fight against when trying to hold up their head.  


Head control and neck strength in all directions

  • The strategy I use most to work on head control and neck strength is the exercise ball.

  • You can use this with a child sitting or on their tummy, and shift them forward, backward, side to side working on having your child hold their head in the middle as well as possible.  

  • In sitting you can slowly tilt them backwards so they try to tuck their chin and hold their head up, which will help them with holding their head up when you pull them up to sit.  


Tummy time to increase neck strength

Tummy time is the best way to increase overall neck strength and head control.  Some other ways to work on tummy time aside from being on the floor:

  • on ball as above
  • over boppy pillow
  • on inclined couch cushion
  • on their  parent’s knees or chest


Remember that any time your child is not lying on their back, they are working on increasing their head control and neck strength, so minimize lying down time when your child is around 2-3 months.


  • Gee-Sly says:

    Hi, I’m a fresh physiotherapist and am working in a paediatrics centre. I must commend you on these amazing resources!

    Please I would like to find out what to do about excessive trunk hyperextension in a baby with cerebral palsy.

    • Natalie says:

      Hi, thanks for visiting my site! If the hyperextension is due to spasticity then you will probably need appropriate positioning/support in a seating or standing device. You may also need to modify your various positions to position their body to decrease the tendency for hyperextension. Another option is bracing but that would have to be discussed with an orthopedist to make sure it doesn’t affect any joints or growth. Taping with kinesiotape or using a theratog to help promote muscles that flex the trunk may also help. Let me know if that helps!

      • sunusi says:

        its really knowledge adding stuffs….am currently working as intern physiotherapist at federal level…pls may I know the general overview for a child presenting with paraplegia/paraparesia post spina bipida surgery..

  • Physio Anesh George says:

    I just like to appreciate this.I am working in a paediatric center centre for neuro development.This helped a lot.

  • Nancy says:

    Hi how do I prevent baby from smushing his face into the ground? We do tummy time on a soft surface of course!

    • Natalie says:

      Hi! Thanks for reading my blog. If your baby can’t keep their face off the floor, they are probably not strong enough to hold their head up in a face down position yet. There are a few ways you can change tummy time to keep your child from smushing their face on the floor. One way is to do tummy time on an exercise ball like i described in this post: – this method allows you to place your child on their stomach and keep their face off the floor. You can also tilt the ball backwards so they aren’t looking straight down. This strategy is useful if your child doesn’t have enough neck strength to hold their head up fully against gravity yet. Another method is to have your child on their tummy over a rolled blanket or towel which will lift their chest off the floor to give their face some clearance. You can also have your kiddo over your knees like in this picture – which provides an alternative way to try tummy time off the floor. Hope these are helpful, let me know if you have any questions.

  • Kelly says:

    Natalie, your website is great! You have wonderful exercises. Currently, my son is 11.5 weeks old and just started PT for his right torticollis. During his initial evaluation at PT I was told he has met all of the milestones for his age so far besides having head lag. The PT could tell that he was trying to engage a little bit initially but still had bad head lag. He is great with tummy time after lots of practice. The PT told us that she is feeling optimistic and would like to see the head lag gone by 4 months. If not then she said it would be a concern. My husband and I have been working with our son the past few days since we found out all the time with the sit to pull exercise (which was advised by the PT) and tummy time. Are there any other exercises/strength type activities that can help his head lag? I am very concerned and scared about other delays/central nervous system problems. Have you worked with children who could meet all skills besides head lag and have success without other long term problems? Also, could you advise me with any other exercises or recommendations to help with his head lag besides the sit to pull and tummy time? Thank you!

    • Natalie says:

      Hi Kelly, thank you for reading my blog and so sorry for the delayed reply! So regarding your question about working on head lag. Since it appears that your son has decreased neck strength, I would focus on overall neck strength and not just practicing pull to sit. I would recommend working on his neck strength in sitting and lying down first. In sitting I would support his trunk so he only has to focus on holding his head in place. When in this position, you can gradually and slowly shift his body in different directions (forward, sideways to the right and left, and backward). Moving backward slowly is a great way to engage those neck muscles that assist with pulling to sit. I would gradually make these activities more challenging by moving him farther in each direction. a great way to practice this activity is with sitting on an exercise ball like in 1 of the above pictures. For lying down activities, I would work on lying on his back and encouraging him to rotate to look to his left and right, which incorporates some key neck muscles. You can make this activity more challenging by lying him on his side and encouraging him to rotate and look to the side away from the floor. Hope these make sense, if not please let me know. Also note that all these activities are encouraging him to use his own muscles and not to force him to turn a certain way by having someone physically.

      In regards to if i have seen other kids like this. it’s hard to say since I haven’t directly seen your son. So i would recommend you discuss this further with your PT and pediatrician to see if they can clarify what specific strength impairments your son is presenting with to help give you a better idea of what could possibly be causing these delays.

      Let me know if you have any more questions! thank you!

  • apurva says:

    Hi ..
    My baby is 7.5 months now but she still cant hold her head steady.i m really worried.she can move her head left to rt and rt to left also during tummy time she can hold her hold and move her head shee even tries to,pull her head up while lying on pillow.but can not hold her head up and steady.plz help me.i m really worried as here we lack gud doctors.

    • Natalie says:

      HI Apurva, thank you for reading my blog.
      I have a few questions first. Do you mean your daughter cannot hold her head steady when she is sitting? If she can hold her head up while on her tummy then that is a good idea of her neck strength. Is she rolling already? Is she trying to crawl? is she able to remain sitting on the floor by herself? If she is able to roll and is trying to crawl then that means that she is gaining strength and is learning how to move her body. If she is not sitting by herself, do you have to fully help her stay seated or can she help to stay balanced? thank you! -Natalie

  • Iqbal MA says:


    My son is 2 years old.Still his neck is not strong. Last one and half year doing physiotherapy ,but no big change .he can’t hold his head steady more than half minute and also he is not able sit by himself.
    He can move his head right to left and when he lying on the bed raise his head and looking everywhere but it’s not more than half minute.I am so disappointed

    • Natalie says:

      HI Iqbal, thank you for stopping by my blog. I’m sorry to hear that your son still cannot hold his head steady for a long time. Does he have a diagnosis that explains why he cannot hold his head up after receiving physiotherapy for over a year and a half? Does he roll or crawl or play on his stomach? -Natalie

  • apurva says:

    Thank you soo much for your reply i m v grateful to u i need someone to talk to v badly.YES she can’t sit without my support and help i need to make her sit with pillows all around.she cannot hold her head during sitting it either lags down or she tries to pushes back.i need to motivate her to Luk towards me and hold her head straight she is able to do it only for few seconds.she rolls from stomach to back v easily but not from back to tummy ( only twice she roll from back to stomach).she can not crawl on knees but thru body she moves little distance.waiting for reply.thank u so much really

    • apurva says:

      hi natalie ,,i m really looking forward for your suggestions.being a mother its really disheartening about such delay…plz help me

  • apurva says:

    Also one more thing when I pull her by lifting her hands she also try to lift her head her head does not lag backwards.

    • Sharan says:

      Hi Apurva,

      I hav a baby boy and his condition is also similar to your daughters. He is in his 9 th month now. I will let you if I find anyway to improvise his motor skills. Please let me know if you find any good therapists or doctors who hav already treated babies with less neck control.

      My mails is
      Thank you

  • aisha says:

    My child is 1 year now… he cannot hold his head steadly but can do for few seconds and he cannot sit without support… please give a tip.. i am very scared about it…

  • apurva says:

    hi ……
    plz rply as your suggestions can big difference in our life

    • Natalie says:

      Hello Apurva,
      Sorry for the delay in reply.

      I can try to answer your questions but it is not possible for me to give accurate suggestions since I have not evaluated your child. Have you gone to your doctor about your concerns? What have they told you about why there may be delays? my suggestions are below, but you need to speak with your doctor before trying these to ensure that we are not affecting another problem that may be going on. And please remember my disclaimer ( ) listed above.

      Regarding your question, here are some suggestions once you have clearance from your doctors:
      to help increase head control, I would recommend having your child sit in a reclined position instead of trying to sit up straight. Sitting in this position will make it a little easier to work on holding their head up and practice turning to the left and right. Being in a reclined position leaning against some pillows also allows your child not to try to hold their trunk up and allows them to focus just on holding their head up. You can work on having her hold her head up longer in this position to see if she can hold her head up more than 5 minutes.

      I would also continue practicing activities on her stomach, having her be on her elbows, with her elbows positioned under each shoulder. This way she can work on her neck strengthening and try to hold her head up. You can either have her be on the floor propped on her elbows, or on your chest or exercise ball so she is not fully looking down, which will make it easier to practice holding her head up. You can practice this activity using toys or objects that catch her attention and see if she can hold her head up at least 2-3 minutes.

      It is good to see that you said she is trying to crawl forward on her stomach, that means she is motivated to move around. I would continue encouraging this activity by using toys or anything that motivates her to move forward. You can help her crawl by pressing against her feet so she can push off your hands to push forward.

      Please let me know if you have any additional questions,


  • apurva says:

    thank you soo much as your suggestions really help me as a mother……i hope there is nothing serious …..ya during tummy time she can hold her neck up for more thing i want to say around her first 4 months she never used to come on our shoulder as she does not like it she always use to play lying down on bed… this the reason of her delay neck control

  • Matebatso says:

    my son is 9months old, he had exchange transfusion on day 5 post birth following hyperbilirubinemia due to RH incompatibility. he could not control his head in any direction and head is still lagging only improving nw since starting physiotherapy. he cannot sit alone, roll over or crawl. am worried sick as to the prognosis and would like to know as to after how long will things be normal with physio?

  • LINKIE says:

    Hi my name is Dina. My daughter’s neck is not straight and her head is flat on one side. She is one year four months now. Will my daughter’s neck has a chance to be straight and head will correct itself. What can I do to help her.

    • Natalie says:

      Hello, so sorry for the delayed reply! I would recommend talking to your pediatrician about your concerns and then they can refer you to a craniofacial specialist and they can talk to you about treatment options. At this age you would have to look at her neck alignment and see what the cause to see whether it is a muscle tightness issue or a bone issue. A craniofacial specialist will give you a better idea about what could be going on. let me know if you have any other questions and thank you for reading my blog!

  • Zunera says:

    Hi Natalie,
    Really impressed with your comments and suggestions. My baby is a premature twin and has hydrocephalus. She had the shunt inserted when she was 3 months old corrected. It took her a while to get her head control and now she has a reasonable head control. But she is still unable to sit and i think she is not motivated to sit also. We have a trained therapist who provides physical therapy six days a week for the past three months. Is there something else we can do her.
    Eagerly waiting for your reply

  • Nikki says:

    Hi…my son was born 7 weeks premature at 33 weeks gestation. He is now 14 weeks not corrected. Luckily he did not have any issues other than being jaundiced. At this point he does not have very good head control. I understand that he would only be 7 weeks if he were full term, but he has been right on with many other things. He smiles and coos and follows objects. He currently weighs 12lbs 11oz, so he is a good size. However, I am having a terrible time with tummy time. He screams so much as soon as he is placed on his belly and wants nothing to do with lifting his head. He does move his head left to right. He does roll from his belly to his back, but I think he does it just so he can get off of his belly. I’m very excited to try the above suggestions hoping these work to strengthen his neck muscles. This is our first child and with him being premature, I held him a lot, not realizing how important tummy time was. I’m hoping I did not cause him to be delayed. He will go for his 4 month check up in 2 weeks, so I plan to discuss this with the pediatrician at that time. Do you have any other suggestions for me or am I just being too hard on him. I just want the best for my child.

    Thank you in advance!

  • aishatu says:

    I lyk did

  • Paru says:

    Hi Natalie,

    Thank you for this wonderful forum. Your blog motivated me to talk about my son’s issues with a hope of receiving some empathy. I am a desperate mother worrying about her son’s head control, shape of the head, Laryngomalacia, rolling over and weight issues all the time. My son is 6 and a half months old now. He was born a month earlier than my EDD. He has been having weight issues right from the beginning. He is now 13.8 lbs. He still looks like he is just 3 months old. He still does not have complete head control. It shakes terribly. Though I realized this from 4th month I have spoken about this to all the doctors I have been to and i was only told that it would get better with time. I knew something was not right and finally ended discussing with the doctor that I am visiting now. The current doctor has recommended a exercise of having my baby lie on his tummy and touch the bottom of the spine with 3 fingers. when I do this my son does lifts his head but cannot hold it for more than 10 to 15 sec. I lure him with toys and colors and everything flashy. Note that I started with this exercise just a week back. when i hold him on the shoulders its easily recognizable that his head is not in control. He also has flat head syndrome for which I have not been recommended anything. His back of the head is completely flat and tip of the head is raised visibly. In short his head has not rounded. I personally suspect Plagiocephaly (after googling). I have raised this concern every time I visit the doctor but have been assured that it will get rounded off once he rolls over which he doesn’t seem to be doing. He moves to the side since he is 4 months and till date and then rolls back flat. I call him lazy but that’s just keeping myself calm. I am dead scared within. I am also told that my son’s wind pipe has not developed due to which i can hear him breathe loudly and also it sounds as if a frog is croaking. For this, doctor has said that it would resolve within 8 months of age and if not then 1 and half years old. Long wait it is. If you have any suggestion for all of the above, please tell me. I am really worried.


  • Veryconcernedmom says:

    Hi Natalie I just read your article and I am really concern about my 6 months old baby. She can’t lift her head up longer than few seconds before burying her face down again. She started rolling from back to tummy since she was 4months old. She hate being on her tummy and will cry. Because of that I always let her lie on her back until recently I tried again. Even when I carry her or tried to let her sit up, her head will always tilt over to one side. Is that torticollisis? Is it too late to fix her problem? I am really concerned and sad.

    I love your article but would love to try as soon as she wake up but I’m wondering do you have a video that I can watch? I’m a visual learner. Btw should I take my daughter to a chiropractor or a Physio? Which one is better?

    • Natalie says:

      Hi Concerned mom, I recommend going to your pediatrician first to rule out anything that can’t be handled by a physical therapist. Her rolling seems to be on track so that is good. To check if her neck is tight, I would have her lie on her back and encourage her to look to her left and right by using some fun toys and see how far she can look by herself. I would not do any stretches until you see your doc and if they recommend physical therapy. I would go to a physical therapist but that’s because I am a PT and I can’t speak much as to what chiropractors do with toddlers. A pediatric physical therapist will be knowledgeable about the various causes of neck weaknesses, but we don’t know if that’s the case with your child until you see a doctor or PT First. Hope that is helpful, let me know if you have any other questions and thank you for visiting my blog!

  • Michael says:

    HI my daughter is seven months old ,but she can not hold on she can turn it left and right ,and able to raise on tummy time,but my problem is the head is heavy than his body,that make it difficult for her to hold her head is there any help.

  • Paru says:

    Hi Natalie,

    How are you doing? Seems like you missed to reply my queries…

    • Natalie says:

      Hi Paru, sorry for the delayed reply. I just read over your question again. If your son is still having hard time holding his head up, I would modify the tummy time by not having him fully face down. I would continue holding him like you are and also sitting him up supporting him with pillows on his side and with his head supported so he can work on holding his head up that way. I would also try lying down on his back and encouraging him to look to his right and left often so he can strengthen those muscles as well. are there any other doctors you can see if you feel your current doctor isn’t addressing your concerns? Regarding the head shape, If it is flat on one side then it is called plagiocephaly, if it is flat directly in the back with the forehead changing shape that is called brachycephaly. They do make helmets for these but you would have to get evaluated to see if the degree of flatness warrants a helmet. I would push your doctor more If you are still concerned and maybe ask to see a PT if there are any in your area. Let me know if that makes sense and if you have any other questions.

      • Paru says:

        Hi Natalie,

        Sorry for a late response. I happened to check your reply today. Thank you for replying. whatever you have advised makes total sense.
        Since the time I wrote to you, I had increased my Son’s tummy time. I would put him on his tummy every 1 and half hour after feed. Initially he would cry but as days passed he would tolerate tummy time for 15 minutes and more. i would keep some extremely eye catching toys and lured him to lift his head up. He slowly began to show sign of improvement and began lifting his head up steady. Guess what!! he rolled over for the first time on 30 Sep. Now he often rolls over. One concern down.
        Guess it is brachycephaly then. I would look for a doctor who gels with my concern and takes a step forward to treat. Helmets are something that I have heard about in the west but not here in the east. However I shall discuss about this with the doctor. I am still hoping that since he has rolled over now his head should show some improvement.

  • Abdul Wahab says:

    Dear Madam: My son is 14 months old but he can not hold his neck properly and for long time……he can not sit uptill now……my whole family is very concerned for his growth…he is also suffering from isovaleric acidemia due which we have used protein-free milk in his early days but now we feed him I-Valex-1….plz guide me that how his developmental delay be improved plz…..

  • vaishnavi says:

    Thanks for sharing.

  • mela says:

    what are some suggestions for a 2.5/3 month old who has excessive xtensor tone ( not due to spasticity or neurological issue. ). the baby began rolling from stomach to back at 2.5 months of age but i think its because of his dominant extensor tone. Hedoes not tolerate sidelying very much but is a pro in prone. My other concern is that his arms need to be constantly readjusted because he prefers his arms extended along side his body as if he’s in a “superman position while on his stomach. your opinion? any suggestions?

    • Natalie says:

      I would try to promote flexion as much as possible. Positions that encourage activation of flexor muscles would be a good way to start. My favorite way is prone on an exercise ball. The shape of the ball works better to challenge extensor tone versus being on prone on the floor. So I would try prone on an exercise ball and change the angle that he is in while on the ball. So I will gradually have them prone in a nearly standing position and then tilt the ball forward until the are face down and then add perturbations. Sitting on an exercise ball and tilting it backwards slightly to activate flexor muscles can also help. I also do this while sitting on the floor and sitting a child at a slight reclined position to encourage flexor activation. Make sure to support head well in case he doesn’t have the strength or uses extensor tone to throw his head back. Let me know if that makes sense or if you have any questions! Thanks for visiting my blog :)

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