Some parents may notice that their baby’s head tilts more towards one side or that he or she prefers to look more to a certain side. This can be a sign of a condition called Torticollis.
Torticollis is fairly common and is estimated to affect about 1 in 300 babies. Parents can breathe a sigh of relief knowing that symptoms of Torticollis aren’t typically permanent.
Torticollis comes from the Latin words tortus (“twisted”) and column (“neck”). The condition is sometimes called wryneck. It happens when a shortened, tight neck muscle causes a baby’s head to be tilted downward and toward one side.
What causes Torticollis?
Congenital Torticollis (also known as Congenital Muscular Torticollis or Infant Torticollis) occurs when the sternocleidomastoid muscle (SCM) is shortened and contracted on one side. This muscle connects the baby’s head and neck to their breastbone.
What makes this muscle shorten and contract?
Here are some possible causes:
- The infant’s position in the womb (i.e., breech or the baby was cramped)
- Use of forceps or vacuum during delivery
- Fibrosis (atypical thickening of the infant’s muscle tissue)
- Hematoma (collection of blood) in the baby’s neck muscles
- The SCM developed abnormally
Signs & Symptoms
Parents should be aware of the signs of Congenital Torticollis so they can seek the appropriate treatment and follow up early on if they have concerns.
Possible signs of torticollis in infants include:
- Head tilting to one side with chin tilting to the other.
- Stiffened neck muscle.
- Neck muscle appears swollen.
- Reduced head and neck movement.
- One shoulder appears higher than the other.
- Facial features that appear uneven.
- A small lump or “knot” in the neck muscle.
Torticollis can lead to several other issues. Here are some of the possible consequences that might result from the condition, according to research:
- Changes in the shape of the head (ex: deformational plagiocephaly); flat head on one or both sides
- Facial scoliosis
- Hip problems
- Unilateral breastfeeding difficulties (difficulty nursing on a certain side)
- Asymmetrical use of hands
- Other functional problems
Because babies with the condition have trouble maintaining midline, they typically spend less time in the prone position or participating in tummy time. That can lead to flat spots on the baby’s head.
Tummy time is important for strengthening the neck and shoulder muscles. These muscles help the baby to be able to sit up, crawl, and eventually walk. Tummy time also helps develop motor skills. By reducing tummy time, Torticollis can lead to delays in all of these areas.
Treatment for Torticollis
Your child’s Pediatrician might recommend making an appointment for your baby to see a Physical Therapist if he or she is showing signs of Torticollis.
According to research, early intervention for infants with torticollis can lead to better outcomes. So to improve your child’s motor skills and keep development on track, it’s best to seek treatment early.
A Physical Therapist can start with an evaluation. Following this, the therapist will likely discuss some exercises to do with your baby at home to treat his or her Torticollis. These might include:
- Encouraging your infant to turn his or her head to the other/”non-preferred” side by using fun toys and motivating sounds.
- Specific stretching exercises that loosen the tighter side of the neck and strengthen the SCM muscle on the weaker side of the neck.
- Discussing different positions for bottle feeding or breastfeeding to encourage your baby to use both sides of his or her head and neck more evenly.
- Laying your baby on their back and with their head turned to the opposite side (weaker/non-preferred side) in their crib when sleeping.
With Physical Therapy, home exercises, and a few modifications, a baby’s Torticollis can improve.
If you have concerns about your child’s speech and language, fine motor, or gross motor skills, he or she may benefit from specialized services from a Speech-Language Pathologist, Occupational Therapist, or Physical Therapist. An initial evaluation can help determine what difficulties your child is having. Ongoing individualized therapy can include techniques and activities to help improve these areas.