What Is Infant Torticollis?

Sometimes falling asleep with your neck in the wrong position on your pillow can result in a stiff neck, making it painful or difficult to turn your head. This is referred to as torticollis,  a fancy Latin word that means “twisted neck”.
Although it may seem unlikely due to newborns incredible flexibility, as many of their bones are still forming from cartilage, torticollis can occur. Especially if there has been trauma in the birth canal due to a difficult child birthing process. Sometimes, it can occur simply because of the baby’s position in the womb. This is referred to as  infant torticollis or congenital muscular torticollis.
While seeing a newborn with a twisted neck or having trouble turning their neck can be unsettling to most parents, a newborn does not feel pain in the same way as someone older. The best thing about Infant torticollis, is that the problem usually resolves itself with time or just by changing the position of the baby. 

What Causes Infant Torticollis?

There is not any need for great alarm when you see torticollis in infants. This head tilt is just as likely to happen in boys, as it does in girls, and usually presents itself anywhere from birth to 3 months of age.
It still remains a mystery as to why some babies present with infant torticollis, and others do not, but doctors are quick to point out that it is very common and parents should not be alarmed. Infant torticollis can happen because there is just not enough room in the fetus and the baby is cramped inside of the uterus. Or, in some cases, if the baby is in a breech position, where the baby’s bottom is facing the birth canal instead of the head facing the birth canal, it occurs with regularity. Additionally, infant torticollis may present itself when the baby is delivered using forceps or if any vacuum devices are used during childbirth. Anytime forceps or a vacuum, or a doctor’s hands, put pressure on an infant’s sternocleidomastoid muscle, known as the SCM, infant torticollis can develop. The SCM is a large and long muscle that runs down the sides of a baby’s neck from the ears to the collarbone, and applying more pressure to one side of the SCM can make it tighten up, causing tension on that side, and making it difficult for a baby to turn their neck. 

Interestingly enough, in the presence of other conditions, such as developmental dysplasia of the hip, infant torticollis may be more prevalent. You can read more about developmental dysplasia of the hip, a condition which often occurs when the baby is in an unusual position in the womb, or goes through a very difficult and tough childbirth. 

What Are the Signs & Symptoms of Infant Torticollis?

A baby with infant torticollis will appear absolutely normal except when it comes to any activity that involves rotating the neck. Some of the signs to be on the lookout for include the following:

 

• • When they put in visible effort to turn towards you and you notice then getting frustrated when they are unable to turn their head completely 

• • When they tilt their head in one direction. This can be difficult to detect in newborns since their heads are so close to their shoulders

• • When they seemingly prefer to only look at you over a preferred shoulder and do not follow you with their eyes as normal children would

• • When breastfeeding, if your infant prefers one breast over the other, or has trouble breastfeeding on one side, over the other. 

• • When a child develops a flat head, known as positional plagiocephaly, on either side from lying in one direction all of the time, they may also develop torticollis. 

• • When an infant develops a small neck bump or lump, similar to a tense muscle “knot”, this may be indicative of infant torticollis

How Is Infant Torticollis Diagnosed?

The most common method for diagnosing infant torticollis is via a physical examination by your pediatrician. Remember that as the parent, you will spend an inordinate amount of time with your infant, watching them, feeding them, bathing and holding them, and it is important that you keep an eye out for anything that seems out of the ordinary. Should you feel that something does not feel or look right, it is important that you take them to see their pediatrician to put your mind at ease. 

How Is Infant Torticollis Treated?

Should your infant or newborn be diagnosed with infant torticollis, the doctor may teach you a few stretching routines that you can perform at home with your baby. These stretching exercises will help to loosen up the tension or tightness in the SCM, while strengthening the weaker opposite side of the neck. It will be weaker because it has been used less. These stretching exercises will help your baby regain normal function and range of motion and help straighten out your baby’s neck. However, there are times that a doctor may recommend taking a baby to a physical therapist or a chiropractor that is trained and licensed to treat infants and newborns. As treatment progresses, your child’s chiropractor will do a routine check up every two to four weeks to ensure that the issue is resolved. 

Helping Your Baby at Home

Simply put, encourage your baby to turn their head in both directions. Doing so will help them loosen those tight neck muscles and the SCM, and alternatively tighten the loose muscles. You may be concerned that you may actually do more harm than good with these exercises, but babies cannot harm themselves by merely turning their own necks. The harm comes from extra pressure that was previously applied.
The following is a list of exercises to try out:

 

• • During the day, and especially during play time, grab your baby’s attention with toys and sounds that make them turn their heads in both directions. 

• • When it is time for a nap, have them face the wall. As babies prefer to look out onto the room, they will turn away from the wall and this will help to stretch out those tight neck muscles. 

• • When your baby is hungry, offer them your breast or bottle in such a way as to make them turn away from the side they are favoring.

 

Don’t Forget “Tummy Time”

Tummy time is incredibly important as an exercise for proper development that helps strengthen neck and shoulder muscles. This strengthening of both muscle groups prepares your baby for crawling, and is very helpful for a baby with torticollis and can help treat this problem by doing the following:

Place your baby on your lap for tummy time and position their had so that it is turned away from you. After doing so, speak or sing to your baby to encourage them to face you or turn towards you. Be sure to do this exercise for 15 minutes or so. 

What Else Should I Know?

By practicing these stretching exercises and position changes, most babies with torticollis will improve within 6 months, although some cases may take up to a year. These stretching exercises work best when your child is three to six months old. However, if your child’s torticollis does not improve with these exercises, be sure to consult your pediatrician regarding muscle release surgery. This procedure is used for children with infant torticollis which do not improve with exercises and therapy.