What Is Torticollis? Ways To Prevent And Treat It
What Is Torticollis?
Torticollis is a common diagnosis in infants and is a fancy way of saying that a baby has a preference to turn his or her head toward one direction. Pediatricians typically screen for this during well checks, along with head shape asymmetries. If there is a concern with a flat spot or asymmetrical head shape, torticollis is often playing a role.
Torticollis may be congenital, meaning that your baby was born with a preference due to positioning during pregnancy, or it can be acquired, meaning that the preference developed over time. As a physical therapist, I more commonly see acquired torticollis.
Typically a baby with torticollis will present with a preference to turn his or her head to the right or left, along with a preference to tilt his or her head in the opposite direction. This is due to the fact that there is a muscle called the sternocleidomastoid (SCM) that helps to turn the head to one direction and tilt it in the opposite direction. This muscle can be tight in some cases, or there can be an imbalance in strength between one side and the other.
How to prevent torticollis
If your baby has congenital torticollis, this is unpreventable due to their position throughout pregnancy. This may cause tightness in the SCM. However, it is treatable and your pediatrician will likely refer to physical therapy early on.
Other factors that may play a role in torticollis are reflux and vision. With reflux, there can be a strong preference to extend the neck and look toward the right side for comfort. This is just something to consider when treating torticollis if your baby has significant reflux.
If you notice a preference over time, even if it is within the first few months of life, there are things you can do at home to help prevent the preference from getting stronger.
Encourage floor time and tummy time instead of time spent in equipment, such as bouncers, swings, bumbo seats, and exersaucers. The more time your baby spends on a flat surface, the more they will actively move their head in both directions.
Help your baby turn his or her head in both directions. Use your face, toys they love, light up rattles, or musical toys to capture their attention.
Vary the way you carry and burp your baby. Switch off arms that you are holding your baby in and feeding your baby in.
Be mindful of the direction your baby’s head is resting when in a carrier. Try to make sure you have the baby sometimes resting his or her head to the right, and sometimes to the left.
How to treat torticollis
It is important to intervene as soon as possible with torticollis because your baby will likely not outgrow this preference on their own. It can impact symmetry with all of their gross motor milestones, including rolling, sitting, crawling, pulling to stand, and walking. It can also impact balance and vision along with all of these skills. With early treatment of torticollis, you can work with physical therapy to achieve milestones and work toward symmetry throughout developmental stages. It is common for your baby to be followed, at some frequency, until he or she is walking independently.
Physical therapy can be very helpful in treating this diagnosis and it doesn’t necessarily mean going to appointments weekly. I often see patients weekly or every other week in the beginning to establish a home exercise program and then decrease frequency. However, this is dependent on the needs of your baby. The most helpful part of treatment is what you do at home with your baby.
Things you can work on at home:
Position their body in the bath and on the changing pad so that they are looking toward you and toward the side you are working on.
Vary which arm you carry and feed your baby in.
Encourage a lot of tummy time! Limit time in equipment to 15 minute periods.
If your baby is sitting on your lap, facing away from you, you can slowly tilt their body toward one direction and then the other. This helps them to use the muscles on either side of their neck.
Use siblings and pets to your advantage - these often are the most exciting thing to look at for your baby!
It is a lot easier to start working on these things from early on, instead of when your baby is running across the room. Torticollis is very common and also very treatable. If you notice a turn or tilt preference in your baby before anyone else does, bring it up to your pediatrician!