Torticollis in Infants
Updated: Nov 10, 2022
What is it?
Torticollis is most commonly seen in infants.The most common type is called congenital which the baby contracts at birth usually due to in utero positioning or possibly occurs during the birth process if forceps or a vacuum extraction is required. If the baby contracts torticollis after birth it is called acquired. Torticollis involves the sternocleidomastoid muscle (SCM) which comes from the ear and attaches to the collarbone. Torticollis occurs when this muscle becomes shortened. When a baby has torticollis you may notice the baby has a preference to look or turn its head a certain way. The baby will usually be tilted ear toward the affected shoulder and head turned away from the affected side. Prolonged torticollis can result in head flattening. We are also finding some correlation with torticollis and oral ties and restrictions.
Torticollis may not be noticed until 6 to 8 weeks after birth as the infant is starting to learn motor control of the head and neck. You may notice your baby’s head turning more to one side with their chin pointed to the opposite shoulder. The baby’s head may have trouble turning side to side and up and down. You may notice that when you try to turn their head to the opposite direction they immediately turn right back to the position.. The infant may prefer to breastfeed on one side more than the other due to mobility restrictions. They may develop a flat spot from this because they are laying in on one side more than other positions. You may also notice that the baby will accidentally roll to one side when placed on their back due to tension in the neck and body.
It is important to try and notice the signs of torticollis early to prevent any long term problems that come with it. Treatment involves stretching the affected side and strengthening the opposing side. Some complications include less control of their heads, plagiocephaly, limited reach on the affected side, delays in sitting or walking, problems feeding, poor balance, and crooked crawling.
The primary management of torticollis is getting your infant to stretch the affected SCM and strengthen the opposing side. Chiropractic care is vital to make sure the baby has proper joint motion in the affected areas. Dr. Kristen will typically always co-treat torticollis cases with a well trained occupational therapist or physical therapist to ensure the best results. Stretches will be pivotal in order to release tension in the SCM. Strengthening exercise will also play an important role in helping improve strength in the unaffected side.
There are also other helpful tips and things to think about day to day with your infant who has torticollis. Here are some tips to implement at home today:
Change the side/hip you hold your baby on.
Alternate position/direction you lay them on the changing table and in the crib.
Roll the baby into tummy time after each diaper change
Limit container usage
Football hold/carry as often as you can.
During tummy time place toys and distractions to the opposite side baby prefers to look
Allow baby to take contact naps belly to belly on the parents chest with head turning opposite direction of preference