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Have you noticed that your baby tilts her head while at rest? Does your little one have a hard time turning his head fully from one side to the other? If so, perhaps your baby has torticollis. Torticollis occurs when pressure is put on the large neck muscle, called the sternocleidomastoid. This pressure causes the muscle to tighten, pulling the head to the affected side and pointing the chin to the opposite shoulder. This makes it difficult for the baby to turn the head and neck to the opposite side. Sometimes a knot or bump can even be felt in the baby’s tight neck muscle.

Torticollis is a relatively common condition in newborns and young infants up to 3 months of age. It is thought to most commonly result from abnormal positioning of the baby in the mother’s uterus, whether it is from being cramped in the limited space or breech position. Sometimes a baby can develop torticollis if they have had a difficult delivery requiring forceps or a vacuum device.

When a baby spends too much time with his head turned to one side, the head can become flat, resulting in a condition known as positional plagiocephaly. Fortunately there are safe and simple exercises you can do at home to help stretch the tight neck muscle and allow the head to round out on its own:

  • Tummy time. Putting babies face down on a firm surface or your lap for a few minutes several times a day encourages them to lift their heads, ultimately strengthening their neck and shoulder muscles.
  • If your baby tends to look in one direction when lying in his crib, position toys or a mirror on the opposite side, encouraging your little one to turn his neck. Also when feeding, offer the breast or bottle in a way that encourages him to turn his head to the opposite side. When carrying your baby, position him on his side and use your forearm to support the head in such a way so that you are stretching the affected muscle.

There are also gentle stretching exercises you can do at home with your baby lying on his back on a firm surface such as a carpeted floor or changing table.

  • Side bending. If your baby has right torticollis (the right neck muscle is tight), hold the right shoulder down with your left hand, then using your right hand on top of the right side of your baby’s head, gently bend the left ear towards the left shoulder.
  • Head turning. For right torticollis, place your left hand on your baby’s left shoulder. Using your right hand, cup your baby’s head. With your left hand hold the chin and gently turn the nose toward the right shoulder.

These positions should be held for 30 seconds as tolerated by your baby, then repeated 2-4 times. Practice these stretches at least 3 times per day to gradually lengthen the shortened muscle. If your baby has left torticollis (the left neck muscle is tight), reverse these stretches to the opposite side.

It is important to begin stretching exercises as soon as your pediatrician has diagnosed your baby with torticollis. These exercises work best if they are started in the first few months of life. If your baby does not seem to be improving over the next couple months, your baby’s doctor may recommend a physical therapy evaluation for further treatment.

Takeaways

  • Torticollis occurs when a baby’s neck muscles are tight, so a baby has trouble turning his or her head to one side.
  • It is a common condition, often cause in utero or during delivery.
  • Simple exercises including head turning and neck stretching can help some babies.
  • The earlier you can start exercises, the better.

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References

  1. Congenital Muscular Torticollis and Positional Plagiocephaly. Pediatrics in Review.
  2. Head Tilt. American Academy of Pediatrics, HealthyChildren.org.

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