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Severe untreated torticollis can lead to developmental problems later in life.

Torticollis is a condition that causes your baby’s head to tilt to one side while rotating to the opposite side. If you have noticed that your baby has difficulty turning the neck to one side or your baby holds the head in a tilted position, torticollis may be the cause. While it’s often caused by abnormal positioning in the womb or from a difficult childbirth, you may not even notice the symptoms until your baby is a few months old.

The most common cause of torticollis in infants is congenital muscular torticollis (CMT). CMT is relatively common, occurring in about 1/250 births.

The most common cause of CMT is damage to or shortening of the sternocleidomastoid muscle, the long strap-like muscle that runs up the side of the neck. This damage can occur during birth, or it may be the result of compression while the baby is still in utero. There is often a knot or lump in the neck muscle where it was damaged.  Fortunately, torticollis generally causes no pain to the baby. However, if left untreated, it can cause problems with flattening of the head on one side. This condition, called positional plagiocephaly, can be corrected by reshaping the baby’s head with the use of a helmet worn daily for several months. Also, severe untreated torticollis can lead to developmental problems later in life, as babies with torticollis often learn to compensate for their condition, affecting oral motor development and speech. Children with untreated torticollis may need oral motor feeding and/or speech therapy as they get older.

Fortunately, torticollis can be successfully treated in the vast majority of cases. Torticollis is primarily treated with physical therapy to stretch the short, tight neck muscle. The physical therapist will teach parents stretching exercises that need to be done several times a day at home.  The therapist will also discuss positioning changes to encourage the baby to look in the opposite direction. Even simple changes such as placing a toy or mirror opposite to the side that your baby favors will encourage your baby to look in that direction. At least one hour of tummy time per day is also extremely important so that your baby begins to strengthen the muscles in the neck and upper body. Even after the torticollis has been successfully treated, the therapist may encourage you to have your child re-evaluated frequently, as relapses may re-occur around motor developmental milestones such as crawling or walking. Very rarely, surgery may be required to treat torticollis, but most children respond very well to physical therapy.

Successfully treated torticollis doesn’t have any permanent or long-term effects on your baby’s development.

Reviewed by Dr. Sara Connolly, December 2018

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References

  1. Medscape. Torticollis.
  2. Spiegel DA and Dormans JP. Torticollis. In: Behrman RE, Kliegman RM, Jenson HB. Nelson Textbook of Pediatrics. 19th ed. Philadelphia PA: W.B. Saunders; 2011.

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