Torticollis sounds like a very clinical term, but many new parents become quickly aware of what it means if they notice their baby’s head is tilted to one side (usually seen in conjunction with the head turning towards the opposite side). Well, the term specifically refers to tightening of the sternocleidomastoid muscle (SCM- much quicker to pronounce and write out), which results in this positioning.
Why does this happen? There are several causes including in-utero positioning, a difficult or traumatic birth, or ocular (vision) irregularities. There is also thought to be a correlation between torticollis and tongue/lip ties.
If you do notice this tilt, should you wait to see if your baby “grows out of it”?
No! It is so important to recognize the signs and take action as early as possible and here’s why:
1. Since the whole body is connected, the head tilt can cause tightness through other parts of the body-in the trunk and hips- that will affect how your baby will reach motor milestones. You may notice baby looking towards only one side, rolling primarily to one side long after the milestone is mastered, using one hand more than the other, or hitch crawling (with one knee bent).
2. A flat spot on the side of the head will likely appear (plagiocephaly). Now why is this a bigger deal than the flat spots so many babies get on the back of their heads (brachycephaly) from sleeping on their backs? Plagiocephaly can actually lead to asymmetries in the face and once that happens, it is extremely difficult to correct.
3. Imagine looking at the world sideways since you were born? Your perception of reality would be totally off. And that’s what happens if your baby’s head is always tilted as she’s visually taking in her environment. Vision irregularities may be an effect of torticollis, but it can actually also be the cause. It’s very important to get a vision test to rule out any ocular abnormalities if typical treatment strategies aren’t showing results.
This isn’t meant to scare you at all. Infant torticollis is absolutely treatable. However, we do want to stress the importance of acting quickly.
So what can you do?
A. Seek professional guidance from a local PT or OT as soon as possible. Do not wait! If you think you see a tilt, trust your gut even if others don’t see it. You know your baby best.
B. Hold and place your baby in the crib in different directions to encourage stretching of the neck muscles.
C. Bottle feed and/or nurse your baby on both sides equally
D. When baby is on his tummy, lying on his back or sitting up, encourage visual tracking across her entire visual field. Take a rattle or other preferred toy, start in midline to catch baby’s attention, then move towards one side of baby’s head, back to midline, then to the other side. If baby loses focus, go back to midline to redraw baby’s visual attention.
E. Infant Massage! Massaging both sides of the body helps relax the muscles and brings awareness to both sides of the body equally. This is a great add-on to therapeutic stretching and exercises.