What is torticollis?
Torticollis is a neck muscle problem that causes the head to tilt
downward.
If your child is born with this condition, it is called congenital
torticollis. This is the most common type.
Babies can also develop the disease after birth. Then it is called
"acquired" and not congenital. Acquired torticollis may be associated
with other more serious health problems.
What are the reasons?
You have long muscles on both sides of your neck that run from the back
of your ear to your collarbone. It is called the sternocleidomastoid.
When your child has torticollis, this rotator muscle shortens on one
side. Why does a muscle shorten? Your baby may have been cramped in the womb or
may have been in an abnormal position, such as in a breech position. This can
put extra pressure on one side of your child's head, which can lead to strain
on the sternocleidomastoid muscle.
If your doctor used forceps or a vacuum during labor, they could also
put pressure on your baby's sternocleidomastoid muscle.
Symptoms
You may not notice anything unusual about your baby for the first 6 or 8
weeks. Typically, the symptoms of torticollis become apparent as the infant
gains more control of the head and neck.
Some of the symptoms you may see:
- Your child’s head tilts to one side with their chin pointed to the opposite shoulder. In about 75% of babies with torticollis, the right side is affected.
- Their head doesn’t turn side to side or up and down easily.
- You feel a soft lump in your baby’s neck muscle. This isn’t dangerous, and goes away within 6 months, usually.
- Your baby prefers to look over the shoulder at you. Their eyes don’t follow you because that would require turning their head.
- They have trouble breastfeeding on one side or prefers to feed on one side only.
- Your baby works hard to turn toward you, struggles to turn their head all the way, and -becomes upset because the movement is hard.
- They might start getting a flat head on one side from lying in one position all the time. This is called “positional plagiocephaly.”
When should I call my doctor?
If you notice any signs that your child may have torticollis, make an
appointment with your doctor.
The doctor will start by checking how far your baby's head will turn.
They may also order imaging scans, such as x-rays and ultrasounds, to check for
other conditions. About 1 in 5 children with torticollis will also have hip
problems.
Most children with torticollis do not have other health problems. But
sometimes it is due to infections, bone fractures, allergic reactions to
medications, or genetic conditions such as Down syndrome or Klippel-Feil
syndrome.
Why treatment matters
If you act early, you can prevent any long-term problems for your child.
Without treatment, your child may have complications, including:
- Less control of their head
- Limited reach on the affected side and less tracking with the eyes
- Delays in sitting and walking
- A problem feeding
- Poor balance
- Crooked crawling
- Rolling onto one side only
What can you do at home
Try to get the child to stretch the neck muscles. This is the best
remedy for torticollis, and it is safe.
The doctor can teach you specific exercises for your baby. These
movements will help lengthen the shortest, tightest muscle, as well as
strengthen the muscle on the opposite side.
Here are some other things you can do at home:
- Use your child's appetite as a stimulus. Offer the bottle or
your breasts to turn in the right direction.
- Place
toys so that your baby is forced to look both ways. Those with lights and sounds
are really good at getting their attention.
- Get them to play with their hands and feet.
Babies love to bring their hands and feet to their palms. When your baby does
this, he develops the muscles he needs to crawl.
- Give them lots of tummy time. Holding the child in
this way will strengthen the back and neck muscles and prevent the back of the
head from flattening. Ideally, they should spend 15 minutes on their stomach 4
times a day. You can place them on your chest, on your knees, or on a pillow if
that makes it easier for you.
Other procedures
In addition to home treatment, your doctor may recommend that your child
see a physical therapist.
Once torticollis is diagnosed and stretching begins, most children
improve within 6 months. Two things can speed up recovery: early diagnosis and
adherence to a treatment plan.
Very rarely, children with torticollis require surgery to lengthen the sternocleidomastoid muscle. Doctors usually wait until your child is preschool to consider this option.