T
orticollis is a common
condition where the head
is tilted to one side with the
chin turned to the other
and there is usually difficulty turning
the neck. It can happen in adulthood,
but it’s more common in babies. In
fact, it occurs in about one out of every
250 infants, and although present at
birth, it can take up to three months
to fully develop. In the vast majority of
cases, it’s reversible, and most babies
don’t feel any discomfort.
No one really knows why some
babies develop torticollis and others
don’t, though it’s thought to be related
to the position of the baby in the womb
or as a result of muscle damage during
delivery. It often results in tightness
in the muscle that connects the
breastbone and the collarbone to the
skull.
Less commonly, torticollis can be
caused by abnormalities in the shape
of the bones in the neck or by their
becoming fused. It’s important to know
the difference, as the treatment is very
different. In rare cases, there can be
other serious underlying conditions.
If you have any concerns, your baby
should see a doctor.
If you notice that your baby has
any of the following symptoms, visit
your doctor for a full examination.
Check to see if your baby:
holds her head to one side;
has limited neck movement;
has one shoulder that’s higher than
the other;
has stiffness in the neck muscles;
has difficulty breastfeeding on one
side (or prefers one breast only);
has an asymmetrical head shape or
a flat spot on the head (plagiocephaly).
Ninety per cent of babies with
torticollis also have this and it can be
present from birth or develop from
repeatedly lying in one position;
has swelling in the neck muscles.
Then your doctor can perform a
physical examination to determine
whether the baby has torticollis.
The doctor might suggest that you
take your child to a physiotherapist,
who will provide treatment and
demonstrate a programme of exercises
that you can do at home each day
to assist in stretching the relevant
muscles, including these:
Gently stretch and massage the neck
muscles.
Gradually stretch and reposition the
baby’s head – this should be performed
several times a day for maximum
effect.
Stimulate and encourage the baby
to turn her head to her less-favoured
side. This can be done while bottle-
feeding.
Place your baby on her tummy when
she’s awake, which is important for
developing the neck muscles.
When she’s on her tummy, position
your baby so she has to turn away
from her favoured side to face you,
and encourage her to look by talking
or singing. If this position is difficult
for your baby, place a rolled up towel
under her chest to slightly elevate her
head.
Alternate the sides that your baby
sleeps on.
Reposition the cot or place the baby
so that her favoured side faces the wall.
This will encourage her to turn to
watch you or look out onto the room.
During play, draw your baby’s
attention with toys and sounds to make
her turn in the other direction.
Position foods or toys closest to the
weak side in order to encourage your
baby to reach with her hand.
Make use of a Tortle – a beanie-
style hat specifically designed by a
paediatrician to prevent or help with
flat head and torticollis. (See page 10
for more details.)
If torticollis is discovered early and
you follow the prescribed stretching
programme, improvement can be
apparent within weeks, and, except in
severe cases, the condition should be
fully corrected within one year.
Melanie Potgieter is a physiotherapist at
Island Health Family Practice.
treating
If your baby seems to hold her head
to one side or have limited neck
movements, a common condition might
be to blame, writes
Melanie Potgieter
.
torticollis
October 2013
25
