By Hailey Huey, D.P.T., M.H.A.
As many new parents know, caring for a new baby is both physically and mentally exhausting. As you navigate your way through the fog of new parenthood, you start to learn your baby’s preferences. Many of these are harmless: "He likes to be bounced rather than swayed." "She likes her pacifier when falling asleep." However, if you start to notice a preference for looking one direction over the other, it may be time to intervene.
What Is Torticollis?
Infant torticollis is caused by tightness in a neck muscle (called the sternocleidomastoid) causing your baby to tilt their head to one side and prefer turning in the opposite direction. Torticollis can affect up to 16% of infants. It can be present at birth or develop after birth due to positioning, such as always being held the same way or spending too much time in a baby swing or car seat. If left untreated, it can cause restrictions throughout the body leading to developmental delay.
Your pediatrician should be screening for torticollis at your child’s well visits from birth to six months. Historically, pediatricians have taken the “wait and see” approach, telling parents that if neck preferences don’t improve, they will refer to physical therapy. However, more recent research shows that early intervention is KEY to success in treating torticollis, and early referrals are becoming more common.
What Should Parents Be On the Lookout For?
- A head tilt or rotation preference
- Flat spot on the backside of head on the preferred side (called plagiocephaly)
- Changes in face symmetry (one ear more forward, forehead bulging, difference in eye shape)
- Preference for eating on one side or in one position
- Difficulty tracking objects to one side
- Difficulty bringing hands to midline
If you notice any of these signs in your baby, a physical therapy visit may be warranted.
Can Torticollis Be Prevented?
Some, but not all, cases can be prevented. Parent education prior to birth is helpful in identifying early signs of torticollis. Here are some things you can do at home to help prevent torticollis.
- Alternate sides when holding baby.
- Alternate sides when feeding baby.
- Limit use of baby containers (e.g., swings, bouncers, car seats).
- When playing with baby, sit on both sides to encourage turning head in both directions.
- Alternate direction baby lays in crib.
- Tummy Time!
How Can Physical Therapy Help?
So, you think your baby may have torticollis. Now what? The good news: it is highly treatable, especially if identified and treated early! If you notice your baby is demonstrating signs of torticollis, it is important to seek out an evaluation by a pediatric physical therapist right away. Research shows that the length of physical therapy intervention is significantly less in cases where treatment starts before one month of age, and 98% of infants fully recover.
Your physical therapist will perform a thorough evaluation of your child looking at neck and trunk mobility as well as head shape deformities. Your baby’s ability to perform age-appropriate motor milestones will also be assessed. Your PT will likely ask about your child’s birth and health history to identify any risk factors for developmental delay. Treatment is often family-centered and play-based to encourage improved movement patterns and postures.
Here are some simple things you can do at home if you are noticing a head preference in your baby:
- Get baby off their back. Play with baby in side-lying and on their tummy.
- Visual tracking: encourage baby to track a toy with their eyes and head in both directions.
- Talk and play with baby on their non-preferred side.
- Chances are, if you are right-handed, you will tend to hold baby more on your left. Try holding baby on the other side to help them turn their head in the opposite direction.
- Use baby swings and bouncers in moderation – no more than 10-15 minutes at a time. Try to aim for more floor time than container time throughout the day.
Do you have concerns that your pediatrician keeps brushing off, saying, “Let’s wait and see"? Trust your gut; you know when something is off with your little one. In Iowa, if you have private insurance, you can obtain physical therapy services without a physician’s referral. Here at Des Moines University Clinic Physical Therapy, you and your loved ones will be in good hands. Our exceptional physical therapists will listen to all your concerns and help get your baby back on track in their development.
Call 515-271-1717 for an appointment if you have concerns about your baby having torticollis.
