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Monday Medical: Treating infant torticollis

Susan Cunningham
For Steamboat Pilot & Today

While it may not seem like a big deal, a tilt or twist in the neck — also known as torticollis — can cause big issues for babies.

Diana Sperry, a pediatric physical therapist at UCHealth SportsMed Pediatric Therapy Clinic in Steamboat Springs, outlines why this issue happens and how to address it, below.

What is infant torticollis?

In this condition, muscles on one side of a baby’s neck are tight, causing a baby to tilt his head toward the tight side and turn his head in the opposite direction. It can affect as much as 16% of infants and can contribute to a flattening of the head called plagiocephaly.



Why does it happen?

Torticollis is usually the result of a baby’s position in utero.

It may be exacerbated if babies spend most of their time on their backs. While it’s important for babies to sleep on their backs to help avoid sudden infant death syndrome (SIDS), it’s also important to make sure babies have supervised time on their tummies, so they can naturally work out neck tightness and develop strength.



“In addition to time sleeping, the increase in the use of ‘containers,’ such as car seats, swings, bouncy seats and strollers has today’s babies spending a disproportional amount of time on their backs,” Sperry said.

Why should it be treated?

Tight neck muscles may alter a baby’s posture and create muscle imbalances, which can contribute to challenges with rolling, crawling, sitting up independently and other skills.

“And torticollis doesn’t just affect the neck — we’re attached head to toe, so this can impact many areas, including vision, feeding and the sensory system,” Sperry said.

How do I know if my baby has torticollis?

To catch the issue early, watch to see if your baby favors one side. For instance, he may always look to the left, or she may only nurse well on the right breast.

“If that happens, it’s probably because it’s uncomfortable for them to turn the other way,” Sperry said. “You can also review some baby photos, and you might notice your baby always tilts his head one way.”

How is it treated?

A physical therapist or occupational therapist who has training with newborns can guide parents through exercises and stretches to do at home throughout the day. Simple alterations in how you carry, position or feed your baby can go a long way in encouraging a baby to turn toward the tight side.

Don’t skimp on tummy time, which is critical for any baby’s development, as well as for treating torticollis. Start with a few minutes several times a day and increase to at least 60 minutes total each day, by three months of age.

“You want to start supervised tummy time on Day 1,” Sperry said. “You can hold them on your chest or lap, but they also need to have time on a hard surface. That’s how they develop their muscles — by pushing up, looking around and getting ready to move.”

The phrase “back to sleep, belly to play” can be a helpful reminder.

If you have concerns, speak to your pediatrician and seek help early. With proper treatment, the condition often resolves.

“Early treatment is key,” Sperry said. “Studies show if babies get therapy early, or by about three months old, and parents learn to do regular stretching, positioning and exercises at home, babies usually spend less time in therapy and have better results.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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