In other instances, plagiocephaly happens first, and THEN torticollis results because the flat spot forces his head to one side. Positional torticollis and plagiocephaly are more common in babies that spend too much time on their backs or in containers like: swings, carseats, etc.
4. Other infant conditions
There is also a correlation between torticollis and babies with reflux and/or hip dysplagia.
HOW CAN I TELL IF MY BABY HAS TORTICOLLIS?
Torticollis can be very obvious in some babies and more subtle in others. Pay attention to asymmetries in your baby’s posture and alignment, but also in his movements.
1. Head tilt
Is your baby’s head tilted to one side more that the other?
If your are not sure, look and see if one ear is closer to shoulder than the other ear. Also check if your baby’s nose and chin are in line with his breast bone.
If you are noticing a head tilt, pay attention to whether or not your baby can actively move in and out of this position or if he appears "stuck".
If he does appear “stuck”, you can gently try and move his head to midline. Make sure that you do this very GENTLY. If you feel any resistance, stop immediately.
2. Head rotation
Check and see if your baby’s face is turned more to the left or right.
Again, you can look at the alignment of his nose and chin relative to his breast bone to see if his head is rotated. You can also look at your baby’s eyes to see if one eye appears more forward than the other eye.
As mentioned above, observe whether your baby appears “stuck” in this position or transitions in and out of head rotation to one side.
You can VERY GENTLY try and move your baby’s head out of this rotation. DO NOT use any force to rotate your baby's head unless your baby has been assessed by a medical professional and they have instructed you to do so.
3. Gaze preference
A baby with torticollis may favor looking at objects to one side more than the other.
Try moving a toy from one side of your baby to the other side, keeping it no more than about 12 inches from his face throughout. Look and see if your baby turns his head in both directions to keep track of the toy.
A baby with torticollis will often track a toy further to one side than the other.
4.Only rolling to one side
Torticollis is most know for asymmetry in the neck, but it can result in asymmetrical movement and development in your baby.
5. Gross motor development delay
Torticollis can be characterized by a lack of progress with gross motor milestones like, rolling, reaching, crawling, sitting, etc.
Keep in mind that there is a broad spectrum for developmental milestones. Feel free to check out this post for more information.
Does your baby struggle to breastfeed on one side?
Some babies with torticollis refuse to breastfeed on one side. Neck stiffness can prevent your baby from getting a good latch or he may fuss due to discomfort.
That being said, when breastfeeding on either side, make sure your baby’s ear, shoulder and hip are all in a straight line. Good alignment will help prevent injury from prolonged neck or spine twisting.
My Breast Friend is my favorite breast feeding pillow for good posture for mom AND baby.
For more information on healthy breasting feeding positions for mom and baby, check out this post:
Start by calling your baby’s pediatrician and set up an appointment. The pediatrician will complete an assessment and may recommend physical therapy.
Again, torticollis is a common diagnosis and can be successfully treated if caught and treated early enough.
Do NOT try and treat it yourself.
Torticollis is not simply treated with neck stretches. Torticollis often affects a baby’s entire body and can significantly delay normal gross motor development.
A physical therapist will be able to provide whole-body guidance based on your baby's specific needs. Progress towards age-appropriate gross motor milestones will also be addressed with physical therapy.
WHAT CAN YOU DO?
Maybe your baby doesn’t have torticollis but you want to prevent a positional torticollis from developing after birth.
Or maybe you suspect your baby has torticollis but are still waiting to go to your baby’s pediatric appointment?
There are a few simple things you can do for your baby in these cases.
7. Breastfeeding on both sides
I always promote good alignment and posture for mom AND baby while breastfeeding. Switching sides for breastfeeding can further prevent asymmetries in your baby’s neck and spine from developing over time.
If your baby absolutely will not breastfeed on one side, you may need to wait for your baby’s pediatrician appointment to find out why. The main cause could be torticollis, but other reasons to consider are milk supply, tongue ties, and more.
8. Less time in containers
Babies that spend lots of time in containers like swings, carseats, etc. are more susceptible to developing flat head spots (plagiocephaly) or positional torticollis.
Young infants lack head control, and often rest in a container with their head slightly tilted to one side. Over time this head tilt can cause neck stiffness, leading to torticollis.
It is OK to use containers for short periods of time. Just make sure to also give your baby lots of time to move his body freely on the floor.
9. Prevent flat head spot from forming
As mentioned above, torticollis can cause flat head spots (or plagiocephaly), and plagiocephaly can cause torticollis.
In other words, if your baby's neck stiffness keeps his head turned in one direction while laying on his back, that side of the head can flatten. But also, if the baby has a flat spot, always forcing the head to turn in one direction, neck stiffness can occur over time.
10. Tummy time
Putting your baby on his belly has so many health benefits, including neck strengthening and range of motion.
Please check out this post for a comprehensive overview on tummy time:
A very young infants cannot lift his head yet, so make sure that you alternate which way you turn his head for tummy time sessions. This will promote symmetrical development of muscle strength, neck motion, and awareness of his environment.
For an older infant that can prop on elbows, encourage him to look for and reach to the left and right by placing toys on both sides.
If your baby has a neck restriction that will not allow him to turn his head to one side, DO NOT force his head to turn. Please wait for the guidance of a medical professional before pursuing any stretching.
11. Carry baby on both sides
This goes for if you are cradling your baby in your arms or if you are using a carrier, again to promote symmetrical neck development.
Carriers are a great way to hold your baby and be hands free. Please check out this post for carrier recommendations and extra tips on how to wear your baby!