As your baby develops head control, she’ll want to turn and look at the world all around her — at bright toys, towards silly sounds and into your adoring eyes. But sometimes, tight neck muscles can prevent baby from seeing the full picture.
Babies with torticollis have limited mobility in their necks, causing their heads to tilt to one side. Unlike some other health conditions that can crop up during those early months, torticollis is easy to spot. But with treatment — stretching and strengthening exercises, for example — most infants with torticollis regain full head and neck mobility within months, as well as the ability to look all around them.
What is torticollis?
The name “torticollis” comes from two words in Latin: “tortus” and “collum,” which translate to “twisted neck.”
When babies have torticollis, tight neck muscles cause them to tilt their heads to one side and their chins to the other. The most common type is congenital muscular torticollis, which affects up to 2 percent of all infants.
What causes torticollis?
There are two main types of torticollis, each with different causes:
Congenital muscular torticollis
This type of torticollis is present at birth, and it can happen if your baby experienced cramped conditions inside the womb, like in the breech position. It can also occur if your doctor used forceps or a vacuum device during delivery. Both of these put pressure on your baby’s sternocleidomastoid muscle (SCM), a large, rope-like muscle that runs on both sides of their neck, contributing to torticollis.
Congenital torticollis is often discovered when a baby is about 2 months old and has better control of head movements. You may also notice it sooner if your baby always rolls to one side while sleeping.
Read This Next
Acquired torticollis
Acquired torticollis usually shows up later in infancy (after 4 to 6 months) or in childhood.
An upper respiratory infection or an injury can cause throat inflammation. This swelling moves vertebral bones out of whack and causes neck muscles to spasm. It usually comes on quickly, and, unlike congenital muscular torticollis, feels painful.
Symptoms of torticollis
For the most part, a baby with torticollis will eat, sleep and play like any other baby, except when it comes to activities that involve turning. You may see:
- A constant head tilt in one direction.
- A limited range of motion in the head and neck.
- A preference to look at you over one shoulder, rather than to follow you with her eyes.
- Trouble breastfeeding on one side.
- A flat spot on the head (positional plagiocephaly) from lying in one direction all the time.
- A pea-sized neck lump or bump, like a knot in a tense muscle.
Treatments for torticollis
Babies with congenital torticollis usually get diagnosed by the time they're 2 months old via a physical exam.
If your doctor determines your baby has torticollis, it’s important to start treatment right away to prevent permanent asymmetry, a flat spot on your baby’s head and restricted head movement. Treatment options may include:
Physical therapy
Your baby will undergo an evaluation to identify which neck muscle is tight. The physical therapist will also evaluate your little one’s neck strength, head shape, gross motor skills and range of motion. They will perform some neck stretching and strengthening exercises and teach you how to do some with your baby at home.
They will also show you ways to encourage neck turning and make sure you are holding your baby the right way. Research suggests that attending physical therapy is more effective than solely doing exercises at home.
Home exercises
Your physical therapist will recommend that you do tummy time and stretching exercises with your baby every day, like neck rotation stretches and lateral head tilt stretches.
As your baby gains head control, you will also learn to place your baby in certain positions so that she uses her muscles to lift her head against gravity. This helps strengthen the neck muscles.
Continue building those all-important muscles by motivating your little one to turn her head to the side she normally doesn't turn to: Place her in the crib on her back with her face to the wall, encouraging her to roll her head to see the the room (or the noisy, colorful toy you’re shaking).
You can also put her to sleep on her back with her head positioned in the opposite direction of the tilt.
Surgery
About 10 percent of children with congenital muscular torticollis require surgery to lengthen their shortened neck muscles. This is done by an orthopedic surgeon, usually right around the time your child starts preschool.
Heat and massage
If your child develops acquired torticollis, the typical course of treatment is to apply heat and use massage and stretching to ease the pain. Botox injections are also an option for older children with severe torticollis. Your pediatrician can refer you to a neurologist or orthopedist for more treatment.
Most children with both forms of torticollis respond to treatment and recover. Babies with congenital torticollis in particular tend to respond very well to physical therapy programs, usually within a matter of months. The key is to get a prompt diagnosis, so your baby can begin treatment ASAP — and begin looking at you from any angle.
Yes 
No 
Trending On What to Expect
