Infant Torticollis
Does your baby lie with their head positioned to one side or is unable to feed from both sides equally?
The word torticollis is derived from the Latin, "tortus" meaning twisted and "collum" meaning neck. Torticollis is usually related to tightened muscles on one side of the neck.
Torticollis in infants is common and is reported to be as frequent as 3 in every 100 babies. It is usually diagnosed within the first month of life.
You may notice the following signs with your baby:
Baby’s head tilts or rotates to one side. More specifically; the head and ear are tilted towards the affected sternocleidomastoid muscle and the chin points to opposite side
They prefer looking in one direction
They prefer breastfeeding on one breast only or have more difficulty on one side
Limited range of motion in head and neck
Asymmetry in baby’s head and face (plagiocephaly)
A small lump in your baby’s neck
What causes it?
Your baby may have been born with torticollis (congenital) or it may present after birth (acquired torticollis)
CONGENITAL (Muscular or postural type)
Symptoms and signs may not become obvious until your baby is 6-8 weeks old and gains more head and neck control. The most common type of torticollis is muscular.
The sternocleidomastoid muscle attaches from the sternum and inner clavicle to the mastoid process of the temporal bone. When it becomes shortened it pulls your baby’s head into a tilt and/or rotation. This muscle can become tight and contracted due to the following factors
Abnormal uterine position, for example breech position
Injury during birth
Forceps or vonteuse delivery
Abnormalities related to the cervical spine.
Rarely, it may result from a congenital disease affecting the nervous system
Babies diagnosed with infant torticollis should also be assessed for Developmental Dysplasia of the Hip (DDH)
Acute onset or torticollis diagnosed after 6 months (acquired) requires urgent further investigations
What you can do?
If your baby's head tilts to one side, they prefer looking in one direction and have difficulty breastfeeding on both sides equally, there are several things you can do to help your baby:
Osteopathy: Make an appointment with your osteopath to address any underlying strains or restrictions related to uterine position and/or birth trauma
Feeding: When feeding your baby, encourage them to turn away from their favoured side by bottle/breast positioning
Sleeping: When putting your baby to sleep, position them facing the wall so they need to actively turn their neck to the restricted side to look out into the room.
Playing: Encourage neck rotation to the restricted side with toys, sounds and singing.
EXERCISES
Two exercises for infant torticollis are tummy time and guppy pose.
TUMMY TIME: position your baby so their head is turned away then encourage your baby to turn towards you by talking or singing
GUPPY POSE: support baby on their back over your lap and allow their head to extend backwards, allow the chin to move away from the chest Encourage rotation to the restricted side. This pose releases tension through the front of the neck, and chest.
How can an osteopath help
An experienced osteopath who works with babies will assess for any cranial or facial asymmetries related to torticollis, they’ll assess for restricted cranial articular motion, cervical spine and rib dysfunction. They will palpate the sternocleidomastoid and scalene muscles for any lumps and tightness.
As torticollis may have an impact on the vestibular system and can affect the visual system, your osteopath will also check your baby’s visual tracking.
It’s really important to treat infant torticollis as early as possible. If left untreated, it can lead to functional restrictions of the spine, plagiocephaly and it has also been associated with thoracic scoliosis.
Dr. Michelle Sherriff use a very gentle form of osteopathic treatment for babies called Biodynamic Osteopathy to treat infant torticollis. This type of treatment allows your baby to come to a point of stillness, allowing an unwinding and rebalancing of their system. Osteopathic treatment aims to restore normal function, optimise healthy development and assist your baby’s own innate capacity to heal and restore balance naturally.
