My Helmet Baby (Squared)

Our family's journey with plagiocephaly

Torticollis Information… To Pass Along to New Moms

on April 23, 2012

There is a Plagiocephaly Support Group in the Community that I have visited throughout our experiences with our babies’ helmets.  Most people go into that group seeking support from other parents who have gone through similar experiences, and the group really provides the support in a multitude of ways.  The group owner posted some information recently that could be really helpful to a new mom.  Pass this along, and I’ll link to the post at the bottom so that she gets credit for it!

What is torticollis? In newborns, we are generally referring to congenital muscular torticollis, which is a shortening of the sternocleidomastoid muscle in the side of the neck. The SCM attaches to the clavicle at one end and the skull base on the side of the head at the other end on each side of the neck. The SCM is responsible for turning our heads and being able to hold our heads straight. When the SCM is damaged or its growth is impaired, it causes CMT (hereinafter torticollis). Torticollis is most frequently seen in infants who were in a breech position, who “dropped” early, other causes of in utero constriction, or those who had a difficult delivery requiring vacuums or forceps.

What are the warning signs of torticollis? Although the hallmark symptom of torticollis is a head tilt due to the shortened SCM on one side of the neck, this tilt is NOT always apparent or severe – especially in newborns who have little neck control. Experienced mothers may notice something is wrong very soon after their newborn’s birth when they attempt to breastfeed: babies with torticollis often cannot turn their head in both directions with an equal range of motion, making it difficult to nurse on oneside but not the other. That being said, here are some of the early warning signs of torticollis:

  • A strong preference to look in one direction is often one of the most telling signs that torticollis may be present. Many parents report that their baby is able to turn his or her head past one shoulder “like an owl” (which is normal) but not the other. Newborns with torticollis will almost always only sleep on one side of their head no matter what direction they are placed in the crib. Babies with tort will stare at a blank wall as opposed to turning their heads to look out into the room simply because they cannot turn their head in the opposite direction.
  • Tort babies usually hate tummy time. Tummy time takes some getting used to for all babies, but if an infant refuses to lift his or her head, seems unable to lift his or her head, or tries but then immediately lays down on the same side of his or her face each time, tort may be present.
  • A head tilt. If a baby consistently keeps his or her ear toward one shoulder and his or her chin pointed toward the opposite shoulder, this is most likely torticollis. The tilt does not need to be severe – in fact, for the first few months of life, it can be easy to miss because the baby is not having to fight gravity to keep his or head up. When sitting in a bouncer or swing, however, parents may notice a tilt.
  • A flat spot on the baby’s head. Unfortunately, many babies with torticollis are either born with or develop plagiocephaly (a flattening of the back side of the head) as a result of their torticollis. Since in utero constraint is one of the most common reasons torticollis develops, many infants concurrently develop plagiocephaly in the womb due to the same constraining factors. Other infants without noticeable plagiocephaly at birth will develop plagiocephaly as a result of their inability to turn their heads in both directions. Rapid brain growth during the first few months of life and the amount of time a newborn spends sleeping can make a flat spot appear quite suddenly, and any infant that develops plagiocephaly should be evaluated for torticollis. As many as 85% of infants that develop plagiocephaly also have torticollis.

So how is torticollis treated? Torticollis is treated with physical therapy. A pediatric physical therapist will teach the parents a series of stretches (also seen here) that lengthen the affected SCM. As the baby progresses, exercises are added to the daily at-home regimen to strengthen the weaker side of the neck. Occasionally, physical therapists will recommend TOT collars or physio tape for persistent tilts. Physical therapy is extremely effective, and very few infants will need surgical intervention to correct their torticollis. Torticollis that does not respond to physical therapy may not be muscular in nature (there are several other causes of torticollis, including ocular tort, bony abnormalities, and benign paroxysmal torticollis).

And what are those helmets for anyway? Cranial bands are used to treat the plagiocephaly that often occurs with torticollis (or can occur on its own without torticollis). Active bands apply a mild pressure to prominent areas of the head and gently encourage growth to the flattened areas, while passive bands provide a symmetric shape to mold the skull as the infant grows. Aggressive repositioning can be equally effective if it is initiated prior to four months of age.

If you are a parent of a child who is looking for more information and a supportive group of parents to “talk” to, this Plagiocephaly Support Group is really great!

2 responses to “Torticollis Information… To Pass Along to New Moms

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  2. I’m gone to say to my little brother, that he should also visit this webpage on regular basis to get
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