What Is Torticollis in Babies? Causes, Symptoms And Treatment

Torticollis, commonly known as ‘wry neck’, is a condition often observed in babies, characterised by a noticeable tilt of the head to one side. This condition arises due to the shortening or excessive tightness of the sternocleidomastoid muscle, which runs from the back of the ear to the collarbone. While torticollis can be present at birth (congenital torticollis), it may also develop later in infancy (acquired torticollis).

Causes of Torticollis in Babies

Understanding the causes of torticollis is crucial for early detection and effective treatment. Here are some of the primary causes:

1. In-Utero Positioning: The most common cause of congenital torticollis is related to the baby’s position in the womb. Crowded conditions, particularly in cases of multiple births, or a breech position, can place undue pressure on a baby’s neck, leading to muscle tightness.
2. Birth Trauma: Complicated deliveries, especially those involving forceps or vacuum extraction, can result in injury to the baby’s sternocleidomastoid muscle. This trauma during birth can lead to swelling or tearing of the muscle, eventually causing it to shorten and tighten.
3. Muscular Fibrosis: In some infants, the sternocleidomastoid muscle may have a fibrotic section, a condition that can be present at birth. This fibrosis causes the muscle to be shorter and less flexible than usual.
4. Acquired Torticollis: Unlike congenital torticollis, which is present at birth, acquired torticollis can develop later in infancy or childhood. This type can be caused by several factors, including:
5. Injury to the neck or spine: Trauma or injury to the neck area can result in muscle damage, leading to torticollis.
6. Infections: Certain infections, such as upper respiratory infections, can cause lymph nodes to swell, putting pressure on the muscles of the neck.
7. Gastroesophageal Reflux Disease (GERD): In some cases, babies with severe reflux may develop torticollis as a way to alleviate discomfort from acid reflux.
8. Vision Problems: Vision issues can cause a child to tilt their head to see better, leading to a muscular imbalance.
9. Reactions to Medications: Certain medications can cause adverse reactions that lead to the development of torticollis.
10. Neurological Conditions: In rare cases, torticollis may be a symptom of an underlying neurological condition that affects muscle control and movement.
11. Environmental Factors: Prolonged time in positions that keep the head turned to one side, such as during sleep or in baby seats, can contribute to the development of torticollis, especially if the baby already has a predisposition to the condition.

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Symptoms of Torticollis in Babies

The primary symptom of torticollis is the head tilting to one side with the chin pointing towards the opposite shoulder. In addition to this, other symptoms may include:

• Head Tilt: The most noticeable symptom of torticollis is a consistent tilt of the head to one side. The baby’s head tilts towards the affected side while the chin points towards the opposite shoulder.
• Limited Range of Motion: Babies with torticollis may have difficulty turning their head in certain directions. This limitation is often due to the tightness of the neck muscles.
• Preference for Looking in One Direction: Infants with torticollis often show a preference for facing one way. This might be more evident during feeding, playing, or when they’re lying in their crib.
• Difficulty Breastfeeding on One Side: Torticollis can make it challenging for a baby to breastfeed on one side due to discomfort or inability to turn their head effectively.
• Flat Spots on the Head (Plagiocephaly): Due to the limited range of motion and a preference for holding their head in one position, babies with torticollis may develop flat spots on one side of the head.
• Facial Asymmetry: In some cases, prolonged torticollis can lead to asymmetry in the baby’s facial features or skull shape.
• Fussiness or Discomfort: A baby with torticollis might display signs of discomfort or be fussy when attempting to move their head in a particular direction.
• A Lump in the Neck Muscle: Sometimes, a small lump or tightness can be felt in the sternocleidomastoid muscle, which is the muscle affected by torticollis.
• Developmental Delays: In some cases, torticollis can lead to delays in achieving certain developmental milestones, especially those related to motor skills, as the condition can limit a baby’s ability to explore their environment fully.
• Visual Tracking Issues: Due to the limited range of neck motion, babies might also exhibit difficulty in visually tracking objects or people as they move.

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Treatment of Torticollis in Babies

The approach to treating torticollis in babies is usually non-invasive and involves a series of measures:

• Physical Therapy: The cornerstone of torticollis treatment, physical therapy, involves stretching exercises to lengthen the muscle and improve neck motion. A trained physiotherapist guides the parents on how to safely perform these exercises with their baby.
• Positional Changes: Encouraging the baby to turn their head in the opposite direction of the tilt can help. This can be achieved through strategic positioning of toys, during feeding, and while sleeping.
• Tummy Time: Regular tummy time when the baby is awake and supervised strengthens the neck, shoulder, and arm muscles, thus aiding in correcting torticollis.
• Use of Orthotic Devices: In some cases, custom-made orthotic devices may be recommended to help improve head alignment.
• Surgical Intervention: This is rare and usually only considered in severe cases where conservative treatments have failed, and the child is older.

Potential Complications

If untreated, torticollis can lead to complications such as permanently limited range of motion in the neck and asymmetrical facial and skull development. In some cases, it may also impact the baby’s overall development and motor skills.

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Regular follow-up with healthcare professionals ensures that the baby is on the right track to recovery and helps in the early identification of any potential complications. With appropriate care and treatment, most babies with torticollis can achieve normal neck movement and head alignment. For more such articles on health, read EuroSchool blogs.

The information provided on this website is not a substitute for professional medical advice. EuroSchool encourages you to consult with a qualified healthcare professional for any health concerns you may have. The information on this website is not intended to diagnose, treat, cure, or prevent any disease.