It starts with a tilt—a subtle turn of your baby’s head that doesn’t seem quite right. At first, it might go unnoticed, but soon questions arise. Could it be something else? Recognizing infant torticollis early gives parents the chance to take effective steps. But what should you be looking for, and what comes next? The answers may surprise you.
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How to Identify Torticollis in Babies
This condition occurs when the sternocleidomastoid muscle, located on each side of the neck, becomes tight or shortened, making it hard for the baby to move their head. While it doesn’t cause pain, it can affect posture, feeding, and motor development if left untreated.
A common sign is a tilted head, where the baby holds it to one side with the chin turned toward the opposite shoulder. The baby might also have difficulty moving their head both ways, especially away from the preferred side. This limited range of motion can make the baby uncomfortable and lead them to avoid turning their head entirely.
In some cases, you may notice a small, soft, painless lump in the affected neck muscle. The baby might also always look in the same direction, avoiding the other side. This repeated posture can affect motor development and symmetry.
Another frequent outcome is positional plagiocephaly—when one side or the back of the baby’s head becomes flat due to constant pressure. Some babies may also struggle with feeding on one side because the neck stiffness limits head movement.
Treatment Options for Torticollis in Babies?
Torticollis treatment typically starts with conservative methods like repositioning and stretching exercises. These often correct the condition effectively. If there’s no significant improvement after several months, surgery may be considered, especially in more severe or resistant cases.
Surgical Treatment Options
If torticollis doesn’t improve with physical therapy or other non-invasive treatments, surgery might be recommended to restore full neck mobility. Common procedures include:
- Sternocleidomastoid (SCM) Muscle Lengthening: One of the most common procedures. The SCM is either lengthened or partially cut to relieve tightness and improve range of motion. This is done through a small incision and usually produces long-term results.
- Tenotomy: This involves cutting the SCM where it attaches to the bone to help lengthen the muscle and restore function. It is chosen based on the type and severity of muscle tightness.
- Bipolar SCM Release: This approach targets both ends of the muscle to correct tightness more precisely. It has been shown to produce positive functional and cosmetic outcomes.
New surgical techniques aim to reduce scarring and preserve muscle flexibility. Some involve fat grafts with regenerative cells to support a more natural recovery and lower the risk of complications.
Most babies improve with non-invasive treatments. Surgery becomes an option when other interventions don’t work. The decision should be made with medical guidance, always prioritizing the baby’s specific needs and health.
When to Seek Professional Help for Your Baby’s Torticollis
Knowing when to consult a healthcare professional can make a major difference in treating torticollis. While many cases improve with at-home care, there are signs that suggest the need for expert evaluation and intervention. Acting early speeds up recovery and helps prevent long-term physical complications.
Contact a professional if:
- Your baby keeps turning their head to one side without improvement after several weeks.
- There’s a strong preference for one side, along with facial or skull asymmetry.
- The baby resists or cries during movement exercises or struggles with position changes.
- There’s no progress with daily stretching routines or ongoing difficulty feeding on one side.
- The baby can’t complete basic exercises like tummy time or gentle head turns.
During a consultation, the specialist will assess your baby’s neck range of motion and muscle tension. Based on this, a treatment plan may include:
- Guided therapeutic exercises tailored to your baby’s condition, such as rotations, side stretches, and manual stretches.
- Localized massages using soft circular movements over the affected muscle for 3 to 5 minutes to help relax the tissue and improve circulation.
- Pulsed therapeutic ultrasound in 2 to 3-minute sessions to stimulate healing and support the breakdown of muscle fibrosis.
- Posture advice and sensory stimulation techniques to encourage head movement toward the less-used side.
Early care improves outcomes and prevents future problems like muscle pain, imbalanced posture, or scoliosis. If you notice concerning symptoms, consulting a qualified specialist is a reliable step toward supporting your baby’s healthy development.
Non-Surgical Treatment Options for Torticollis in Babies
Non-surgical treatment is the first approach for infant torticollis and often works well when started early. It usually involves physical therapy designed to restore full neck movement.
Therapy helps prevent problems like shortened muscles, motor development delays, or other issues affecting breathing, feeding, or vision. Sessions are tailored to each baby and include daily exercises at home.
This type of care brings together professional guidance and active family involvement. Stimulating both sides of the baby’s body, avoiding long periods lying on the back, alternating feeding positions, and engaging the baby visually from different directions all support healthy progress. When practiced consistently and with proper supervision, these strategies can effectively correct torticollis and promote balanced motor development.
Sources:
- Bronfin, D. R. (2001). Misshapen heads in babies: position or pathology? Ochsner Journal, 3(4), 191-199.
- Schertz, M., Zuk, L., Zin, S., Nadam, L., Schwartz, D., & Bienkowski, R. S. (2008). Motor and cognitive development at one-year follow-up in infants with torticollis. Early Human Development, 84(1), 9–14.