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Expert Q&A:
What is torticollis?

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Suzanne Dixon
Answered by Suzanne Dixon M.D., M.P.H.
"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Question


I have a 3-month-old daughter who was admitted to the hospital because she favors her head to the right and she can't hold her head up at all. The doctors said she has torticollis. What is that? Does it have something to do with why she can't hold her head up? They're going to give her an injection in her neck to temporarily weaken the muscles on one side of her neck.

Answer


Torticollis means "turned neck," a description of your daughter's neck position. There are several different causes for this, including tightness of the neck muscles on one side, an irregularity in the neck spine, one-sided weakness (generally due to a brain problem that began prior to birth), or even a bruise, a scar, or a growth in the neck. Your child's physicians probably considered these conditions and didn't find them to be present. If the problem is simply muscle tightness on one side, the injections can be helpful, although there is a small chance the condition may recur. We like to see this condition addressed early as it is important for her vision, hand-eye coordination, and the use of both hands together. Physical therapy to stretch the tight muscles and positioning so that the child prefers to turn the other way are first-line treatments. My guess is that these treatments have been tried and didn't produce the desired results or that the condition is such that a bigger intervention has the best likelihood of success. Surgery is needed in only the most severe or resistant cases to get things straightened out.

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