FAQ: What Is Torticollis in Infants?

Some babies are born with or develop a head tilt soon after birth. This is known as torticollis. If your baby is diagnosed with this condition, know that it’s generally not permanent and can be remedied with the right treatment. Although your baby most likely doesn’t feel pain, this temporary condition does need treatment to fully go away. Find out what infant torticollis is, what causes it, the signs and symptoms to look out for, and what type of treatment your healthcare provider may recommend if your baby has torticollis.

What Is Torticollis?

By definition, torticollis means “twisted neck” in Latin. A stiff neck that’s hard to turn and sometimes painful is referred to as torticollis, head tilt, or wryneck.

The muscle that is affected by torticollis is the sternocleidomastoid muscle, which connects the head and neck to the breastbone. When this muscle is contracted, it causes a head tilt.

This condition can occur in adults, as well as in infants, babies, and small children. When torticollis is present in newborn babies, it’s called infant torticollis or congenital muscular torticollis.

Torticollis is actually a common condition in newborns and can be present at birth or appear up to three months later.

Does Torticollis Go Away and How Long Does It Last?

Following the treatment plan recommended by your baby’s healthcare provider can help your baby’s torticollis go away. Keep in mind that it can take up to six months to see results and even up to a year or longer in some cases. The stretching exercises recommended by your baby’s healthcare provider are usually most effective when they’re started when your baby is between 3 months and 6 months old.

How Is Torticollis Diagnosed?

If you suspect your baby might have torticollis, take them to their healthcare provider. The condition can usually be detected in the first six to eight weeks after birth. During the examination, your baby’s healthcare provider will check to see how far your little one can turn their head and will typically search for a lump in the contracted sternocleidomastoid muscle on their neck. In some cases, your baby’s provider may order X-rays to help identify the condition or recommend you take your baby to a physical therapist, neurologist, or orthopedist if the usual forms of treatment aren’t helping.

Torticollis Symptoms in Infants

Some of the symptoms of torticollis in infants include:

• Your baby keeps tilting their head to one shoulder

• Your baby's chin points in the opposite direction of the head tilt

• The neck muscles seem tight

• Your baby favors looking over one shoulder instead of turning to look the other way or they turn their head to one side when sleeping

• If your baby is breastfeeding, they may seem to favor one side or one breast

• Your baby may show frustration when they're unable to turn their head

• Your baby may develop a flat spot on their head from keeping it in the same position when lying down

• They may have a small lump, like a knot, on their neck on the side of the contracted muscle.

If your baby tilts their head to one side occasionally, consult with their healthcare provider for a diagnosis.

Causes of Torticollis

So, what causes torticollis? In babies, torticollis may be due to the infant's position in the uterus. It may also occur (though this is rare) during birth, especially if it’s a breech birth (for example, if the baby’s bottom is first into the birth canal instead of the head) or a difficult first-time delivery.

Experts aren’t certain why some babies are affected by torticollis, but some contributing factors or possible causes of infant torticollis include:

• The uterus was too cramped for the baby

• The baby was in an unusual position at birth, such as being in a breech position

• Forceps or vacuum devices were used during delivery.

Vision problems can also lead to torticollis. Ocular torticollis can result when a baby has a misalignment of the eyes, known as strabismus, which can be present at birth or could develop later in childhood.

Torticollis Treatment

If your little one is diagnosed with this condition, follow your healthcare provider’s advice. Your provider may suggest a number of ways on how to help treat your baby’s torticollis, including the following:

• Help your baby do exercises that work to stretch the tighter side of their neck. This helps loosen the tightened sternocleidomastoid muscle and strengthen the weaker muscle on the opposite side.

• When it’s time for bed or a nap, put your baby to sleep on their back (as is recommended for safe sleep) in the crib with their torticollis side facing the wall. This means that your little one has to crane their neck in the opposite direction in order to look back at you or see into the room. This may involve you changing the crib's location to get them in the right position.

• During the day (for example, during tummy time), position your little one in a way that requires them to stretch their neck in the opposite direction of their head tilt. Try dangling toys or attracting their attention with fun sounds to try to get them to look your way.

• When it’s feeding time, bottle-feed or breastfeed your baby in a way that encourages them to face in the opposite direction of their head tilt. You can read more about breastfeeding positions here, but you might like to ask your healthcare provider for personalized advice.

• In some cases (for example, if other forms of treatment haven’t worked), surgery to lengthen the tendon may be recommended to treat the torticollis.

The Bottom Line

Torticollis is a treatable condition. If you suspect your baby has this condition, it’s best to take them to their healthcare provider so that treatment can begin sooner rather than later. In time and with the right treatment, the condition will improve, and the next thing you know, you’ll be back to worrying about whether you have enough diapers on hand.

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