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Could Your Baby Have Congenital Torticollis? Signs To Watch Out For

by — Last updated: 2015-09-16 in Children's & Teens Health

Congenital torticollis is a condition in which the sternocleidomastoid is tight on one side, leading a baby to have their head twisted to one side all the time. With the right exercises, the condition usually resolves quickly.

Has your baby just been diagnosed with torticollis, or do you think you have noticed the tell-tale signs of this condition? It's important to know that the condition isn't usually painful and that it most often resolves with the help of exercises and changes in positioning. What else do parents need to know about wryneck in babies?

What Is Torticollis?

Torticollis, also called wryneck colloquially, means "twisted neck" in Latin — and that's basically exactly what it is. Torticollis can roughly be divided into two main categories: acquired and congenital. Torticollis that devlops later in life has a really wide variety of causes, from tumors and infections to certain medications and underlying medical conditions. If torticollis is present at birth or becomes apparent shortly thereafter, it's called congenital torticollis. 

In congenital torticollis, a baby's neck will be twisted in one position, and their chin in the opposite direction. While torticollis can look disturbing, affected babies don't tend to experience pain from this condition. The condition affects boys and girls equally, and about one in 250 babies will experience it.

A tight sternocleidomastoid muscle (the muscle that connects the collarbone and breastbone to the skull) is almost always the cause of congenital tortocollis. 

Though experts aren't fully certain what lies behind that, they have a very good idea about the risk factors. It is known that a shortened sternocleidomastoid muscle can occur as a result of strange positioning in utero or because of a difficult birth, for instance. Bleeding and scarring can trigger a shortening of the relevant muscle. Breech babies and those who required forceps to be born are more likely to develop torticollis, and 10 to 20 percent of those affected also have hip dysplasia.

More rarely, abnormalities in the neck bones, known as Klippel-Feil syndrome, can be the culprit in cases of congenital torticollis. The condition can also be hereditary or the result of uncommon underlying conditions including tumors of the brain or spinal cord. Because of torticollis, a signifcant number of those affected also develop plagiocephaly, a condition in which the baby's head has a flat spot or is misshapen — in this case due to laying in the same position all the time.

Torticollis: The Tell-Tale Signs

Severe torticollis is quite noticeable: if you don't notice that your baby's neck is titled to one side with the chin pointing to the other side, your pediatrician or the staff at your hospital will. A bump on one side of the neck is another tell-tale sign, along with limited mobility of the neck. Whether a baby is born with torticollis or develops it over time, it's almost always diagnosed within the first two months of life.

READ Are The Benefits Of Breastfeeding Really So Minimal That You May As Well Use Formula?

If you suspect your baby may have torticollis, you may notice:

  • Your baby tilts their head to one side.
  • Your baby strongly prefers to breastfeed on one particular side, if breastfed.
  • Your baby cries when attempting to turn their head to the problematic side.

Torticollis In Babies: Diagnosis And Treatment

Diagnosing Torticollis

A physical examination in which the physician determines how far the baby can move their neck combined with X-rays of the neck are used to diagnosed torticollis. Your pediatrician will almost certainly notice the symptoms of tortocollis themselves, but if you have spotted the signs, you should certainly bring it up and ask for an examination. Most cases of torticollis are "stand-alone", but because the condition can be related to hip dysplasia, Klippel-Feil Syndrome, Down Syndrome, infections, factures (including those that may have happened during childbirth), or even because of adverse reactions to medication, it's important that the cause of torticollis is determined.
 
 
If your pediatrician didn't already know about the circumstances of your baby's birth, they will ask you detailed questions, as difficult births and abnormal fetal positions are contributing factors.

Treating Torticollis: Something That Can Usually Be Done At Home

Once diagnosed, your doctor will most probably suggest stretching exercises for you to complete at home with your baby. These exercises serve to strengthen the sternocleidomastoid muscle on the unaffected side, while loosening the one on the affected side. Treatment is necessary in order to ensure the baby's face and skull develop evenly, and the baby will develop the full range of neck motion. These exercises are simple in nature and involve you encouraging your baby to move their neck to the other side:

  • Offering the non-preferred breast.
  • Offering a bottle in such a way that encourages the baby to turn to their non-preferred side.
  • Using toys to encourage your baby to look in both directions.
  • Placing your baby to sleep in a way that encourages them to look at their non-preferred side. Babies want to see what's going on around them, so try to get them to twist their head to the weaker side in order to see you as you enter the room.
  • "Tummy time" to strengthen your baby's neck muscles.
These exercises aren't complicated at all, but do ask your pediatrician to explain them in detail, and ask questions if you're not quite sure what they want you to do. As you see, all the exercises serve to get your baby to look in the direction that doesn't come naturally to them because of the torticollis.
 
If the condition is discovered early enough — by two to three months at the latest — these exercises should lead you to see an improvement within a matter of weeks. Stretching exercises work best in babies between the ages of three and six months.
The torticollis should be totally gone by the time your baby is one year old. In about 15 percent of cases, however, surgery of the sternocleidomastoid muscle is needed to correct the problem. This surgery is also known as "muscle release surgery". This will usually be recommended if the torticollis hasn't resolved by 18 months of age, and it will cure most cases of torticollis that don't go away with stretching exercises alone. In other cases, your pediatrician will suggest sessions with a physical therapist.
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