It can be cute to see a picture of a baby with their head tilted a little to one side. But what if it’s always tilted to the same side? It may be an indication that the baby has torticollis. Torticollis is a condition that involves tightness of the sternocleidomastoid muscle in the neck, causing the head to tilt to the side of the tight muscle, and turn to the opposite side. Torticollis is relatively common among infants (up to 3 per 100 babies, according to some statistics) and may be present at birth (called congenital muscular torticollis, or CMT), or acquired later in infancy. It is often associated with plagiocephaly, which is a flattening at the back of the skull on one side (typically, the side the baby turns toward.) It can also be associated with developmental dysplasia of the hip (a condition where the hip joint does not develop properly and is unstable.)
Fortunately, torticollis is treatable, and can resolve quickly with early intervention. A pediatric physical therapist can teach parents tips and tricks that will help them get the tight muscle stretched out before it leads to other postural or movement asymmetries. A baby who only looks to one side will tend to start reaching with only the hand that they see in their visual field and ignore the other one. While we all develop a dominant hand when we are very young, infants need practice using both sides of their body equally in order to develop the nerve pathways in their brains appropriately before they choose a dominant side.
Here’s how to help your baby if you suspect they may have torticollis:
- Check with your pediatrician to see if a referral to a pediatric physical therapist is warranted.
- Position your baby in the crib (or anywhere else) so that all of the interesting things in the room are to the non-preferred side. This will give them a reason to turn their head to the side that is harder, and can help your baby perform their own stretch.
- When playing with your baby, present toys to the non-preferred hand, and encourage them to grasp the toy with that hand. This will allow your baby to practice grasping and manipulating toys with their non-preferred hand, while also turning their head and looking to the non-preferred side.
- Practice tummy time as much as possible. Many babies fuss during tummy time, but sometimes tolerate it better if they are placed on your chest at a bit of an angle, or if they are positioned over a Boppy pillow or towel roll to give them some assistance to stay up against gravity. Tummy time is ideal for taking the pressure off the back of the head in order to prevent plagiocephaly.