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Torticollis in Infants

Torticollis in Infants

Congenital torticollis is a condition wherein an infant's head is tilted to one side. It usually occurs when the sternocleidomastoid muscle in the neck is tight and shortened. This write-up provides information on this condition.
Smita Pandit
Torticollis, also known as wryneck, is a condition wherein the baby's neck seems to be tilted to one side. The baby's chin seems to be pointing towards one shoulder, whereas his/her head tilts towards the opposite shoulder. This condition could be congenital (present at birth) or acquired later in infancy or childhood. If you notice such symptoms in your little one, you must visit a pediatric specialist soon.

Contributing Factors

Wryneck is caused due to the shortening of the sternocleidomastoid muscle. The sternocleidomastoid muscle connects the base of the skull to the collarbone and facilitates the movement of head. This particular muscle might get affected, if the baby is positioned with the head tilted to one side in the uterus. Any injury to this muscle before and during childbirth can cause bleeding and swelling, which might lead to the formation of scar tissue. This could cause shortening of the muscle. The presence of fibromatosis colli, which is a benign fibrous growth of the sternocleidomastoid muscle, could be a contributing factor for wryneck. Bone abnormalities in the cervical spine could also cause tilting of the head to one side. It is believed that the use of suction or vacuum devices for the delivery is another risk factor.

An infant affected by this condition has problems turning the head from side to side, and keeps the head turned to one side. Affected infants might have a tight neck muscle on one side, and a weak neck muscle on the opposite side. Since infants have tender skin, the infant's head might also get flattened as he/she sleeps with the head always turned on one side. It can also lead to facial asymmetry. The flattening across the back and side of the head is referred to as plagiocephaly. A soft lump might be seen in the baby's neck muscle in the first few weeks. Ocular torticollis is another type that could occur due to an eye muscle imbalance. Vertical misalignment of the eyes and congenital nystagmus can also lead to head tilt or chin up posture. In case of a horizontal misalignment of the eyes, the child could develop a head turn.

Treatment

If you feel that your baby's head remains tilted to one side only, you must consult a pediatrician soon. There are certain exercises that could help in treating this condition. These include gentle neck rotation and side bending. Parents can learn these stretches from a physiotherapist. They must also try different ways to encourage the infant to turn the head on the other side.
  • Position the baby crib or carry the baby in such a manner that encourages the child to look on the other side.
  • During feeding, you must hold your baby in such a manner that will make him/her rotate the chin to the correct position.
  • Similarly, place your child's favorite toys so that your baby has to turn his/her head to see them and play with them.
  • You could also lay the baby on her back and very gently tilt the head to the other side.
  • If your baby prefers looking to the right, hold the baby against your left shoulder and vice versa.
  • Put the baby in the cot in such a way that he/she will have to turn, as you enter the room.
  • Put a rolled up soft towel under the baby's chest or place your baby on your stomach when you are lying down. You can also have the baby lie on the belly over a wedged surface that is at least 5 to 6 inches high. Place toys around, so as to encourage the baby to turn her head.
  • Make your baby look at and follow faces or toys.
An early diagnosis and treatment of this condition is very essential. If you notice any abnormality in your child's movements or child development, consult a doctor soon. When discovered early, gentle stretches, positioning methods and exercises can help in correcting this abnormality to a great extent. In case of ocular type, parents must consult an eye doctor. Klippel-Feil syndrome is one of the risk factors for this congenital form of this condition. Once the baby has completed the age of 18 months, and the baby's head is still tilted to one side, then the doctors might suggest surgery to treat this condition.

Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.