Helping kids of all ages to live a more active life through FUNctional movement.
By Paige Pebesma, Physiotherapy Resident
Do you notice that your baby often looks in one direction? Does it look like your baby is tipping his/her head or body to one side? Maybe you notice that your baby struggles with feeding on one side? These are some of the possible signs that your baby may be developing torticollis. Our Physiotherapy Resident Paige Pebesma provides some information on torticollis and some simple tips to incorporate into your daily routine.
WHAT IS TORTICOLLIS & WHAT CAUSES IT?
Torticollis means that the sternocleidomastoid muscle (a muscle on each side of the neck) is shorter on one side. This usually results in the baby tilting their head towards the side of the short muscle, and rotating their head the other direction. Torticollis may be present at birth, or it can present within the first few months of life. There are a variety of causes for torticollis, but some common ones include intrauterine positioning, multiple birth pregnancies (ex: twins, triplets, etc.), trauma during labour or delivery, and more.
POTENTIAL SIGNS OF TORTICOLLIS
Some potential signs you may notice in your baby are:
persistent head tilt and rotation, which can potentially lead to flattening on one side of the head
struggling to feed on one side
dislike for “tummy time”
curving body to one side like a “C” when sitting
3 WAYS TO PREVENT OR HELP TORTICOLLIS
Daily activities to prevent or help torticollis in the early stages:
1.Supervised prone play / “tummy time”
Supervised tummy time when your baby is awake can be started right away with most infants and is not only great for helping prevent torticollis but is also helpful for infant motor development. Supervised tummy time should be performed 3 or more times every day. By 3 months of age babies should be accumulating 60 minutes of tummy time total per day, and by 6 months they should spend 90 minutes total per day on their tummies.
2. Promote baby turning their head both ways
In order to prevent or help torticollis, it is important to encourage your baby to look both ways equally. This can be done by rotating the way your baby faces at night when sleeping – each night flip which end of the crib the baby’s head is positioned. As a result, your baby rotates his/her head one way one night, and the other way the next, thereby keeping the movement symmetrical. Another way to promote your baby looking both ways is to also flip where your baby’s head is during diaper change. Just like when sleeping, your baby will want to look up at you during diaper change so by flipping ends your baby will alternate which way it has to turn to look up at you…this will also challenge your coordination 😉 . Another time to promote looking both ways is by feeding your baby on alternating sides each feed.
3.Active body movement & limiting time in containers
Babies develop and learn through moving their bodies, so it is important to give them that opportunity. This means that it is best to limit the amount of time that your baby spends in a container which includes car seats, strollers, baby swings, etc. Your baby should be in these containers when it is necessary and to keep them safe. However, spending too much time in these containers restricts your baby from being able to move in the way they want and need. Containers like car seats and strollers also promote your baby lying on their back. If your baby already has a preference to look one way and is starting to develop a flat spot on their head, spending less time on their back can help address these issues too.
These are 3 ways to prevent or help torticollis in your baby. However, early intervention is key, so if you have tried these tips and are still noticing your baby’s preference to look or feed one way, curving to one side, flattening of the head on one side, or have any other concerns, then a physiotherapist may be able to help you and your baby. Call to find out more about what services a physiotherapist can offer, or how to work 1-1 with Paige or one of our other Physiotherapists/ Physiotherapy Residents.
Flannery, A. M., Tamber, M. S., Mazzola, C., Klimo, P., Baird, L. C., Tyagi, R., Bauer, D. F., Beier, A., Durham, S., Lin, A. Y., McClung-Smith, C., Mitchell, L., & Nikas, D. (2016). Congress of Neurological Surgeons systematic review and evidence-based guidelines for the management of patients with positional plagiocephaly. Neurosurgery, 79(5), 623–624. https://doi.org/10.1227/neu.0000000000001426
Kaplan, S. L., Coulter, C., & Sargent, B. (2018). Physical therapy management of congenital muscular torticollis: A 2018 evidence-based clinical practice guideline from the APTA Academy of Pediatric physical therapy. Pediatric Physical Therapy, 30(4), 240–290. https://doi.org/10.1097/pep.0000000000000544