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Torticollis: What to Do if Your Newborn’s Head Tilts to One Side

If you’re the parent of a newborn, you may find yourself watching for any signs of problems in your baby. If you notice that your baby’s head is tilted to one side, it could be congenital muscular torticollis. Also called wryneck, this condition might be noticeable when your baby is two to four weeks old. It happens when the baby's neck muscles are tight, so the baby’s head tilts toward one side with the chin pointed in the other direction. A baby with torticollis also might have a reduced range of motion in their neck.

You might be worried if your baby’s head is tilted, but torticollis doesn’t usually cause any pain. And, if it’s treated promptly, there shouldn’t be any long-term issues. 

What causes torticollis?

Tamara Zach, MD, a pediatric neurologist with Banner Children’s, said tightness in the sternocleidomastoid (SCM) muscles on one side causes the condition. These muscles run from the back of the neck to the breastbone and collarbone and help you move your head to the side, rotate your head, and extend your neck. Researchers don’t know exactly why babies develop tightness in these muscles. But babies with it tend to:

  • Be firstborn
  • Have decreased movement in the uterus
  • Have low fluids in the uterus before birth
  • Be born in a breech presentation
  • Have a birth that was assisted with forceps or a vacuum

Once born, they may also not spend much time on their belly or not position their head on different sides. 

What are the symptoms?

The tilted head is the main symptom. This head position can also cause flattening of the head on one side. Torticollis can also cause developmental delays such as poor head control or difficulty sitting or crawling, as well as a preference for one hand over the other, since the baby tends to look toward one side and favor the hand they can see. 

How is it diagnosed?

Your baby’s doctor can diagnose torticollis with a physical exam where they check the twist or tilt in the baby’s head and neck. They might also order imaging studies such as an X-ray, CT scan or MRI to make sure there’s nothing else causing the tightness. If your pediatrician notices a lump on the neck or limited hip movement, other specialists might need to be involved, since other issues could be causing the problem. 

How is torticollis treated?

At home, you can make sure your baby gets tummy time and encourage side-to-side head movement by placing mirrors or mobiles on both sides of the crib and offering toys to your baby from both sides. Your pediatrician will also probably recommend physical therapy, which can teach you stretching exercises and how to massage the neck muscle. 

“Physical therapy is better when it’s started early,” Dr. Zach said. Never try to stretch your baby’s neck without learning the proper technique, though. Physical therapy almost always works to treat torticollis, but if it doesn’t, surgery is an option. 

The bottom line

Torticollis is a common condition in newborns where tight neck muscles cause the head to tilt to one side. It might seem scary, but it’s usually treatable with no long-lasting issues. Treatment works best when it’s started early, so if you’re concerned about the positioning of your baby’s head, check with a health care provider right away. 

Do you have concerns that your baby may have torticollis?

Schedule an appointment with a pediatrician near you.

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