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Torticollis is a common condition that occurs when one of the muscles in your baby’s neck is tight or weak making it difficult to turn the head to one side or causes the head to tilt or pull to one side.

Signs of Torticollis

  • Flat spot developing on the back or one side of your baby’s head (also called plagiocephaly).
  • Preference for your baby to keep his/her head turned to one side or ability to turn head farther in one direction than the other.
  • Inability to maintain or bring head to midline or hold head in line with their trunk.
  • Difficulty feeding from both breasts (if breastfed) or prefers one breast over the other.

Common questions about Toticollis

Q: Can I wait and see if the flat spot gets better?

A: While waiting to see is always an option. It may not always be the best option and it is heavily encouraged to have your baby’s flat spot evaluated by a physical therapist so see if there is a reason why the flat spot is developing and if there are any exercise and positioning activities that can be performed with your baby to help. If left untreated can lead to positional plagiocephaly.

Q: What is midline and why does it matter if my baby can bring his/her head to midline?

A: Midline head position is when the head is aligned with the trunk with eyes facing forward and no rotation or tilt of the head. Think of an imaginary line down the middle of your baby’s body from top of head all the way to between their feet. Finding midline with the head is key to developing midline skills throughout the rest of the body, including bringing hands to midline and then crossing midline. Crossing midline is an important part of development and promotes the ability to use both sides of the body together in a smoot and coordinated manner to reach, crawl, roll, sit, etc.

Q: How is breastfeeding related to Torticollis?

A: During breastfeeding your baby needs to turn his/her head to both directions in order to switch breasts. If there is tightness or weakness in your baby’s neck that is limited turning his/her head to one side, then the breast that requires them to turn in that direction may be more challenging to nurse from, leading to your baby not wanting to latch or nurse from that breast.

Goals of physical therapy with Torticollis

-Regain full neck mobility and strength
-Symmetrical use of both sides of the body
-Symmetrical movement/transitions to both sides of the body (ie. rolls to both sides, transitions in/out of sitting over both sides)

– Article written by: Anne Ferguson PT, MPT