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Infant Torticollis
Does your baby lie with their head positioned to one side or is unable to feed from both sides equally?The word torticollis is derived from the Latin, "tortus" meaning twisted and "collum" meaning neck. Torticollis is usually related to tightened muscles on one side of the neck.
INFANT TORTICOLLIS
Does your baby lie with their head positioned to one side or is unable to feed from both sides equally?
The word torticollis is derived from the Latin, "tortus" meaning twisted and "collum" meaning neck. Torticollis is usually related to tightened muscles on one side of the neck.
Torticollis in infants is common and is reported to be as frequent as 3 in every 100 babies. It is usually diagnosed within the first month of life.
You may notice the following signs with your baby:
Baby’s head tilts or rotates to one side. More specifically; the head and ear are tilted towards the affected sternocleidomastoid muscle and the chin points to opposite side
They prefer looking in one direction
They prefer breastfeeding on one breast only or have more difficulty on one side
Limited range of motion in head and neck
Asymmetry in baby’s head and face (plagiocephaly)
A small lump in your baby’s neck
What causes it?
Your baby may have been born with torticollis (congenital) or it may present after birth (acquired torticollis)
CONGENITAL (Muscular or postural type)
Symptoms and signs may not become obvious until your baby is 6-8 weeks old and gains more head and neck control. The most common type of torticollis is muscular.
The sternocleidomastoid muscle attaches from the sternum and inner clavicle to the mastoid process of the temporal bone. When it becomes shortened it pulls your baby’s head into a tilt and/or rotation. This muscle can become tight and contracted due to the following factors
Abnormal uterine position, for example breech position
Injury during birth
Forceps or vonteuse delivery
Abnormalities related to the cervical spine.
Rarely, it may result from a congenital disease affecting the nervous system
Babies diagnosed with infant torticollis should also be assessed for Developmental Dysplasia of the Hip (DDH)
Acute onset or torticollis diagnosed after 6 months (acquired) requires urgent further investigations
What you can do?
If your baby's head tilts to one side, they prefer looking in one direction and have difficulty breastfeeding on both sides equally, there are several things you can do to help your baby:
Osteopathy: Make an appointment with your osteopath to address any underlying strains or restrictions related to uterine position and/or birth trauma
Feeding: When feeding your baby, encourage them to turn away from their favoured side by bottle/breast positioning
Sleeping: When putting your baby to sleep, position them facing the wall so they need to actively turn their neck to the restricted side to look out into the room.
Playing: Encourage neck rotation to the restricted side with toys, sounds and singing.
EXERCISES
Two exercises for infant torticollis are tummy time and guppy pose.
TUMMY TIME: position your baby so their head is turned away then encourage your baby to turn towards you by talking or singing . (Tummy Time blog)
GUPPY POSE: support baby on their back over your lap and allow their head to extend backwards, allow the chin to move away from the chest Encourage rotation to the restricted side. This pose releases tension through the front of the neck, and chest.
How can an osteopath help
An experienced osteopath who works with babies will assess for any cranial or facial asymmetries related to torticollis, they’ll assess for restricted cranial articular motion, cervical spine and rib dysfunction. They will palpate the sternocleidomastoid and scalene muscles for any lumps and tightness.
As torticollis may have an impact on the vestibular system and can affect the visual system, your osteopath will also check your baby’s visual tracking.
It’s really important to treat infant torticollis as early as possible. If left untreated, it can lead to functional restrictions of the spine, plagiocephaly and it has also been associated with thoracic scoliosis.
osteopathy near me
Dr. Michelle Sherriff use a very gentle form of osteopathic treatment for babies called Biodynamic Osteopathy to treat infant torticollis. This type of treatment allows your baby to come to a point of stillness, allowing an unwinding and rebalancing of their system. Osteopathic treatment aims to restore normal function, optimise healthy development and assist your baby’s own innate capacity to heal and restore balance naturally.
Plagiocephaly
When a baby is born with an asymmetrical head it is called plagiocephaly, from the Greek “plagios” meaning oblique and “kephale” meaning head. A true plagiocephalic head will resemble a parallelogram when viewed from above.
When a baby is born with an asymmetrical head it is called plagiocephaly, from the Greek “plagios” meaning oblique and “kephale” meaning head. A true plagiocephalic head will resemble a parallelogram when viewed from above.
Newborn skulls are cartilaginous and membranous which allows them to be soft and malleable through the birth process. Birth strains usually resolve quickly or by six weeks post birth. “As the twig is bent so shall the tree incline” is a well known phrase from the founder of osteopathy, Dr. Andrew Taylor Still. Early osteopathic treatment is recommended to address cranial and facial strains related to plagiocephaly. When left untreated, plagiocephaly may contribute to postural imbalances and delays in early milestones,
There are two types of plagiocephaly; primary and secondary. Primary plagiocephaly is present at birth and may be related to the following factors:
Through pregnancy:
abnormal uterine positioning or strong moulding forces in the uterus
Primiparity, first child
Twin pregnancies, less space
Intrauterine constraint
Low amniotic fluid or premature engagement of the head and pelvis
Premature baby, the skull is still very soft and malleable
Torticollis related structural anomalies, for example congenital fusion of cervical vertebrae.
The birth process:
A difficult or lengthy labour
Assisted delivery (especially if ventouse or forceps used)
Secondary plagiocephaly appears several weeks to months after birth. Causes include:
Torticollis where plagiocephaly develops secondary to torticollis.
Dysfunction of C1 causing fixation of the head
Positional flattening, baby spends too much time lying on their back
Restricted position of newborns
ON EXAMINATION
You may notice a flat spot at the back or side of your baby’s head as well as bulging, called “bossing” at the front of their head on the same side. Your baby may have difficulty turning their neck to one side, prefers resting their head in one position or to feed from one breast. You may notice you baby’s eyes and ears are not symmetrical.
Your osteopath can inspect and palpate (feel) the cranial bones, suture and fontanelles to diagnose plagiocephaly.
OSTEOPATHIC TREATMENT
Early and frequent osteopathic treatment is important to treat any intraosseous restrictions and strain patterns of the cranial base and resolve any membranous and fluid strains. Treatment of the cervical spine is indicated if torticollis is related. Dr. Michelle Sherriff utilises a very gentle form of osteopathic treatment for babies called Biodynamic Osteopathy in the Cranial Field. This type of treatment allows your baby to come to a point of stillness, allowing an unwinding and rebalancing of their system.
WHAT YOU CAN DO
Make an appointment with your osteopath for early and regular treatment
Face Time, when you baby is awake play with them face to face
Tummy Time, place them lying down on their tummy (when awake) or on their side from from 1-2 weeks of age.
Encourage your baby to turn their head to the restricted side with toys, rattles or positioning cot so your baby turns to look at you.
Vary the position of your baby’s head when putting them down to sleep to avoid the flat spot
To reduce risk of SIDS babies must always be placed on their back to sleep
A helmet may be an option if the deformation is moderate or severe and persists beyond 6 months.
A more serious condition called craniosynostosis must always be excluded before plagiocephaly is treated conservatively