What is Torticollis?

Torticollis is a condition in which a newborn's head tilts to one side. It is sometimes referred to as "wryneck." A baby with this condition will have his chin pointed toward one shoulder, and the top of his head pointed in the direction of the opposite shoulder. Torticollis is painless, but it can be upsetting for a parent to see their newborn with the condition. It is sometimes present at birth (congenital torticollis), or can develop over the first three months of life. Most of the time it can easily be treated, but in some cases it can indicate more serious underlying conditions.

Causes of Torticollis

One form of torticollis - muscular torticollis - is actually fairly common, but doctors don't know exactly what causes it. Often, it may happen because of tightness in the muscle that connects the sternum and collarbone to the baby's head. Researchers believe that positioning in the womb is the most likely culprit in these instances.
In rare cases, torticollis can be due to a malformation of the neck bones, a condition known as Klippel-Feil syndrome. This syndrome is often accompanied by hearing and kidney problems, and can't be treated in the same way as the muscular form of torticollis. It is important to get a solid diagnosis of the source of torticollis, because in a very small number of cases it can indicate a tumor on the spinal cord.

Torticollis Symptoms

Pediatricians will often check for torticollis, and they can identify it even if parents haven't noticed any of the following symptoms:

  • Head tilts to one side
  • Baby prefers to feed only on one breast
  • A small lump may form on one side of the neck
  • The baby may not turn his head to maintain eye contact

Treatment of Torticollis

Stretching and Exercise
Your pediatrician will teach you some simple and safe ways to stretch out the affected muscle, if your baby has congenital torticollis. The doctor will also recommend ways to hold the baby during feeding times, in order to strengthen the proper neck muscles. Another thing you can do is position the baby in his crib so that he has to turn his chin the proper direction in order to see the room. (Remember to put some colorful toys in his field of vision to encourage this.) As the muscles strengthen, the condition should go away - typically within a couple of months. In severe cases, it can take 6 months to a year before the baby makes a full recovery.

Tummy Time
Tummy time is really important when a baby has torticollis. Place the baby on a soft surface or blanket on his tummy and put some toys in front of him. You can also play with the toys in front of him and interact with him. The goal is to get him to lift his head up and look straight ahead to see all the action. This will strengthen the muscles and encourage healing.

Surgical Treatment
Sometimes stretching and play time directed at strengthening muscles aren't enough to bring about a full recovery. If the baby still has weakened muscles by 18 months, the doctor may refer the parents to an orthopedic surgeon. An operation can sometimes lengthen the muscles, although doctors generally prefer that you continue with the exercises before opting for surgery. It is almost always preferable to try to resolve torticollis through natural, non-surgical methods.

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