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If you’ve noticed your infant has an unusual tilt to her head or prefers to look in only one direction, you’ve noticed a common problem called infant torticollis. It occurs when a baby has a tight neck muscle that makes it difficult to turn the head. While it can be upsetting to see, infant torticollis is common and generally doesn’t cause babies any pain.

“Adults who wake up with a stiff neck know they need to stretch it out to feel better,” says Kristen Ferguson, physical therapist at Beaufort Memorial. “But a baby naturally avoids anything uncomfortable, so they need some help stretching and repositioning themselves. With early intervention, almost all babies outgrow torticollis.”

What Causes Baby Torticollis

Torticollis develops when the sternocleidomastoid muscle, which runs along the side of the neck, is too tight and short. It’s not clear why this happens, but it may have something to do with a baby’s position in the womb.

“Some babies are cramped or in an abnormal position inside the uterus,” says Cheryl Rodriguez, physical therapist at Beaufort Memorial. “This can cause shortening of the neck muscle or the development of a habitual pattern.”

Signs of Infant Torticollis

Because torticollis doesn’t often cause babies pain at rest, the main symptom you’ll notice is how your baby turns his or her head. Babies with the condition may:

  • Have asymmetrical flattening of the back of the head
  • Have limited range of motion and difficulty rotating their head side to side or tilting it side to side
  • Have a soft, painless lump in the affected neck muscle
  • Look at you over one shoulder instead of turning to follow you with their eyes
  • Prefer to breastfeed on one side
  • Tilt their head to one side with the chin in the opposite direction (for most babies, the left neck muscle is affected.)

Call your child’s pediatrician if you notice any of these signs. Your child’s doctor can confirm a diagnosis and refer you to pediatric physical therapy to teach you how to help loosen your baby’s neck muscle.

How to Help at Home

Follow these tips to help your child with infant torticollis:

  • Encourage position changes. Try placing toys where your baby will have to turn to see them. You can also position a crib or changing table so your baby must look away from the limited side to see you.
  • Have tummy time. Lay your baby on his or her stomach while awake for “tummy time.” This helps babies strengthen neck muscles.
  • Stretch at home. Your physical therapist will teach you how to do exercises to stretch and strengthen your baby’s neck. These are gentle stretches done throughout the day to help improve their range of motion.

“Ask your pediatrician at your well baby check-ups if you notice your baby only looks in one direction,” Ferguson says. “If it seems difficult to encourage them looking in the opposite direction, seeing a physical therapist who is trained to work with infants may be beneficial.”

Infant torticollis generally improves with help, whether from physical therapy or stretching exercises, but it can take up to six months. Early intervention is key to making a full recovery. A small number of children may need surgery when they reach preschool age to correct the condition.

Children have special needs that require care from a specialized team. Beaufort Memorial offers pediatric physical therapy in Bluffton and Beaufort for children with a variety of conditions, including infant torticollis.