Torticollis: Does your child prefer look to one side?

Check the pictures you have been taking of your new baby. Does your child always tend to look to one side in the pictures? Have you noticed a preference for a certain side when they sleep? Do they not like breast feeding or prefer to do it only on one side? Do they get uspet when they are held a certain way?

Some children are born with a condition called torticollis. It is usually caused by the position of the baby in uetero. There are other reasons that the muscle can be involved such as a difficult delivery. The muscle (the sternocleidomastoid muscle (SCM)) in the neck which extends from the bone behind the ear (the mastoid) to the same side collar bone (clavicle) where it joins the breast bone(the sternum) becomes tight because the baby is unable to move out of this position in the last months of pregnancy. The muscle on both sides of the neck, therefore, do not develop equal length-tension ratio. The one on the opposite side is often a bit weak. Sometimes facial and cranial asymmetry, where the face and the skull are abnormally shaped, will accompany torticollis.

In this picture it is very subtle but if your child has torticollis you will know this posture. Her tight neck muscle would be on her left side.

This is important: it is unlikely that your child has torticollis if you see the tilt/rotation to one side as much as you see it on the other side or if the ratio is close.

Everyone has a sternocleidomastoid muscle on each side. This muscle, when it contracts on just one side, produces two movements. It turns the head opposite that side and tilts the head toward that side. (The tight muscle is on the right side for this little guy.)

A doctor should be seen if you are concerned that your child has torticollis. The earlier it is diagnosed and treated the better the outcome. A pediatric physical therapist should treat the condition. The treatment for this condition is stretching of the tight SCM and strengthening of the weak SCM. There are ways to incorporate the treatment into your day and to do it without a lot of discomfort to your baby.

Other reasons for this same posture to present in your child exist so be sure to have a pediatrician evaluate your child. Less common reasons for torticollis can be a tumor, infection or visual problem. These conditions will require other treatments.

For information on treatment techniques, plagiocephaly and more on torticollis watch for next week's blog.