Have you noticed that your baby tends to tilt their head down to one side? Is the shape of your baby’s head becoming more asymmetrical or flatter on one side? These are signs of a Torticollis, which you will need to get looked at by your health professional sooner rather than later.Torticollis is a relatively common, easily treated, condition in babies. If you know what to look out for, the first signs of a torticollis can be picked up and treated in the first few weeks of life.

A torticollis is where there is a shorter sternocleidomastoid muscle on one side of your baby’s neck compared to the other. The Sternocleidomastoid is a neck muscle that connects the base of your skull to your collar bone. You have one on either side of your neck and in some people, especially in new born babies one side can be shorter than the other. This will cause your baby’s head to tilt down and turn towards one side. There is often a small benign lump on the muscle of the baby’s neck which is an indicator of Torticollis.

With treatment this muscle will stretch and grow and the problem will resolve. However, if left untreated it can cause permanent changes to the shape of your baby’s skull, have a detrimental effect on their development, restrict their normal movement patterns and cause a permanent limitation of your baby’s neck.

There are several reasons that a Torticollis can occur in babies, it is thought that the most common cause is a lack of space for the babies head in the mother’s uterus. Babies can often stay in one position for a long period of time without any space to move their neck. This means that as the baby grows their Sternocleidomastoid muscle can become under developed, stiff and tight on one side and over stretched and weak on the other.

If left untreated a Torticollis can begin to effect the shape of your baby’s head. In fact, a flattened head shape is often the first sign picked up by parents that something maybe wrong and it is only weeks, months down the line when an assessment of the head is done that the Torticollis is found to be the main issue.

The bones in a babies skull are not fully formed until approximately 12 months old, until this point they are thin and flexible to allow the head to grow and mould into shape. Due to the muscle shortening caused by a Torticollis, your baby will naturally tilt their head down to one side and have reduced ability to turn their heads. This means that only one side of your baby’s head is ever in contact with a surface and has al the weight going through it, preventing the head from being moulded into a well rounded shape.

1. Normal head shape
2. Plagiocephaly – flattening to one side
3. Brachycephaly – flat back of head

Do not panic if this is the case with your baby. The head shape continues to be mouldable until approximately 12 months old and the altered head shape does not, in any way effect your baby’s brain development. You still have a perfectly healthy baby, there are just a few things you made need to do to help the head shape correct. Seeing your child’s health professional or a Children’s Physio as quickly as possible, is the best thing you can do if you have concerns about your baby’s head shape.

How can you help?

*The following advice is provided by “The Children’s Physio” a highly specialised, fully registered paediatric physiotherapist based in London United Kingdom- The information provided is guideline advice only and not a suggested treatment of a Torticollis. A full assessment of your child is recommended prior to carrying out these exercises to determine the cause of the Torticollis and guide you with appropriate treatment.

Your baby needs to be encouraged to turn their head to the opposite side that the Torticollis is puling them towards.

• When your baby is in their cot, position them so that al the environmental stimuli is on the side they avoid turning to. So that when you walk into the room they have to turn the way they normally avoid in order to see you.
• When cuddling your baby, carry them on the opposite shoulder to the side of their Torticollis. So if they favour looking to the right, carry them on your left shoulder and vice versa.
• Remember Tummy time is important. It strengthens your baby’s neck and allows the back of their head to have a break from being in contact with surfaces. If you have problems with encouraging tummy time, speak to a Children’s Physio to help give you ideas to help your baby enjoy tummy time!
• Be mindful of how you handle your baby when feeding them. If you always feed from the same side you will be inadvertently encouraging a preferential head turn.
• play with your baby from both sides, encourage them to look around, turn their head and seek out objects out of their direct line of vision.

If you have any questions or concerns about either your baby’s head shape or neck movement, don’t hesitate to contact The Children’s Physio for advice or for a convenient home visit appointment.