News - March 2011
by Carolyn Graham, MS,PT
Torticollis describes an abnormal posture of the neck. This posture in an infant is typically with the head tilted toward the body in one direction and rotated in the opposite direction. This presentation usually occurs in the first year of life.
Additional symptoms include:
- One side of the face being larger than the other
- One eye being larger than the other
- Favoring of one side to play, roll, or sleep
- Flattening of the back of the head (especially on one side), otherwise known as plagiocephaly
Early treatment is important for these infants, including physical therapy. Physical therapy may include stretching of the neck muscles, strengthening of the neck and trunk muscles, positioning techniques, and facilitation of gross motor skills. Treatment may also include corrective helmets and/or orthotic collars.
There are many activities you can do at home to help your baby with torticollis.
One of the most important is encouraging tummy time. Tummy time will help develop your baby’s neck muscles so that he can hold his head up on his own and reduce head flattening. Some babies do not like being on their bellies. Some ideas to make your baby more comfortable include rolling up a towel and propping it under his chest,and using tummy time mats or boppy pillows. As a parent, you want to encourage tummy time as often as possible during the day.
Another important activity is to encourage your baby to look or rotate her head to the opposite direction of her preferred side. You can use toys with bright colors, toys that make noise, and mirrors to encourage her to turn to one side. Position your baby so that she is encouraged to look to the right or left, whichever is opposite from her preference. This can include positioning on the floor or changing table, as well as the way you face her in a swing or bouncy seat. Babies love to look and listen to their parents and siblings. Talk to your baby and sing songs to encourage your babyto turn her head towards you.
When putting your baby down to sleep at night or for a nap, turn his head to the opposite direction. He may rotate back to his preferred side at some point, but the more time he spends on the opposite side, the more comfortable he will become.
It is important to encourage your baby to play in various positions. In addition to tummy time, you also use a Bumbo Seat. Once your baby can hold his head up,he can sit in a Bumbo seat for short periods. This will help develop his neck strength as well as reduce the amount of pressure on the back of his head. The Baby Bjorn is another nice option for your baby to be off the back of his head. If your baby does not yet have enough head control, he can face in towards you. If your baby has adequate head control, he can face out and work on turning his head in both directions. Sidelying is another position for your baby to play in on the floor. You can prop him up with a towel roll or wedge behind him. This position will encourage your baby to bring his hands to midline, roll, and alter the pressure distribution on your baby’s head.
If you are bottle or breast feeding make sure that you switch sides at each feeding. This will encourage your baby to look in both directions. If your baby is eating solid foods, angle her seat to the right or left, so she will turn in the direction of the food. Encourage her to pick up finger foods with her right or left hand to encourage turning to the side that is opposite her preference.
Alternate the side that you carry your baby on to encourage your baby to turn in both directions. If you are carrying your baby up at your shoulder, turn his head so he is facing away from his preferred position. If your baby is older and can be carried on your hip, face him so he is looking out to his opposite side.
Car Seat Positioning:
If your baby tends to tilt his head to one side or rotate to one side when he is in the car seat or if he falls asleep, neck wings can be helpful. These padded cushions strap onto your baby’s car seat straps. They help to keep your baby’s head in a more neutral position during car trips. You can also place hanging toys on your baby’s car seat to encourage him to turn in the opposite direction.
Try these suggestions at home with your baby. Always consult with your doctor or physical therapist for any further medical advice or questions.