WHAT IS INFANT TORTICOLLIS?
Torticollis is a symptom that causes a child's chin to be rotated to one side and his head tilted to the other. There are many causes of torticollis but the one most commonly affecting infants is known as congenital muscular torticollis.
Congenital muscular torticollis is a condition that occurs at birth or up to 2 months of age. The postural change occurs when the sternocleidomastoid (SCM) muscle on one side of the baby's neck becomes tighter than the other. This will cause a shift of the head and neck and cause the familiar tilted position.
However, more often there are restrictions found in other areas of the body contribute to a "pulling" in the tissues of the neck resulting in the familiar torticollis positioning. Only looking at the neck for the assessment of torticollis will often result in poorer outcomes.
CAUSES
There are a few common reasons why the neck may have restricted movement and cause your infant’s head to tilt to one side:
The way the baby was positioned in the womb before birth (dropped early in the pregnancy)
Abnormal development of the SCM muscle
Trauma or damage during birth
GERD (Gastroesophageal reflux disease)
Hip dysplasia
Pelvic torsion
Rib / thoracic restrictions
Any soft tissue, visceral or bony alignment issue that pulls on the tissues causing the child to move into a position of ease. A sideband or rotation of the spine can take tension off the tissue and reduce the "sensations" felt.
WHAT DOES IT LOOK LIKE?
If the right torticollis, the infant will hold his head with his chin rotated to the left and his head leaning to the right. In addition to the head posture, you may be able to feel tension in the affected area, which is usually most noticeable between 2 and 8 weeks of age.
FUNCTIONAL COMPLICATIONS OF TORTICOLLIS
Although pain may not be a factor, you may experience other difficulties with your infant.
Breastfeeding latches may be challenged due to the inability for the infants head to be held in a correct position. Efficiency and comfort may be affected for both mom and baby. The baby often has one side of feeding that is more difficult than the other. This is because gravity is causing a stretch on the neck muscles and this can be uncomfortable if there is tension present. This will often result in a tighter latch. When the head is rotated, it will also cause tension in the tongue on the same side, resulting in poorer movements of the tongue during feeding.
Digestive changes; There has been links of torticollis to GERD. Increased gas, bloating, difficulties burping and pain may be a result of the restricted tissues through the neck, chest and abdomen. When the latch is compromised, the swallowing of air can occur more easily. This is often referred to as aerophagia.
TREATMENT
Torticollis usually improves with manual therapies such as Myofascial Release & Craniosacral Therapy, as well as with changes made to feeding, play and sleeping postions. If left untreated, it can lead to positional plagiocephaly (flattened head) and facial asymmetry if your child's head lies in the same position all of the time. Treatment of the affected tissues as well as compensatory tissues is vital.
Early intervention is the best approach. Your child will not likely outgrow this without some corrective measure made. Forceful stretching will NOT help the restrictions and can actually be counter-productive.
HOW CAN YOU IDENTIFY IF YOUR CHILD NEEDS TO BE ASSESSED?
Answer these simple questions; (meant for informative purpose only. Not to replace a qualified therapists assessment)
Does your child's head lean one direction most of the time? Easily noticed in a car seat, swing or while sleeping.
Does your child's head turn to either direction easily and equally when following a toy?
If you baby wear, will your child allow you to have there head resting in either direction?
If breastfeeding, does your child prefer one breast over the other, possibly even refusing one side (provided milk production issues have been eliminated).
Can you gently turn your child's head to each side (normal is near 90 degrees)
If you child can hold their head upright, are their eyes level?
If you are unable to complete 2 or more of the above tasks, it doesn't mean your child has torticollis, but it is advisable to see a qualified therapist for a proper assessment. There may be a restriction present.
Disclaimer - Everything shared is for informative purposes only. It is not intended for assessment, diagnosis or treatment purposes. If you feel there needs to be further investigation, please seek out a qualified health care professional for a proper assessment.