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Published on October 16, 2017

Why is my baby’s head tilting in one direction?Why is my baby’s head tilting in one direction?

The first few weeks after giving birth are busy times for new parents. They may be adjusting to breastfeeding, not getting enough sleep and taking care of one or more other children.

But, once they settle into somewhat of a routine and become more familiar with their newborn, this is often the time new parents may notice any peculiarities their baby may have. One such peculiarities is a tilted head, that, when straightened by the parent, immediately turns back down toward the shoulder.

There are several reasons your baby could have this characteristic, but it’s important to discuss the observation with your doctor because it could be congenital muscular torticollis, also known as “wryneck” or “twisted neck.”

“Torticollis is a condition when babies are born with their head tilted to one side, caused by tight muscles in the neck,” explained pediatrician Gregory Parkinson, MD, at Falmouth Pediatric Associates. “Sometimes people will feel a lump on one side of the neck. You don’t always feel the lump, but it’s common. Torticollis occurs in about one out of every 200 births, so it’s not that unusual.”

Newborn babies should not have a preference of looking in one direction or the other, unless they happen to be interested in something that is in one particular direction, Dr. Parkinson said.

Turned heads can also be caused by secondary conditions as well. The most common one is caused by vision problems. A baby with ocular torticollis might turn his or her head in one direction to correct their own focus in order to see better. In that case, it’s not really a problem with the neck muscles, per se, but an adaptation to a vision problem.

Doctors don’t know exactly what causes congenital muscular torticollis, Dr. Parkinson said, but the most common theories are: overcrowding in the womb, an odd position in utero, or a minor trauma during pregnancy or birth.

It’s best if torticollis is caught early, at the first or second month checkup, because that’s when it is most easily corrected, usually in just a couple of months.

Catch It Early

“The earlier you know about it, the better,” Dr. Parkinson said. “It’s like any other type of muscle. The longer it stays like that, the harder it is to get it back to normal.”

If the torticollis is not too severe, pediatricians show parents some simple stretching exercises to straighten the neck. They recommend that parents turn the head to the side that needs stretching at every diaper change.

Also positioning the baby in a way that makes them look towards the opposite direction is a good idea. Nursing mothers automatically switch sides when feeding, which helps baby’s necks develop strength.

“They don’t have to be doing therapy every minute of the day,” he said. “Sometimes that can take all the joy out of the rest of parenting. Having set times when you do it regularly is good.”

When the torticollis is more severe, infants are referred to physical therapy at Spaulding Rehabilitation because they have pediatric physical therapists. There physical therapists work with parents to teach them a more comprehensive stretching program to do at home.

Babies with congenital torticollis also qualify for physical therapy at Early Intervention through Cape Cod Child Development.

In the rare cases that don’t respond, sometimes Botox is used to relax the muscle. If all else fails, surgery is done to lengthen the tendon.

“About 95 percent of the time, you can fix this with stretching,” Dr. Parkinson said.

Featured Photo: Baby Chloe of Brewster was diagnosed with infant torticollis at her one-month pediatrician visit. Her physical therapist thinks she will need about two months of physical therapy and then be just fine.