A bad night's sleep can mean waking up with a stiff neck, which makes it hard or
painful to turn your head. This is called torticollis
(Latin for "twisted neck").
In newborns, torticollis can happen due to the baby's position in the womb or after
a difficult childbirth. This is called infant torticollis or congenital muscular torticollis.
It can be upsetting to see that your baby has a tilted head or trouble turning
his or her neck. But most with babies don't feel any pain from torticollis. And the
problem usually gets better with simple position changes or stretching exercises done
What Causes Infant Torticollis?
Torticollis is fairly common in newborns. Boys and girls are equally likely to
develop the head tilt. It can be present at birth or take up to 3 months to happen.
Doctors aren't sure why some babies get torticollis and others don't. It might
happen if a fetus is cramped inside the uterus or in an unusual position (such as
being in the breech position, where the baby's buttocks face the birth canal). The
use of forceps or vacuum devices to deliver a baby during childbirth also makes a
baby more likely to develop it.
These things put pressure on a baby's sternocleidomastoid (stir-noe-kly-doe-MAS-toyd)
muscle (SCM). This large, rope-like muscle runs on both sides of the neck from the
back of the ears to the collarbone. Extra pressure on one side of the SCM can make
it tighten, which makes it hard for a baby to turn his or her neck.
What Are the Signs & Symptoms of Infant Torticollis?
Babies with torticollis will act like most other babies except when it comes to
activities that involve turning. A baby with torticollis might:
tilt the head in one direction (this can be hard to notice in very young infants)
prefer looking at you over one shoulder instead of turning to follow you with
his or her eyes
if breastfed, have trouble breastfeeding on one side (or prefers one breast only)
work hard to turn toward you and get frustrated when unable turn his or her head
Some babies with torticollis develop a flat
head (positional plagiocephaly) on one or both sides from lying in one direction
all the time. Some might develop a small neck lump or bump, which is similar to a
"knot" in a tense muscle. Both of these conditions tend to go away as the torticollis
How Is Infant Torticollis Diagnosed?
Your doctor will do an exam to see how far your baby can turn their head.
How Is Infant Torticollis Treated?
If your baby does have torticollis, the doctor might teach you neck stretching
exercises to practice at home. These help loosen the tight SCM and strengthen the
weaker one on the opposite side (which is weaker due to underuse). This will help
to straighten out your baby's neck.
After treatment starts, the doctor may check your baby every 2 to 4 weeks to see
if the torticollis is getting better.
Helping Your Baby at Home
Encourage your baby to turn the head in both directions. This helps loosen tense
neck muscles and tighten the loose ones. Babies cannot hurt themselves by
turning their heads on their own.
Here are some exercises to try:
When your baby wants to eat, offer the bottle or your breast in a way that encourages
your baby to turn away from the favored side.
When putting your baby down to sleep, position them to face the wall. Since babies
prefer to look out onto the room, your baby will actively turn away from the wall
and this will stretch the tightened muscles of the neck. Remember — always put
babies down to sleep on their back to help prevent SIDS.
During play, draw your baby's attention with toys and sounds to make him or her
turn in both directions.
Don't Forget "Tummy Time"
Laying your baby on the stomach for brief periods while awake (known as "tummy
time") is an important exercise. It helps strengthen neck and shoulder muscles
and prepares your baby for crawling.
This exercise is especially useful for a baby with torticollis and a flat head,
and can help treat both problems at once. Here's how to do it:
Lay your baby on your lap for tummy time. Position your baby so that his or her
head is turned away from you. Then, talk or sing to your baby and encourage him or
her to turn and face you. Practice this exercise for 10 to 15 minutes.
What Else Should I Know?
Most babies with torticollis get better through position changes and stretching
exercises. It might take up to 6 months to go away completely, and in some cases can
take a year or longer.
Stretching exercises to treat torticollis work best if started when a baby is 3–6
months old. If you find that your baby's torticollis is not improving with stretching,
talk to your doctor. Your baby may be a candidate for muscle-release surgery, a procedure
that cures most cases of torticollis that don't improve.