Torticollis and the Hare

As a pediatric Physical therapist who specializes in 0-24 months, I treat a lot of babies with torticollis. Torticollis is very common in newborns especially multiples. Its a tightness in the muscles on one side of the neck which causes your baby to prefer to look in one direction. This tightness can occur in utero (due to no fault of your own) or can result from positioning once born. Preferring to look to one side can cause the naturally soft newborn skull to become flat on that side (called plagiocephaly).

The increase in torticollis (not tortoise, haha) is in part due to the Back to Sleep initiative which came out 20ish years ago and has significantly helped to decrease infant deaths from SIDS. The initiative states infants should sleep on their backs and should not have loose clothing, blankets, toys or bumpers in their crib. The surface for sleeping should be flat and firm.

Because we need to sleep our babies on their backs for safety we need to "rotisserie" the baby during the other hours of the day especially when they can be supervised. That sounds like a funny thing to do but it just means we need to give our babies the opportunity to be on either side and to do tummy time so that their naturally soft heads get even pressure and stay round. This also allows them to use all the muscles around the neck so that one side doesn't become tight. If you've ever gotten a crick in your neck you know its not so easy to turn your head and look around. It generally doesn't feel good at all. Hence the chicken and the egg situation between torticollis and plagiocephaly. Its hard to determine which comes first. They are besties and they hate to break up.

That leads me to the hare part of the story. The hare is fast and so should you be when you notice an issue with your baby's neck or head shape. The first 3-4 months are the best time to work on both these co-dependent enablers. Baby is less mobile and stays in position when placed. Their head is very soft and easy to reshape. Stretching of the neck muscles is also easier to do with less fussing because baby is less alert and less mobile. As a pediatric PT I teach easy ways to hold your baby, feed your baby and position them to combat torticollis and plagiocephaly. Once baby is 4-5 months old keeping them in one place is exponentially more difficult and a helmet may be your only option.

If we start working together early I can also give good recommendations for limiting or avoiding container use. There are so many on the market that it can be overwhelming to decide what you need and what is just taking up space in your home. Toy recommendations and tips for baby wearing are also included in a pediatric PT's education during a session. Don't hesitate to reach out if you would like to discuss any of these issues. I am here to help.