During one of your routine check-ups, your professional tells you that your 2-month-old baby has a torticollis!
Between 3.9 and 16% of newborns will have congenital muscular torticollis (CMT).
The causes identified to explain torticollis at birth are :
- restrictive posture in the uterus (in 50% of cases),
- long labor and delivery,
- a large baby (macrosomia),
- childbirth trauma (forceps/ventouse),
- shoulder dystocia during delivery,
- breech or face delivery,
- a first baby (labor often takes longer).
Torticollis can be seen as early as birth, linked to the causes identified above, but can be diagnosed as early as 3 weeks after birth, since the tension may amplify after delivery, becoming more visible and eloquent.
The presence of a torticollis is the main cause of plagiocephaly (flat head in babies), since the baby is likely to always turn his head to the same side, which is the easiest for him. This, in turn, will create greater pressure on one side of the baby’s head, then flatten it out.
The baby’s head may be bent to one side or rotated due to the tension of the sternum and jaw muscles, resulting in facial asymmetry. Facial asymmetry can be seen in the alignment of the eyes, which are not equal, one cheek bigger than the other, and the mouth “crooked” when the baby yawns or smiles.
You may also notice small “muscle nodules”, hard lumps at the base of the skull behind your baby’s head. In fact, this is a tension in the fibrous tissue that may dissipate in one place and reappear in another, depending on the tension. Nothing serious here, although these nodules are known as “pseudotumors”.
You may suspect torticollis when the baby refuses a breast for feeding, has weaker sucking, difficulty opening the mouth or getting into a good position, and of course the head is very often turned to the same side. It’s therefore very important to work on biomechanics first, to optimize latching on, swallowing and efficient breathing at the same time.
Acting quickly is always the best solution. Results are very rapid and effective before 3-4 months of life. After that, physical treatment will require more sessions to achieve results, as the bones of the skull are increasingly fused together, with less mobility during surgery. Osteopathy, physiotherapy and chiropractic are interesting practices for this kind of problem, but always with a practitioner who specializes in babies or paediatrics, of course.
Tummy time and position changes
Until you have an appointment with your specialist to treat this condition, it’s advisable to change your baby’s position often, to put him on his tummy several times a day, for short periods, as recommended, from 2 weeks of life and when the cord has fallen off.
The Pediatric Society recommends tummy time for 10 to 15 minutes a day, every day, around 2 months of age. However, you can start with a newborn by placing him on your chest, for example, to avoid the constant pressure on his skull in the dorsal position.
At 3 months, we suggest 45 minutes on the stomach, and at 4 months, 80 minutes a day.
Limit time in baby’s accessories (shell, vibrating chair, swing, etc.) as much as possible, to one hour at a time. This will also help reduce the risk of skull deformation.
During naps, you can also try switching baby’s head to one side.
Marie Fortier
The Baby Expert
Updated article : July, 2024
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