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Parents

Why Is My Baby's Head Tilted?

Dr. Allison Mell, DPT
December 29, 2022
Why Is My Baby's Head Tilted?

You know those nights where you sleep the wrong way and you wake up with a stiff neck? Well, your baby can also experience tightness in the neck muscles, though it’s not caused from sleeping the wrong way in their crib. Let’s introduce Torticollis, aka a baby’s stiff neck.

 

Torticollis can sound like a scary medical term, but the reality is many new parents will quickly become familiar with this diagnosis. Torticollis is normally diagnosed after a parent or physician starts to notice that a baby’s neck is consistently tilted to one side while their head is turned to the opposite side (for example, if there is a neck tilt towards the right, the head is turning towards the left). This term, “torticollis” specifically refers to the tightening of the sternocleidomastoid muscle (SCM), which results in this tilted and rotated head positioning.

 

Like most parents facing this challenge, you will probably wonder how this condition happened. Did you do something wrong? Is it fixable?

 

There are actually several ways a baby can develop Torticollis. 

  1. In-utero positioning can lead to tightness in the SCM (similar to how sleeping without moving your neck all night will lead to tight muscles). 

 

  1. Tongue/lip tiesT, even after they’ve been clipped, can also lead to tightness in the neck. If the mouth muscles are tight or not functioning as they should,, the neck muscles can become tight- everything is connected. 

 

  1. Ocular (vision) irregularities may also be an underlying cause of torticollis. If the eyes aren’t working together properly, baby may tilt their head to see the world better and consistently tilting the head can lead to tightness.

Your physician may or may not be able to pinpoint the exact reason why your child is experiencing torticollis, but figuring out the “why” is very important to treat the condition effectively.

FREQUENTLY ASKED QUESTION: IF YOU NOTICE THIS NECK TILT AND HEAD TURN, SHOULD YOU WAIT TO SEE IF YOUR BABY “GROWS OUT OF IT” OR CONSULT YOUR CHILD’S DOCTOR?

The sooner the better! It is SUPER important to recognize the signs and take action as early as possible and here’s why:

  1. Since the whole body is connected, the head tilt can cause tightness through other parts of the body.  This tightness could affect baby’s trunk and hips- which in turn,  will affect how your baby reaches their motor milestones. You may notice baby looking towards only one side, rolling primarily to one side long after the milestone is mastered, using one hand more than the other, or hitch crawling (with one knee bent), which are all effects of torticollis that can be resolved with proper treatment

  1. If your baby has torticollis, a flat spot on the side of their head will likely appear (plagiocephaly). Now, why is this a big deal? Won’t the flat spot fix itself over time? Well, actually no. Without treatment the flat spot won’t disappear and plagiocephaly can lead to asymmetries in the face. Once that happens, it is extremely difficult to correct. 

  1. Imagine looking at the world sideways since the day you were born? Your baby was already super confused by this new world he was born into, now imagine how much his perception of reality would be totally off if he only saw it sideways. That’s what happens if your baby’s head is always tilted as he visually takes in his environment. Vision irregularities may be an effect of torticollis, but it can also be the cause. It’s very important to get a vision test to rule out any ocular abnormalities if typical torticollis treatment strategies aren’t showing results.

Please note that none of this is meant to scare you. In fact, infant torticollis is very common and also extremely treatable especially when you notice the symptoms early.

SO WHAT CAN YOU DO TO HELP?
  1. Get Professional Help. Seek professional guidance from a local PT or OT as soon as possible. We have a trained eye to see the nuances and preferences your baby is presenting with. If you think you see a tilt, trust your gut even if others don’t see it. Remember, you know your baby best and getting an evaluation will either help diagnose the condition or rule it out.

  1. Switch Sides. When holding baby, switch arms every once in a while and show toys to the opposite side they normally look. When placing baby in the crib,, switch directions each night, one night lie her with her head by the top and the next night, lie her with her head where her feet were the previous night. This can help encourage baby to turn the head towards the non-preferred side.

  1. Feed in Both Directions. Bottle feed and/or nurse your baby on both sides equally. You may notice one side is easier for your baby to feed from, but encouraging this change will help stretch the neck. 

  1. Encourage Visual Tracking. When baby is on her tummy, lying on his back or sitting up, encourage visual tracking across her entire visual field. Take a rattle or one of her favorite toys, start in midline to catch her attention, then move towards one side of baby’s head, back to midline, then to the other side. If baby loses focus, go back to midline to redraw baby’s visual attention. Keep doing this back and forth motion as long as you have her attention to encourage that full neck and head movement.

  1. Infant Massage. Massaging both sides of the body helps relax the muscles and brings awareness to both sides of the body equally. This is a great add-on to therapeutic stretching and exercises. You can find an extensive Infant Massage Course inside the Tots On Target Membership.
BOTTOM LINE: Torticollis is very treatable, but the sooner the better! This condition happens when there is tightness of the sternocleidomastoid muscle (SCM) in the neck. It can be caused by in-utero positioning, a tongue/lip tie, or visual abnormalities. When not treated, babies can develop flat spots on the head, difficulty reaching motor milestones, and visual irregularities. If you notice a head tilt or a consistent positional preference, seek out guidance from a PT or OT as soon as possible. 

Dr. Allison Mell is the founder of Tots on Target and a physical therapist based out of New Jersey.

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