Torticollis & Plagiocephaly
Dr.Heather Hunt DC
It is important to check babies after birth for any restrictions in their physical body caused by in-uterine constraint patterns or birth injury. Because they still so new and soft, any restrictions there usually release very easily and effectively. However, if a baby was in a position in mama’s tummy and did not move for a long time the restriction patterns can be more persistent and cause things like torticollis (where a baby favors looking one direction) and/or plagiocephaly (flattening on an area of the head). The most important thing for both issues is to be treated with chiropractic/cranial sacral and also TUMMY TIME! If a baby does not like tummy time, get them checked!
Torticollis
Torticollis, meaning “twisted neck” in Latin, can happen due to position in the womb or after a difficult childbirth. For many parents, Torticollis may not be spotted until babies begin to hold their heads up and it becomes obvious that the baby has a tilted head or is having a hard time turning their neck. With chiropractic adjustments, craniosacral therapy, simple exercises and tummy time this can be treated and can greatly improve or clear it altogether.
More about torticollis
Relatively common in newborns
Affects boys and girls equally
Can be present at birth or take up to 3 months to develop
What is torticollis?
Significant head preference to one side
Restriction in either active or passive range of motion of neck
The entire length of the body, especially the spine, is implicated
Causes
In utero position/constriction/shape of uterus
Pregnancy mobility/movement and function for both mom and baby
Abnormal positioning(such as being breech)
Use of forceps or vacuum devices during delivery
Embryologic or gestational insult or trauma
Birth trauma, can be emotional
Congenital/genetic issues
Reflux
Sleep positioning, nursing side preference
Decreased or lack of tummy time
Increased time in restrictive positioning devices (container lifestyle)
Signs of Torticollis:
Facial asymmetry
Breastfeeding/bottle feeding difficulty/issues
Significant head preference to one side
Difficulty or discomfort with head or neck movements
Crying in 1st two weeks can be a sign
Limited movements
Red lines in neck
Baby does NOT like tummy time
Plagiocephaly
Plagiocephaly, also called “flat head syndrome,” usually comes hand in hand with torticollis. Because babies are born with soft heads to allow for their amazing brain growth, their heads are easily molded. It is normal for a baby’s head to be a bit oddly shaped during the few days or weeks after birth. But if baby develops a lasting flat spot, either on one side or the back of the head, it could be plagiocephaly. This usually occurs when a baby sleeps in the same position most of the time or because of tightened neck muscles.
More about plagiocephaly
Very common
Very treatable
Develops when infant’s head is rapidly growing and meets some kind of resistance- either prenatally in the womb or after delivery because baby’s head is pressed against a flat resting surface
What is plagiocephaly?
Flat spot or misshapen on one side or back of baby’s head
Often there is some facial asymmetry
Opposite side sometimes protrudes out creating a “bulging” area
Causes
Increase in cases since the advent of SIDS recommendations for parents to keep babies on their backs
Baby’s sleep position
Container lifestyle (too much time in car seat, stroller, carrier, swing or bouncy seat)
Premature babies are more likely to have a flattened head
Being cramped in the womb
Torticollis, as they have difficulty turning to one side or the other (babies with plagiocephaly also usually develop torticollis as the muscle gets tight as it gets harder for them to turn their head and the neck becomes stiff from lack of use)
Signs
Usually easy to see, flat head on one side or on the back of head
Bald spots or less hair on one side if the head or back
Look at baby’s head from above to see if it is symmetric
Look at position of ears to see if one is pushed forward
Head may bulge on opposite side of flat side
If torticollis is the cause, the neck, jaw and face may be uneven as well
What can you do to help your baby with Torticollis or Plagiocephaly?
Chiropractic, Craniosacral, Physical therapy
Notice and take action to correct as babies head becomes less soft and pliable as they grow. The younger the your baby is the easier it will be to correct. Once they can roll they will move out of tummy time.
Take a photo of the spot from above and continue to do so each month while being treated to see what changes are occurring. These images are also helpful for to see effectiveness
Change your baby’s head position when they sleep to rounded side to help balance
Alternate positions in the crib or during co-sleeping
Hold your baby more often
Baby yoga and stretches (look online for baby yoga stretches or go to a class)
Pressure ON the bulging area
Pressure off the flat spot
Brain train- right arm to left leg, left arm to right leg (after 3 months of age)
Ankle circles (both directions)
For severe flat head syndrome, doctors may provide a custom-molded helmet or head band
Reposition all areas where baby plays, eats, sleeps and how they are held, nursed and changed
Most importantly! Tummy time! A half hour a day, can be broken up in small time segments. Be persistent, babies with torticollis/plagiocephaly do not usually like tummy time. You want your baby to rest with their forearms on the ground and lift their head and torso up into a cobra type pose.
Suggested treatments
TUMMY TIME! Half hour a day done in small segments so the baby does not get too fussy. It is ok to have some fussiness.
2. Car Seat Intervention
Observe baby in car seat
Make adjustment so baby is in good postural alignment
3. Sensory/Senses
Heat/neutral warmth – relaxes tissues, as warm as possible wet washcloth or in the bath, massage neck and shoulders.
Singing and movement activities –“Head, Shoulders, Knees and Toes” song as you move baby in positions they tend to avoid. Do this only when they are in calm alert (watch my video on Babies, Sleep and Understanding the Sensory System on my website.)
Swinging – both linear and rotary, using a swing is great too.
Seated lifts, calms baby
Pull to sit/lower/lift activities
Make non startling sounds (soft bell) to bring babies eyes to follow movement to opposite side.
Use voice to encourage head turning. Ask older sibling to call baby to turn direction not usually comfortable to turn to.
Mood
Parents to stay grounded, centered, relaxed, breathing easily, and ready to listen and follow are extremely helpful.
Try to be as comfortable as possible with baby’s cries and respond unswerving compassion and continue to provide all the help that is available. Stay connected with you baby as treatments are applied.