T.P. asks from Gilbert, AZ on May 04, 2010
My Son of four months was just diagnosed with infant torticollis, we are waiting for the PT to be approved by the insurance so we can make an appointment, But I rotate him often through the day, it seams like no matter how often or persistant i am about it his condition keeps getting worse.. Any sleep positions i should try, they say dont let him sleep on the tummy. And since he was Breeched Could that be why he has this cause he was looking the same way in the womb alot of the time...
A.C. answers from Cincinnati on May 05, 2010
one thing you can do now is rotate him in the crib so the side he prefers to look from is facing towards the wall --- e.g. if his head is typically rotated to the right, place him in the crib with his left side facing out so if he wants to look out of the crib he has to rotate his head to the left.
There are a number of causes of torticollis. The following link is to Guidelines that Cincinnati Children’s Hospital uses. It is an evidence based research guideline (every research article was read, analyzed and graded on strength of evidence. It is written for therapists, families, primary care doctors.
Hope that helps. Good luck!
K.M. answers from Flagstaff on May 05, 2010
The problem encountered in infant torticollis is most often a tailbone that went out of default position through the birthing process, breech per se, by pressure and pull on the tailbone and spine, in head-first births a "whiplash injury" when the child's head is pushed against structures on the way out (e.g. pubic bone) or caused by the difference on pressure on the child in utero to out of uterus in Cesarian births, (similar to a diving accident). The tailbone is a security "device" that will move out of position to prevent pull on the spinal cord and brain. the best and most gently approach would be work by an experienced cranial sacral therapist or Integrated Manual Therapist to not only move the tailbone back gently and carefully, but to release all other involved "systems" from their stress, too. Autonomous nervous system rebalancing, traction on the spinal nerves, muscle tension, released by neurofascial or myofascial work, etc.
I talk from the experience in my own practice and my clinical background as an MD although I have left Western Medicine behind.
Maybe you can find a cranial sacral therapist where you live -
Heartfelt Greetings, K. von Merveldt-Guevara
NB: I just read about the gastric reflux problems that some children had as well here in the other answers. The traction on the spinal cord shown by the torticollis, goes hand-in-hand with an upward pull of the anterior structures in the front of the body: foodpipe, windpipe, aorta...the stomach gets pulled into the diaphragm, the foodpipe irritated, air trapped in the stomach, which is basically the problem of gastric reflux, colics, hiatal hernia etc. symptoms may subside, but show up again later in life.
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D.D. answers from Denver on May 04, 2010
Our boy was diagnosed with torticollis at twelve weeks also. The right side of his face was quite flat in comparison to the left, and now, at age three, there is a slight difference. The pediatrician and EVERYONE else tells me that they don't see the difference, so I'm just paranoid.
Anyway, what we had to do with the sleep positions to help even out the growth of his face was to put him on his left side. We used bolsters, and literally tucked in a blanket to keep him on that side when he slept. Doing that and the PT slowly corrected the problem. He really hated the PT, not because it hurt, but because the therapist had to sort of 'man handle' him to manipulate the muscles and ligaments. I cried the first session because I felt so bad for my little guy. One thing that really helped was to hold my boy in my arms so that he was lying on his 'good' side with his head SLIGHTLY elevated above his shoulders. This position helped stretch him, and he didn't seem to mind it as much as some of the other stretches.
I don't know how severe your son's case is, but rest assured that it is a totally treatable condition and he will be fine. If his case is severe it is likely that you will end up having him in helmets to even out the growth of his skull bones. We didn't have to do this, but from what I read on the internet, it is a successful therapy.
As for why it happens? Unknown. I theorize that my boy's happened because he was head down for the last 9 weeks of the pregnancy. I'm a 'mature' mother and had to be monitored twice per week for the last nine weeks. That monitoring included a weekly ultrasound which showed him head down, ready to go!
If you want to send me a private message, I'd be happy to send you a photo of the side-lying position that helped us so much.
Your precious will be fine.
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S.T. answers from Kansas City on May 05, 2010
my daughter had this as well and we did the physical therapy you will pretty much just keep stretching it out to get those muscles loose we didn't worry so much about how she slept but when she was awake we were doing exercises with her.
J.C. answers from Fort Wayne on May 05, 2010
My son had torticollis also. Basically, it's just that when they were in the womb, they favored one side of their head, and therefore one side of their neck muscles is normal, and the other side is short. Trust me, it will be MUCH easier for you to fix the problem with yours being an infant still. My son was 9 months old and it was HARD!! All the physical therapy had to be incorporated during play. Oooops! I just saw that your son is 4 months, not an infant, or what I think of as an infant. So, basically, he'll go into physical therapy, the therapist will show you certain things you can do to get him to use the other side of his neck muscles. Don't worry, although sometimes it's worse than others, in general, torticollis isn't a huge deal. My son went to PT for about 3 months. I did work with him at home a few times a day for about 15 minutes. He's 6 now.
J.C. answers from Tucson on May 05, 2010
My son was also diagnosed with toticollis as an infant. Sleep positions are only a small part of what you need to do to help him. You have to help him stretch out the muscles in his neck. Below are some links to websites that will show you what to do. We were told to do this every diaper change and we went to phys. therapy twice a week. We were so nervous to do these on such a small baby, but it does get easier. Just don't force it and just be very gentle. When you get in to see a PT he/she will give you more specific ones to do. Do lots of tummy time and move the toys to the opposite side to get him to try and move his head in that direction also. There are several other issues that come with torticollis so make sure you do your research and that your Dr. and PT are doing everything they need for your child. I had to demand that my pediatrician give us a referral for a PT because he gave us the print outs of the stretches and then basically blew me off. Torticollis can cause problems with vision, with motor skills, deformation of the skull and improper alignment of the jaw, etc. We were sent to a pediatric eye dr. and a pedi. neurologist. Another thing to be very careful with is how you lay your baby down and the spots where the pressure is placed on his head when he's lying on his back. My son wouldn't sleep unless he was in a swing. He ended up getting plagiocephaly and had to wear a helmet to reshape his head. There's a product by Boppy called a Noggin Nest. It was only about $20. We put it in the swing and then moved it to the car seat when we went out. That really helps with the pressure spots. Since kids with torticollis don't turn their heads like most babies do it can cause too much pressure on certain spots and cause them to flatten out and push the skull bones into odd places. I hope this helps. It can be a long process but keep it up. If your son has to wear the helmet don't be upset. They look awful and sound horrible, but it's not really as bad as you think. My son didn't even mind it and when he started learning how to walk it saved his head from all the bumps and bruises he would've gotten when he fell down. We went to Hanger and they were wonderful! No mold casting for the helmet. It was all computerized and done in seconds.
K.G. answers from Phoenix on May 05, 2010
My son was diagnosed with torticollis at his 3 month appointment. We did 6 weeks of pt and I had to do several excersizes with him every day. They said the torticollis was caused either by his position in the womb or when he was delivered. He was and still is (2 years old) a tummy sleeper, although I know we shouldn't have let him tummy sleep, he was an extremely colicky baby and was only happy on his tummy at an incline (usually on my chest in a MobyWrap). He also developed reflux around 3 months, they said it was probably brought on by his torticollis. Just wait until your pt appointment and they will tell you how to massage him and what positions to put him in. He is my 4th and last baby, I had never gone through so much with any of my other kids! He's a very active 2 year old now and you could never tell he had anything wrong with his neck now! Good luck and God Bless!!
C.P. answers from Phoenix on May 08, 2010
My son had torticollis as an infant. We did PT. Then stopped. He ended up getting worse again because we didn't keep up with the PT at home. In the end he ended up having surgery to release the muscle when he was 6. He's almost 10 now and fine. He did a lot of PT before the surgery when we noticed that it had returned. I wish we had kept up the PT when he was younger and maybe the surgery wouldn't have happened. We were told he was fine and with moving cross country twice in one year, I think we missed that he was regressing and didn't notice it again until he was 3 and then got the run around with the PT. Make sure it's a PT who is familiar with torticollis and what to do. In the end we ended up with a wonerful doctor who performed the surgery and an awesome PT for before and after the surgery. Ask if there is someone who is familiar with how to treat torticollis before you go. I didn't do that with the second PT and he didn't do anything to help my son. You live and learn. If I had to do it over I would have hopefully done it differently, but as I said, he's fine now, except he has a scar right by his collarbone from the surgery. I still every once in a while have to remind him to straighten his head because he's tilting it to the side.
I'm sure that everything will work out fine, just keep on top of it. I wish I had, maybe we could've avoided the surgery. I will never know.
J.F. answers from Phoenix on May 05, 2010
My daughter had that. She is now 4 years old and perfectly fine, so don't worry. It's like having stiff muscles. They need to be stretched very gently until the become loose again. My pedi gave us a hand out showing exercises to do a few times a day. I also started feeding her on the side that she did Not prefer. Her neck relaxed in no time. The one thing that happened as a result was she got a flat spot on the back of her head because everytime I layed her down she would turn her head to the same side. She outgrew that too. We contemplated the helmet but did not do it. Her head is fine now. Good luck :)