Torticollis in Infants: What Parents Can Do at Home

Every kiddo, case, and treatment recommendation may vary, but every parent I work with typically has the same goal. They strive to do everything in their power to ensure the health and happiness of their tiny tot. But what do you do when you notice that your baby seems to have a preference for turning their head to one side? This common condition, known as torticollis, can be a tough one to navigate. Especially when it’s also wrapped up with a flat spot and/or an oral tie (ex. tongue tie). However, there are simple and effective steps that parents can take at home to help decrease the day-to-day impact on their little one’s preferences. From gentle stretches to engaging playtime activities, there are plenty of ways for parents to actively participate in their baby's recovery and make a positive impact on their development.

Understanding torticollis in infants

Torticollis is a condition characterized by the tilting of a baby's head to one side, rotation to the other side and reduced ranges of motion within the neck. This can impact feeding, the ability to move in either direction, gross motor skill development and the overall comfort levels of a little one. This is most commonly caused by positioning in utero, the birth itself or spending a bit more time than ideal in one position after birth. These circumstances can create tightness or weakness in the muscles on one side of the neck, resulting in an imbalance. A few indicators of torticollis include:

1. baby consistently prefers to turn their head to one side

2. difficulty turning their head in the opposite direction

3. head tilt to one side and rotation (turning) to the other side

Not too surprisingly, due to prolonged pressure along the preferred side of the skull, you may also notice a flattened spot on the back of your baby's head. The good news is that with early intervention and proper care, these cases can be effectively managed.

Seeking professional help for torticollis

Early intervention, a thorough assessment, individualized care, and at-home recommendations are key to proper management and optimal results. While home interventions can be effective in managing torticollis, it's essential to seek out a professional with specific training in this area to ensure your baby receives the best possible care!

Home exercises and repositioning for torticollis

There are several simple exercises and stretches that you can incorporate into your daily routine at home to help manage your baby's torticollis. These recommendations are a great starting point but are not a replacement for an individualized assessment and bodywork as they are base-level and not specific to the needs of your child. Also, keep in mind that we are always looking for your tiny tot to enjoy an activity. We only perform stretches and activities if your baby is calm and alert. If they are upset, another need needs to be met first.

1. Tummy time: As long as your tiny human enjoys tummy time, encourage your baby to spend time on their cute little belly through the use of toys or changing up locations (ex. on a couch, water mat, on an exercise ball, on you, etc.). Start with short sessions and gradually increase the duration as your baby becomes more comfortable. We don’t want to create a negative response every time we place your baby down on their belly so make sure this is a fun and enjoyable activity for your little one. If they are unhappy during tummy time, it’s not because they’re simply just a lazy little nugget. There’s usually a contributing factor such as tension creating discomfort so if your little one fights tummy time, I’d HIGHLY recommend an evaluation.

2. Side and back play: Tummy time is a big hit amongst the “to-do’s” for child development (and for good reason!), but our goal is to encourage free movement through different planes and all different ranges of motion! Placing your baby on their back and encouraging movement to the non-preferred side can be just as beneficial, just in a different way! You can also situate your tiny tot on their side and support their backside with a rolled-up swaddling blanket, burp cloth, or whatever you choose and encourage them to look over their shoulder or even reach for a toy. Placing your little one on their side allows for continued variety in environmental stimuli, muscle activation, and sensory input & integration. All great for development! As always, supervision is recommended whether your baby is on their side, back or belly.

3. Carrying: Hold your little one so they are turned away from the tight side. If your baby prefers to look to the right and you carry your baby upright, carry them on your right shoulder. Their preferred side will rotate them into your neck. Now, as beautiful as your neck may be, little ones are more interested in the world moving around them and will be more stimulated/rewarded by turning to look out to their non-preferred side!

4. Changing feeding positions: If you are breastfeeding, changing sides will occur naturally. If you are using a bottle, alternate the side on which you hold your baby during feeding sessions. This will help encourage your baby to turn their head in different directions and reduce the likelihood of developing a preference for one side.

5. Varying sleep positions: Place your little one in their crib/bassinet so they have to look towards their non-preferred side to see their caregiver. If baby likes to look right, face them so they have to look left to see you.

6. Limit containers to less than 2 hours per day and try to avoid them altogether (especially if severe). Try baby-wearing, tummy time, side time, etc. as much as possible. Car seats count!

7. Encourage finger sucking of the non-preferred hand: if your baby tilts their little head to the Right, encourage sucking of the Right hand.

8. Toys and visual stimulation: Use toys and engaging objects to attract your baby's attention to the non-preferred side during back, tummy or side time to encourage them to turn their head naturally.

9. Stretches and strengthening- someone with specific and specialized training (typically a pediatric physical therapist or occupational therapist, but on occasion, a pediatric chiropractor has additional training as well) can evaluate your child as the tiny, adorable individual they are and provide SPECIFIC recommendations for at-home care. There is not a one size fits all approach (especially if flat spots and/or tongue tie is involved) and exercises/stretches need to be demonstrated to ensure they are being done properly.

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Hi there!

My name is Dr. Dani and I’m an in-home chiropractor for busy women and infants within the Denver Metro area. I work with women of all ages and stages, but truly shine with the pregnancy, postpartum, and pediatric populations. I strive for quality care through extended appointment times, diverse treatment modalities, personalized home-care recommendations, and education so families can feel both empowered and cared for!

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• Resources

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  2. Barbara Sargent, Sandra L. Kaplan, Colleen Coulter, Cynthia Baker; Congenital Muscular Torticollis: Bridging the Gap Between Research and Clinical Practice. Pediatrics August 2019; 144 (2): e20190582. 10.1542/peds.2019-0582

  3. Antares JB, Jones MA, King JM, Chen TMK, Lee CMY, Macintyre S, Urquhart DM. Non‐surgical and non‐pharmacological interventions for congenital muscular torticollis in the 0‐5 year age group. Cochrane Database Syst Rev. 2018 Mar 26;2018(3):CD012987. doi: 10.1002/14651858.CD012987. PMCID: PMC6494257.

  4. J.C.Y. Cheng, S.P. Tang, T.M.K. Chen, M.W.N. Wong, E.M.C. Wong, The clinical presentation and outcome of treatment of congenital muscular torticollis in infants—A study of 1,086 cases, Journal of Pediatric Surgery, Volume 35, Issue 7, 2000, Pages 1091-1096, ISSN 0022-3468, https://doi.org/10.1053/jpsu.2000.7833.

  5. Lee KS, Chung EJ, Lee BH. A study on asymmetry in infants with congenital muscular torticollis according to head rotation. Journal of Physical Therapy Science 2017;29(1):48‐52. [CENTRAL: 5300803; DOI: 10.1589/jpts.29.48; PMC5300803; PUBMED: 28210037]

  6. Carolyn Emery, The Determinants of Treatment Duration for Congenital Muscular Torticollis, Physical Therapy, Volume 74, Issue 10, 1 October 1994, Pages 921–929, https://doi.org/10.1093/ptj/74.10.921

  7. Gundrathi J, Cunha B, Mendez MD. Congenital Torticollis. [Updated 2023 Jan 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549778/

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