If your baby seems to prefer looking one direction and resists turning their head the other way, it’s natural to feel a little worried. Take a breath: wry neck, also known as torticollis, is a common childhood condition, affecting up to 16 percent of babies, roughly 1 in 6.
Here’s what causes it, what to watch for, and how it’s typically treated, so you know what to expect.
What is Torticollis (Wry Neck)?
Torticollis takes its name from the Latin words for twisted (tortus) and neck (collum). It causes a strong preference to turn or look in one direction, along with difficulty turning the other way. It often causes the head to tilt or rotate to one side, and it can limit the movement of your baby’s head and neck, but it’s usually painless and resolves well with time and treatment.
Torticollis can be congenital, meaning present at birth, or it can develop later. Most cases resolve fairly quickly with a combination of stretching, position changes, and patience.
What causes Torticollis in infants?
The exact cause of torticollis isn’t fully understood, and there’s no surefire way to prevent it. If your baby has torticollis, it isn’t because of anything you did wrong.
It typically involves the shortening and tightening of one of the sternocleidomastoid muscles (SCM), a pair of large muscles connecting the back of the skull to the sternum and collarbone. When torticollis is present at birth, parents often don’t notice it until their baby is 6 to 8 weeks old, around the time most babies start gaining control of their head and neck.
Possible contributing factors include your baby’s position in the womb, differences in muscle development, or unusual thickening of muscle tissue. In rare cases, it can be linked to a birth condition called Klippel-Feil syndrome, which causes some neck vertebrae to fuse.
Signs and Symptoms to Watch For
Torticollis is most common in firstborn children, possibly because the uterus tends to be a bit more cramped the first time around. Other factors linked to torticollis include sleeping in an awkward position, a neck muscle injury, or scarring that affects muscle tissue.
If you suspect your baby may have torticollis, look for:
- Head tilting or twisting to one side
- Difficulty or inability to turn the head to one side
- Muscle spasms in the neck
- Flattening on one side of the head (plagiocephaly)
- Difficulty tracking objects on one side
- A preference for eating on one side or in a certain position
In rare cases, similar symptoms can point to something else, like a herniated disc or an infection. Your baby’s provider can help determine what’s going on and the right next steps.
Torticollis and Flat Head Syndrome
Plagiocephaly, commonly known as flat head syndrome, can be caused or worsened by torticollis. The weight of your baby’s head while sleeping contributes to flat spots, so it helps to avoid consistent pressure on the same part of the head. Treating the underlying torticollis often relieves plagiocephaly symptoms too, addressing both issues at once.
How Torticollis Is Diagnosed
Congenital torticollis, the most common form, involves a shortened neck muscle that creates uneven tension and pulls the head to one side. It isn’t always obvious right away, since young babies aren’t yet skilled at moving or controlling their head and neck.
Torticollis is typically diagnosed with a visual exam. Because early intervention helps, providers usually screen for torticollis at wellness visits during the first six months. If you notice signs before your next scheduled visit, you don’t have to wait. Contact your baby’s provider to get an appointment on the calendar.
Treatment Options for Infant Torticollis
You can’t prevent torticollis outright, but you can reduce its likelihood or severity with a few simple habits that encourage your baby to use both sides of their neck.
- Alternate sides when holding or feeding your baby.
- Switch the direction your baby faces in the crib from night to night.
- Place something engaging, like a window or a favorite toy, on the side you want to encourage them to look toward.
- Limit extended time in car seats, bouncers, and other carriers.
- Make time for tummy time, which supports neck strength and development more broadly.
If at-home changes aren’t enough, your provider may recommend seeing physical therapy. Surgery is rarely needed but is an option in select cases.
Home Exercises and Positioning
In most cases, torticollis improves with regular stretching of the sternocleidomastoid muscle several times a day. Common exercises include stretching the neck side to side and gently guiding the ear on the unaffected side toward the shoulder. Consistent stretching, paired with position changes during holding and feeding, gradually expands your baby’s range of motion over time.
Physical Therapy for Babies
If stretching and lifestyle changes alone don’t fully resolve your baby’s torticollis, your provider may refer you to a physical therapist. A physical therapist can assess your baby’s range of motion and build a customized plan to improve their ability to turn their head, bring their chin to their chest, and move more freely overall.
Long-Term Effects of Untreated Torticollis
Torticollis usually resolves with minimal intervention, but left untreated, it can limit your baby’s ability to move their head fully and may contribute to uneven development of the neck and face, developmental delays, or permanent shortening of the SCM muscle.
Torticollis can feel unsettling, especially when you’re not sure what’s going on, but it usually looks more alarming than it is. And you don’t have to figure it out alone. The team at Families First Pediatrics is here to help.
If you’ve noticed your baby favoring one side or you have questions about torticollis, reach out to your provider at Families First Pediatrics. Early attention makes treatment easier, and we’re glad to help you sort out what’s normal and what’s worth a closer look.
Sources:
Des Moines University, Untwisting the Knot: What New Parents Should Know About Torticollis
American Family Physician, Torticollis in an Infant
Cedars Sinai, Congenital Muscular Torticollis
OrthoInfo, Congenital Muscular Torticollis (Twisted Neck)
Johns Hopkins Medicine, Torticollis (Wryneck)
