Torticollis is a condition that results in the tilting of a child’s head to one side. Congenital Muscular Torticollis (CMT) is the most common type of torticollis in infants, and is often due to the shortening of the muscle that bends and turns the neck (the sternocleidomastoid muscle). The traditional approach to treating CMT is physical therapy and involves range of motion exercises, strengthening and a positioning program. In addition, parents can participate in their baby’s treatment with a few key exercises, activities, and precautions.
The team at the HSS Pediatric Rehabilitation Center offers the following top five tips for helping a baby with CMT stay on the right track at home between physical therapy sessions:
1.Spend less time in baby carriers. Carriers such as car seats, swings, strollers and bouncers create contact with the back of the baby’s head. While this is appropriate for short periods of time, it is important for the baby to change positions in order to avoid prolonged pressure on the back of the head. It is also recommended that you change the position of these carriers to encourage your baby to look in different directions. Front baby carriers can be used when support is provided for the head and neck for young infants. Once good head control is achieved, child may be placed facing away from parent in the carrier. It is recommended to carry your child in your arms often.
2. More tummy time! Tummy time promotes strengthening of the neck, shoulder, arm, and back muscles, in addition to preventing flattening of the back of your baby’s head. Tummy time is recommended for at least 15 minutes, 4 times a day. If your baby is unable to tolerate this position for the full time, use shorter intervals of tummy time, with increased frequency throughout the day. Supporting your child on your chest, across your lap, or propped on a pillow helps your baby tolerate tummy time more easily. It is important that your baby is always awake and supervised during tummy time.
3. Engage your child in play activities that promote the use of both hands and both legs.Babies commonly play by bringing hands together and bringing their feet up to their hands. You can help your baby bring both hands to midline and then reach for both feet. Encourage your baby to reach for toys and rattles equally with either hand.
4. Encourage your child to turn his/her head to look to both sides. Toy placement influences the direction in which your baby looks. You want to place toys on both sides of your baby so that they are able to actively look to both sides. Perform this activity with your baby on his/her belly and back. Toys with sounds and lights are especially helpful. Your baby should be able to actively turn his or her head from side to side without limitations. When you place your baby on his/her back to sleep, alternate the side to which the head turns.
5. Interchange the arm with which you hold the baby during feeding. Whether breast or bottle feeding, it is important to change positions for each feeding session in order to provide opportunity for the baby to turn his or her head to either side.