Babies with Flat Head, Tight Neck (Tortocollis and Plagiocephaly) and how to Help

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!



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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

  1.  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. 



  1. 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. 

HeatherHuntDC