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What is the best torticollis treatment for infants?

Infant Torticollis or wryneck
infant torticollis or wryneck

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Exercises as torticollis treatment.

Physical therapy.

Treatment with a torticollis helmet.

Treatment through surgery.

Botox treatment.

Long term effects of untreated torticollis.


Exercises for torticollis infants

According to the American Academy of Pediatrics the initial treatment for torticollis is repositioning infants in the first weeks of life.

Your physician will explain how to position your infant during feeding, sleeping, eating and playing to help stimulate the muscles.

Parents will try to encourage the infant to turn its head to the non-affected side through various activities.

Infants with torticollis tend to move their head to their favored position. When a baby sleeps consistently with its head in the same position he may develop plagiocephaly.




This can be avoided by simply repositioning baby’s head on a regular basis. When a baby starts to roll over on its own and becomes more mobile this treatment will not be that effective anymore.

Introducing baby to tummy time will help him to develop strong and balanced neck muscles. You can start with tummy time when your baby is 3 to 4 weeks old. Tummy time is essential for baby’s optical and physical development.


The following video shows 5 simple moves to help your baby accept and love tummy time.


Physical therapy treatment for torticollis infants

When do babies need torticollis treatment with physical therapy?

If baby's neck movement does not improve with repositioning and exercise by the age of 2 to 3 months your doctor will refer you to a physical therapist. Undiagnosed and untreated infant torticollis can lead muscular and skeletal imbalances and serious problems with a child's coordination.

Physical therapy will help them to a normal muscular and skeletal development. During therapy they will show you exercises you can do at home. How to encourage movements of baby's head and body to the non-preferred side.

You can do this by :

  • Always reaching for your infant from it's non-preferred side.
  • Hang toys where your baby needs to turn his head to the non-preferred side to be able to see them.
  • Carry your baby in a facing-out position.


A physical therapist will also teach parents techniques how to stretch the shortened neck muscle. Usually this is done 5 to 6 times a day and consists of 15 to 20 stretches each time.


Treatment with a special torticollis helmet

When does a baby need torticollis treatment with a torticollis helmet? If the infant also suffers from positional plagiocephaly (flathead syndrome) he may need to wear a specially made helmet to re-shape or re-mold the skull.

Whether treatment with a cranial remolding orthosis is necessary depends on the degree of the asymmetry of baby's head. If your physician thinks it is necessary he will refer you to a craniofacial specialist for an evaluation.

This specialist will scan your baby's head shape and then decide if your baby would benefit from treatment with a torticollis helmet.

Torticollis helmet.

torticollis treatment with helmet
Photo by Marie-Claire Camp

An infant’s head is very malleable until the age of 12 months. Treatment with a torticollis helmet is possible for infants 3 to 18 months old. Doctors recommend the child wares the helmet 23 hours a day for the best result.

How long a child will have to wear the helmet depends on the age he starts the treatment. Therapy lasts somewhere between 3 to 9 months.


Treatment of torticollis through surgery

Torticollis treatment with surgery is needed in some cases where physical therapy and exercise did not have the desired result.

When torticollis is not early detected and physical therapy is delayed children are more likely to need surgical treatment.

If all conservative treatments fail surgery to lengthen neck muscle is usually done in the pre-school years.


Botox treatment in infants with torticollis

The use of Botox injections to relax the tight muscle is a new part of torticollis treatment being tried by specialists.

They are using botox injections in children who have cerebral palsy and other conditions that cause them to have extremely spastic or tight muscles.

Botox injections are sometimes used to improve the effectiveness of stretching exercises and to help strengthening of the muscles on the other side of baby's neck.


What are the long term effects of untreated torticollis?

Torticollis in infants may not be prevented but it is very treatable. If the torticollis is left untreated it may lead to long term problems such as permanent facial asymmetry and a muscle strength imbalance that directly affects baby's development.



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