With: dr Caroline Dana, Orthopedist, Dr. Amélie Rogier De Mare, pediatric orthopedist, and Sandy Martin, osteopath
Torticollis at birth is not unusual. This can be due to poor positioning of the fetus in the womb or difficulties during childbirth. Rest assured that it is possible to treat this minor inconvenience in many ways.
What is torticollis?
For the orthopedic surgeon Dr. Dana, torticollis ” it is the fact that the head is slightly bent, tilted. And have Difficulty turning to one side. The rotation of the neck is performed well on one side and a little less well on the other.” Torticollis causes pain in the neck muscles. It can be much more than a muscle spasm and can prevent the baby from turning his head or tilting it more to one side than another. Generally, an infant does not suffer when they have torticollis, but it can get worse in childhood, especially if there is no specialist treatment. In young children, torticollis is manifested by the head tilted to one side and the chin turned away from the tilt. This worry can manifest itself from birth, right or left, because positional anomalies Where from lack of muscle.
What Are the Causes of Congenital or Postural Torticollis in Babies?
There are two types of torticollis” explains Dr. Dana, and the causes of torticollis are many.
“There is a simple torticollis that is “positional”She says “postural”: It’s a child who spends the pregnancy in a somewhat “stuck” position, and when it comes out there will be a slight sore neck. This torticollis is pretty easy to solveT”, the specialist begins. If we talk about the so-called “postural” torticollis, the child will prefer one side to position his head more than another. You notice that in the first days of life. This phenomenon can lead to muscular imbalance and contraction that is more pronounced on the stressed part of the skull. ” There are many postural torticollis. almost 1 pregnancy from 4, it’s very common.” the orthopedist continues. dr Dana also points out that postural torticollis occurs when ” The baby didn’t have much space to move freely, this can lead to torticollis. Overall, it’s everything that makes the baby fat, everything that makes it have less space. So the twin pregnancies, the fact that there is less fluid in the stomach, the breech position…” This type of torticollis at birth really isn’t serious.
But there is another form of torticollis at birth, muscular origin. « There is what is known as “muscular” torticollis, which is more complex and affects 1% of pregnancies. It is a small artery that supplies the sterno-cleido-mastoid muscle that gets blocked during pregnancy and this leads to muscle infarction like muscle injury. This makes the muscle a little short and a little fibrotic. We fall into a slightly stricter category.” says dr dana There is organic involvement of the neck muscle. Torticollis is considered “congenital”. This is due to retraction of the sterno-cleido-mastoideus muscle. The range of neck rotation is limited. This type of torticollis is rather rare. However, it can be detected at birth or in the first few weeks of life. The baby keeps his head on the same side day and night. Childbirth or incorrect movements during pregnancy can also be one of the reasons for the development of this type of torticollis in infants.
What are the symptoms of torticollis? Plagiocephaly, a secondary risk
“Plagiocephaly can be a consequence of torticollis. If you have torticollis this takes too long, since the baby does not turn his head at this time, he will always be placed upside down on one side, and this will secondarily produce plagiocephaly. It does not occur at birth but later in life. Plagiocephaly has no consequences for the brain, it is only aesthetic. On the other hand it can be Effects on the jaw, on the symmetry of the face. In severe torticollis there is asymmetry of the face such as the flat head, the slightly protruding ears, the jaw not very well centered. But it doesn’t affect the brain.” consists Dr. dana
Diagnosis of torticollis in newborns with head turned to one side
Is it possible to self-diagnose torticollis in babies? You can determine it yourself at home. The warning signs? If your baby tilts the head more to one side than to the other, if the Difficulty keeping your head straight or when he only sleeps on one side of his bed. It is therefore imperative to consult a specialist such as an osteopath or a physiotherapist in order to better identify the problem and, above all, to solve it as quickly as possible. A clinical examination will allow your offspring to recover quickly and will not aggravate the situation. The specialist observes the malposition of the head and tests the age-appropriate mobility of the neck. If the clinical tests are insufficient, the doctor may order an X-ray of the vertebrae and hip.
Osteo or Physio: what is the best solution for baby torticollis? And what to do at home?
The osteopath and the physical therapist can treat torticollis in infants. ” If a congenital torticollis with muscle retraction is diagnosed, the child is looked after by physiotherapy. The physical therapist will treat the torticollis, but he will also treat secondary deformities of the face and skull through manipulation. Osteopathy as such is not the first treatment method. Any child treated by a trained physical therapist will benefit from all the maneuvers needed for their recovery. The French Society of Pediatric Orthopedics recommends physiotherapy for the treatment of congenital torticollis. And osteopathy is a non-obligatory complementary treatment of congenital torticollis”, recommends the pediatric orthopedist Dr. Amelie Rogier De Mare. for dr Sandy Martin, osteopath, are the two health professionals “ complementary “. “In osteopathy we are next to the physiotherapist, that is, we will work on the general assessment of the baby, working close to the torticollis but also at a distance because the torticollis is not limited to the neck . We must take the baby in its entirety through facial, bone, visceral and cranial techniques.. Le dr Sandy Martin « mainly consults babies with postural torticollis”. Treatments vary depending on the diagnosis of torticollis. To treat a baby’s torticollis, whether postural or muscular, requires rehabilitation. Physiotherapy sessions will help your child a lot. Parents can practice caring for their baby themselves when it comes to positional torticollis. For this, It’s mostly manipulation, even parents can do things. Turn the baby’s head regularly, put the light on the side where the baby does not turn his head. When mothers breastfeed, they force the infant to turn in the direction he doesn’t want to get out of his fetal position.” explains the orthopedist.
Treatments when the baby is sleeping
- Place the baby on his back on a firm mattress, in a cot, in an adapted sleeping bag
- Don’t put anything in his bed: no toys, no comforters, no pillows, no blankets
- Do not use bed reducers, head wedges and baby wedges
- Encourage him to look in all directions without a bed frame
Treatments when baby is awake: Force baby to turn head
- Place toys around him to stimulate his positions and encourage him to look to the side
- Take him in your arms often
- With every bottle or breastfeed, remember to switch arms: your baby will turn his head to get your attention
- Limit your stay in the childcare facilities as much as possible (lounge chair, baby relax, cozy, etc.) and reserve seat shells for transport in the car.
A simple sore throat can cause torticollis in babies older than 1 year if the muscles in the neck area are affected. Pain may appear in the throat. Consult a pediatrician immediately, who can prescribe the necessary medication to relieve pain and reduce torticollis a side effect of the infection. He will most likely give your child pain medication. You should also see a doctor if torticollis occurs after an infection such as an otitis media, chickenpox, or bronchitis. Torticollis is mainly associated with infections of the ENT system such as nasopharyngitis. It’s possible that the infection has spread to the vertebrae, especially if your baby also has a fever. A blood test will show the presence of an infection and confirm the diagnosis. If this is the case, the pediatrician will certainly prescribe antibiotics and wearing a neck brace, both of which have good results.
Recommendations for the rapid detection of torticollis
“During pregnancy nothing can be done about the formation of a torticollis, in this case it is because he turns his head well to both sides. And use positioning measures as soon as possible to encourage him to turn his head. Plagiocephaly occurs because stiff necks are not treated quickly enough. says dr Dana, orthopedic surgeon.
Surgery for the most severe cases?
In some cases, fortunately rare, surgical treatment is necessary. But don’t worry, postural and muscular torticollis usually resolve easily with appropriate treatments in physical therapy and osteopathy. Clinical studies show that the earlier treatment is given, the more likely it is that it will not affect the child’s growth.
What happens if torticollis is not treated?
“If we don’t treat torticollis, the child’s head remains tilted. Full neck rotation does not occur, meaning the head remains locked on one side. And in general, the horizontal line of the eyes is created obliquely. Because our brain has a horizon line, if we stay in a tilted position for too long, brain development will cause the child’s horizontality to tilt. Therefore, if necessary, the child is operated on before the age of 3 or 4 years. It’s a little late after that.” closes dr dana