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| |    Torticollis: When a Baby Looks Mainly to One Side by Robert Needlman, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. Many babies develop a habit of looking in one direction only because of the way they are positioned in their cribs. For example, a baby who always lies with his right side facing the wall will tend to keep his head turned to the left so that he can look out into the room. (It's interesting to note that even very young infants prefer to look at other human beings rather than at a blank wall!) After holding the head to one side for the majority of the time, the muscles in the neck tend to shorten up, making it hard or even painful for the baby to turn his head the other way. Specifically, there is one muscle that runs from the collarbone (or clavicle) to the area of the neck just below the angle of the jaw. When this muscle contracts, it turns the head to the opposite side. Thus, when this muscle tightens up on the left, the head turns toward the right. Sometimes this muscle develops a tender swelling or knot in the middle, where it is tensed up and shortened. The medical term for a neck that is always turned to one side is torticollis, which simply means "twisted neck." (It is also known as wryneck.) Torticollis can be present from birth or the early weeks of life (congenital torticollis), or it can appear later in life (acquired torticollis). When it appears in a newborn, it can be due to positioning in the uterus or to mild injury to the neck muscles during a difficult delivery. Whether torticollis is congenital or acquired, the treatment--and prevention--for this problem is the same. First, change which end of the crib you put the baby's head at. That way, the baby has to look in different directions--left one day, right the next--in order to see out into the room. Second, stretch the neck muscles by slowly, gently moving the child's head back toward the midline and then, as the muscle loosens up over several days or weeks, over to the nonpreferred side. To prevent injuring your baby, have a pediatrician or family doctor demonstrate this stretching maneuver before you try to do it yourself! Although most cases of torticollis are merely the result of positioning, occasionally the cause is a medical condition that requires specific treatment. In rare cases, torticollis is caused by abnormalities of the spine or spinal cord, which only show up on x-rays; by abnormalities of vision; or by other medical problems. So, although the odds are strong that the problem is minor, it's still important for a doctor to examine any child who has difficulty turning his head, particularly if the condition seems to get worse over time.
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