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Spot a tilt in your baby's neck?

It could be a case of torticollis, which is usually difficult to detect in newborns

IF YOU ARE A READER of this column, you will know all about baby massage―the oils used for it in India, the efficacy of the massage and so on. But sometimes, the conviction on our practices and beliefs should not make us overlook other, perhaps more, latent issues.

The head of my friend’s baby appeared slightly tilted at birth. Elders in the family massaged her head every day with little or no improvement. It was later diagnosed as a case of torticollis for which no amount of head massaging will help.

If such a tilt is visible in your infant even before the first month is up, it might be a case of torticollis. When a baby is born with a tilted head (while the chin points in the opposite direction) at birth, it is called congenital or infant torticollis. This condition is usually difficult to detect in newborns as

(i) Their necks tend to be unsteady: This causes their head to loll or lean on one side, especially when they are asleep.

(ii) Their head movements are not yet fully developed: Babies take anywhere between two to four months to follow an object that is moved from one side to another in front of their eyes. Until then, they tend to stare in one direction or at one object for a long span even in the absence of a wryneck (torticollis).

(iii) Torticollis can take three months to develop and manifest.

Some other signs that can help detect this condition is when

(i) A baby is unable to turn her neck from the preferred resting side to the side where a hand is clapped or a toy is rattled

(ii) If the chin points in a direction opposite to the head

(iii) There is a tendency to nurse from only one breast. The baby will struggle to turn her neck from her preferred side and consequently make unsuccessful attempts at latching and nursing from the breast on the non-preferred side.

(iv) There is a flattening of one side of head, otherwise known as positional plagiocephaly. This happens because the baby tends to sleep on the same side and that puts pressure on that side. A flat head is more of a cosmetic concern for doctors. Improvement from positional plagiocephaly can occur by changing the position of your baby every time she is put down to sleep.

Reasons for infant torticollis:

(i) a difficult position that the baby might have adopted in the womb―breech, transverse or oblique.

(ii) a complicated birthing, including the use of forceps or vacuum device to pull the baby out.

Such situations put pressure on a baby’s sternocleidomastoid muscle, which connects the back of the ears to the collarbone. When pressure is exerted on this muscle, it can tighten to an extent and the baby is unable to turn its neck from side to side.

While some babies recover from physiotherapy, neck stretching or massaging can be learned from a doctor and continued at home; surgery may be required in some cases. Some amount of medical intervention is required for certain. Do not ignore this condition. No amount of massaging the head can improve the situation. The continual pressing of the head, even if gently, will surely cause discomfort to the baby.

Next issue: Using oil as a cleanser for infants