There is a gentle breeze, the sun is slowly rising on the horizon and gentle waves are rolling in by the seashore. A sense of tranquility starts to take over as you relax in to your holiday, until you hear that one familiar noise. Yes, the cry of your six month bundle of joy demanding milk. As you turn your head towards the noise, your neck catches. That ten hours of inflight ‘baby, please be calm’ sleeping pose has given you a neck that is as stiff as a board. All you can think about now is to feed the baby as quickly as possible and focus on some me time to do the wry neck exercises your physiotherapist taught you recently. Ok, I might be over exaggerating my analogy a little bit here, but do you know that babies can have stiff necks (congenital muscular torticollis) too?
What is congenital muscular torticollis?
The most common cause of a baby’s stiff neck is congenital muscular torticollis. Congenital muscular torticollis is thought to be a ‘packaging’ problem, of baby’s head lying in an awkward position inside the womb causing contracture (tautness) to the sternocleidomastoid neck muscle. Infants who were born with stiff neck have difficulty in turning their head side to side and tend to have their head tilted to the affected side. They might also have a palpable lump along their affected neck muscle.
Diagnosis of congenital muscular torticollis
Congenital muscular torticollis is commonly picked up by caregivers during the first month of life when they realise that the baby tends to sleep with it’s head turned to one side or they note that baby prefers to be fed on one side. The baby’s paediatrician might pick up on an abnormally shaped head or facial asymmetry at baby’s six week check up. This abnormally shaped head and facial asymmetry tend to be more pronounced with late diagnosis.
The estimated incidence of congenital muscular torticollis is less than 1 percent in all live births, lower in head first uncomplicated delivery versus breech baby. Since it is thought to be a packaging problem, babies with wry neck also have a higher incidence of having developmental dysplasia of the hip. Think of what sitting in a cramped economy class seat on a 10 hour nonstop flight holding a cranky baby would do to your hip. Your pediatrician should check for this too.
Treatment of congenital muscular torticollis
The mainstay for treatment of congenital muscular torticollis is physiotherapy. Your therapist will teach you some play exercises that will help your baby to track and follow objects as well as passive massage and lengthening exercises. They will also give practical advice on sleep, toy placement, carrier device positioning. The length of treatment varies depending on the severity of the tightness and the caregiver’s compliance with the home treatment program. Please don’t worry; within six months, most torticollis is usually resolved with this approach.
For further information on congenital muscular torticollis visit the Royal Children’s Hospital fact sheet.
If you feel you require paediatric advice for your child please contact us.
For more qualified, easy-to-understand specialist paediatric information visit Paedicare’s blog.