Don't Overlook Neck Tilt in Babies!

If your baby's head tilts to one side when lying on their back, the tilt persists even after you change their position, and most importantly, it does not correct when you try to straighten it, pay attention… Your baby may have a neck tilt.

We asked the specialists of the Orthopedics and Traumatology Department at Hisar Hospital Intercontinental about neck tilt in babies, which can be treated without surgery through exercises when it is noticed early.

What is neck tilt (Torticollis) and how is it recognized?

Torticollis, literally meaning "twisted neck," can develop due to many causes. The most common neck tilt is "congenital muscular torticollis" (Congenital Muscular Torticollis), which is noticed at birth or appears after birth. Diagnosis is easily made. The sternocleidomastoid (SCM) muscle, a two-headed muscle located on the sides of the neck, is tight and short on one side. Usually, when the muscle is touched, a fibrotic swelling called an "olive" can be felt. The head is seen tilted sideways toward the side where the muscle is tight, with the face turned toward the opposite side. When an attempt is made to rotate the head toward the opposite side of the tilt or to bend it sideways, a restriction of movement is noticed.

Why does neck tilt occur?

Congenital muscular torticollis was first described by Cheselden in 1893. Since masses were also seen within the muscle in the past, it was thought to form through fibrosis, in which a hematoma caused by bleeding into the muscle turns into connective tissue, and to be triggered by birth trauma, especially in cases where the baby is in a breech position. Because it is often seen together with hip dislocation, clubfoot, and some congenital musculoskeletal deformities, genetic origins have been emphasized. However, although how it forms is understood today, why it occurs is still unknown.

Is neck tilt in babies muscle-related?

No. First, when a child with a tilted neck is seen, other organic causes must be ruled out. The most important of these are congenital separation and formation disorders of the cervical spine. Wedge-shaped hemivertebrae are among the most common cervical spine deformities and can lead to severe neck tilts. Apart from this, enlarged lymph nodes (lymphadenopathy) that develop secondary to infections of organs in the surrounding tissues of the neck, such as the tonsils or ear, can cause a temporary neck tilt if painful. Also, in psychiatric disorders of the type we call hysteroid, neck tilts may accompany the condition.

What should parents of a baby with a tilted neck do?

They must definitely consult a specialist in Orthopedics and Traumatology. If it is noticed immediately after birth, it can be completely corrected up to 6 months of age with exercises performed by the mother. The baby's crib must be arranged so that the baby is encouraged to turn their neck toward the side opposite to the tilt. In this way, although some children may not show a tendency to improve, excellent results can be achieved without the need for surgery in a large portion of them. In this case, a corrective surgery will be required between the ages of 1 and 4.

What can happen if it is not treated?

When a person is standing, the line drawn between the eyes must be parallel to the ground. If the neck is tilted, secondary changes develop in the face. An asymmetry becomes apparent in the face, with one eye appearing more prominent. In children over 7 years of age, even if release surgery is performed, this asymmetry does not reverse and becomes permanent. Additionally, compensatory curves develop in other parts of the spine. For this reason, if you have a baby with a neck tilt and want to avoid such problems in the future, and to avoid the need for surgery, we recommend consulting a doctor right away and starting an exercise program.