As parents, we’re often caught up in the joy of watching our babies grow and develop—but sometimes, the smallest signs can signal a need for extra care. When it comes to a baby’s development, there’s an increasing focus on conditions like torticollis and flat head syndrome. These issues can be a source of worry, but with early intervention and the right support, they can usually be addressed effectively.
What is torticollis?
Torticollis or stiff neck is a condition where a baby’s head is tilted to one side due to tightness or imbalance in the neck muscles. It can develop in the womb (congenital torticollis) or arise after birth, often due to positioning issues.
Causes of torticollis
- Position in the womb: Limited space in the womb, multiple births, or an unusual position can create muscle tightness.
- Birth trauma: The strain during birth can sometimes result in muscle tightness.
- Infant positioning: Consistently placing a baby on their back with their head turned in the same direction can increase the likelihood of torticollis.
Babies with torticollis may have difficulty turning their head fully or may always favour one side. Over time, this limited movement can also lead to plagiocephaly (flat head syndrome) as pressure is consistently placed on one part of the skull.
What is flat head syndrome?
Flat head syndrome, or plagiocephaly, occurs when a baby’s skull develops a flattened area. Babies’ skulls are naturally soft and malleable, which allows for easy passage through the birth canal and early brain growth. However, this softness also means that external pressure can shape their skulls.
Causes of flat head syndrome
- Sleep positioning: Babies who sleep in one position, especially on their back, can develop flat spots.
- Torticollis: Limited movement from torticollis can lead to consistent pressure on one side of the skull.
- Premature birth: Premature babies’ skulls are even softer, and they may spend extended time in one position in the NICU, increasing the risk of flat spots.
Leaving torticollis or plagiocephaly unaddressed can have long-term impacts. In addition to cosmetic concerns, untreated torticollis can affect a baby’s motor development, as turning the head is essential for reaching, crawling, and other key movements. Flat head syndrome, while generally more cosmetic, can sometimes affect facial symmetry and, in rare cases, lead to developmental delays.
How paediatric physiotherapy can help
Paediatric physiotherapists specialise in assessing and treating conditions like torticollis and flat head syndrome. They begin by assessing your baby’s head shape, neck muscle tone, and range of motion. This helps determine the severity of the condition and develop a tailored plan that’s gentle and effective. Treatment plan can include:
- Gentle stretches and massages: Soft tissue techniques help relieve muscle tension in the neck, allowing for improved head rotation.
- Tummy time guidance: Tummy time is vital for strengthening the neck, shoulders, and core, and it also relieves pressure from the back of the skull. Your paediatric therapist can show you the best ways to make tummy time fun and comfortable.
- Positioning advice: Your paediatric therapist can help you find ways to change up your baby’s sleep and play positions to encourage balanced development.
- Parental training: To empower parents with easy-to-follow techniques that you can integrate into daily routines.
Progress with torticollis and flat head syndrome can be gradual, so regular follow-ups are crucial to monitor your baby’s improvement, make adjustments to their treatment plan, and to help you feel confident in your role in their rehabilitation.
Simple tips for parents to encourage healthy development
Physiotherapy goes hand-in-hand with positive practices at home. Here are some top tips from our team to support your baby’s development naturally.
Make tummy time a priority
Tummy time strengthens neck, back, and shoulder muscles, which helps counteract torticollis and flat head syndrome. You can start with just a few minutes a few times a day, gradually working up to longer sessions as your baby grows.
Engage your baby with colourful toys, mirrors, or your face to make tummy time more enjoyable. You can also place them on your chest if they’re not a fan of the floor!
Encourage head rotation
If your baby has a favoured side, gently encourage them to turn their head to the other side. Here are a few strategies:
- Crib positioning: Place them in the crib so they naturally turn their head toward the room rather than the wall.
- Feeding: Try alternating arms during bottle or breastfeeding so your baby turns their head both ways.
- Toy placement: Position toys or playmates on their non-favored side to stimulate curiosity and movement in that direction.
Be mindful of “container time”
Excessive time in car seats, swings, and bouncers can increase the risk of flat head syndrome. Try to reduce the time your baby spends in these devices, especially when awake.
Opt for floor play: Floor time allows babies to move freely, explore different positions, and strengthen their muscles.
Provide a variety of movements
Encouraging gentle movement changes and exploration is excellent for development. Alternate between tummy, side, and back play to encourage a range of movements.
Carrying your baby in a sling or carrier can keep pressure off their head while allowing them to experience different perspectives.
When to seek help from a paediatric physiotherapist
If you notice signs of torticollis or flat head syndrome, it’s worth consulting a paediatric physiotherapist early. Common signs to look for include:
- Head consistently tilted to one side or limited head movement
- A flat spot on the back or side of the head
- Preference for looking in one direction or limited head rotation
- Delays in lifting the head, rolling, or other milestones
Remember, early intervention can prevent these minor issues from turning into bigger challenges.
Debunking common myths about flat head syndrome and torticollis
Let’s clear up a few misconceptions!
Myth #1: Flat head syndrome always requires a helmet
While helmets are sometimes prescribed in severe cases, many cases of flat head syndrome can improve with positioning strategies, physiotherapy, and time. Helmets are usually a last resort for when other methods aren’t working.
Myth #2: Torticollis will just go away on its own
While mild cases may improve over time, torticollis often requires targeted stretching and strengthening. Left untreated, it can lead to delayed motor milestones and a persistently tilted head position.
Myth #3: Babies can’t benefit from physiotherapy
Babies may be small, but their bodies are incredibly responsive to gentle guidance. Paediatric physiotherapy is safe, effective, and can make a world of difference in promoting balanced development.
Torticollis and flat head syndrome may seem concerning, but with awareness, early intervention, and the right support, these conditions can often be resolved.
If you have concerns about your baby’s head shape, movement, or development, don’t hesitate to seek answers and help. Paediatric therapists are here to provide advice, reassurance, and the support your baby needs for a bright, healthy future.