Torticollis in babies

What is torticollis?

Torticollis is a postural condition that affects the neck. The most common type of torticollis is called congenital muscular torticollis (CMT), meaning it’s present at birth.

It occurs when the sternocleidomastoid muscle (SCM) in the neck becomes shortened and tight. This muscle controls head movement, including side-to-side and up-and-down motions.

What causes torticollis?

Several factors can contribute to torticollis, including:

• a baby’s position in the womb before birth: limited space can affect neck positioning
• abnormal development of the SCM muscle: this may happen before or after birth
• trauma or muscle damage during birth: particularly in difficult or assisted deliveries

Torticollis symptoms may not be noticeable in the first 6 to 8 weeks but can become apparent as babies develop more head and neck control.

Symptoms to look for in your baby

If your baby has torticollis, you may notice:

• their head tilting to one side, with the chin pointing to the opposite shoulder (most commonly affecting the right side).
• limited head movement, making it difficult to turn side to side or up and down.
• a soft lump in the neck muscle, which is not harmful and usually disappears within six months.
• they have a preference for looking over one shoulder, with difficulty following objects or people with their eyes.
• challenges with breastfeeding on one side or a preference for one feeding position.
• they struggle to turn their head fully, often leading to frustration or discomfort.
• flat spots on the head (plagiocephaly) from lying in one position too often.

Torticollis is one of the leading causes of flat head syndrome (plagiocephaly) in babies. Addressing it early can help prevent long-term effects on head shape and neck movement.

Treatment

In mild cases, no active treatment may be needed. If it’s more serious, your GP may recommend the following:

Gentle neck exercises

Many cases of torticollis can be improved with simple at-home stretching exercises. A specialist paediatric physiotherapist can provide guidance on safe, gentle movements to help loosen and strengthen your baby’s neck muscles.

Cranial remoulding therapy

For babies developing flat head syndrome alongside torticollis, cranial remoulding therapy can improve the appearance of flat spots. This therapy works to gently reshape the baby’s head while their neck muscles are being treated.

If you’re worried your baby has torticollis, speak to your GP. Spotting it early can help your baby improve faster and reduce the risk of complications later.