Who most often has this   

  problem?

         Any baby that sleeps too long in one position can get torticollis.  There are some babies who are more frequently seen with this problem
. 

             Large birth-weight baby

      Males

     Breech position birth

      Multiple birth babies

             Maternal uterine abnormalities

     “KEY PHRASE”

             A “key phrase” helps you know every thing you need to know and you will not have to struggle to remember what to do.  For example,:

                           “to the left”.

           If your baby’s head is tilted to the   left, then all activities are “to the left.”  Your baby should sleep on his left side,  he should be encouraged to look to the  left, all attention devices should be on his left, he should be carried on the left, and be fed in your left arm.
        The following are techniques you can  incorporate into your baby’s life to prevent the process and promote improvement if there is some asymmetry.

“Note to Physician” for early referral:

Recent research indicates that at the first baby visit, the head should be passively rotated to each side, and the three circumferences (face, crown, and posterior skull) should be assessed, looking for asymmetries.  

“The most important factors that predict the outcome of manual stretching are the clinical group, the initial deficit in rotation of the neck, and the age of the patient at presentation.” ⁽²⁾

“We encourage all pediatric providers to look for signs of the "stuck baby" to identify torticollis as early as possible. This may sound intimidating, but it can be done quickly on all babies at their first physical exam.” ⁽³⁾

"When parents are at the doctor's office going through their baby's growth charts, some attention should be given to head shape. ...If there is evident deformation, it should be dealt with right away." ⁽⁴⁾

“Generally, you will see the 'tilt' associated with torticollis in the first week to 10 days of life.” ⁽⁵⁾

References:

1.  Willenger M, Hoffman HJ, Hartford  RB.   Infant Sleep Position and Risk for Infant Death Syndrome. Pediatrics. May 1994; 93: 814-819.

2.  Cheng JCY, Wong MWN, Tang SP, Chen TMK, Shum SLF, Wong ECM. Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants: a prospective study of eight hundred and twenty-one cases. J. Bone Joint Surg. Am., May 2001; 83: 679 - 687.

3. Stellwagen LM, Hubbard E, Vaux K. Look for the "stuck baby" to identify congenital torticollis. Contemporary Pediatrics.  2004:21:55. Available at:

http://www.contemporarypediatrics.com/contpeds/article/articleDetail.jsp?id=108032. Accessed November 18, 2006.

4. Timmerman A. Milwaukee Journal Sentinel, March 4, 2001. Tummy to play.  Available at: http://www2.jsonline.com/lifestyle/parenting/mar01/tummy031801.asp.  Accessed December 6, 2006.

5.  Torticollis Kids http://www.torticolliskids.org/faq's.htm