@emilyjackt Both of my kids have been treated for torticollis. This will be long and this information is what I have been taught by my pediatricians and PTs, otherwise I would link specific sources directly.
I highly recommend getting a PT referral. ‘Y daughter’s torticollis was more severe than my son’s and she definitely had limited range of motion and a difference in neck strength. Despite all of our conservative therapies, she did wear a helmet for about 5 months and it really wasn’t the worst thing in the world. For whatever reason, her body just responded slower to therapy than by son’s and we weren’t able to avoid the helmet. I’m glad we did it, though. My son’s is much more mild and has almost gone away after 3-4 months of PT.
PT consisted of many things as time went on, but the first and most important things were the neck stretches. There are two big ones: rotating the head/neck over to the non-preferred side, and bending the head ear to shoulder to stretch the tight side. A PT can show you how to properly do these stretches. I did not feel comfortable doing them without the guidance of one, but that is just me.
In addition, they’ll likely instruct you to do lots of tummy time and focus on active looking to the non-preferred side, side lying play, carrying your baby sideways to build strength, etc. Really, any time you can encourage your baby to actively look to the non-preferred side is huge - put them in their crib so they look the other way to see into the room, put them on their changing table so they look non-preferred to look at you, move their car seat so the window is on the non-preferred side, etc. It’s great that you are already trying to do this, but babies do have ways of compensating so they will try to just look with their eyes or give up on their non-preferred side and try to turn and see it the “long way”. Side lying and side carries are also great because they require the baby to use their neck muscles to lift their head and keep it at midline against the force of gravity. This is something they actually do when evaluating the baby for differences in strength. PTs have tons of techniques and strategies to help you!
Something you can do right now is limit the time your baby has pressure on their head. I took this very seriously and only let them be on their heads when sleeping at night and in the car seat. We did a ton of baby wearing and contact naps. Avoiding “containers” as much as you can will be hugely helpful.
This next part is not meant to scare you, but to empower you in advocating for your child - the thing about torticollis is that it’s not really about just the neck and head and avoiding plagiocephaly and a helmet. Often, kids with torticollis develop asymmetries in other parts of the body that can show up in ways such as not rolling equally both ways, atypical crawling patterns, uneven stride, etc, even eyes sometimes! That was the most surprising thing for me. PT will be your greatest tool for helping ensure symmetry! My daughter ended up staying in PT for about 9 months to make sure she had adequate range of motion, strength, and was developing symmetrically. It was a long time, but incredibly worth it. She is 2.5 now and you would never know we did all that just by looking at her.
As far as causes go, my understanding is that the cause is not certain. The prevailing theory seems to be that most are caused by uterine positioning or, less commonly, an injury. It’s likely nothing anyone The neurosurgeon we saw (Don’t freak out, this is who we had to see to prescribe the helmet) anecdotally told us that they’re seeing many more cases these days that they think are linked to better prenatal care and maternal nutrition so we are having babies that are born larger and tend to stay in longer. Again, that is just what they were seeing in their practice. This link has a good overview even though it’s not a specific study:
www.ncbi.nlm.nih.gov/books/NBK549778/
