Baby Solely Turning Head to Left

emilyjackt

New member
We have a 7 week-old l/o who will only turn his head to the left when laying on his back. We have tried to promote turning to the right while on his back by placing stimulating items and interacting with him on his right and making the left side unstimulating, but he will just shift his eyes to the right or crank his neck even further to the left instead of turning his head to the right.

For a little bit of background context, he was born at 37 weeks but did have shoulder dystocia during birth, which complicated his birth a little bit.

After doing some searching, Congenital Muscular Torticollis (CMT) seems to be a diagnosis that fits the bill. I’ve sent a message to his pediatrician to get him in, but I wanted to see if anybody has experience with CMT with their l/o or has worked with a l/o with CMT. What did treatment look like? When did treatment start? What do results look like following treatment?

If anybody has any links or research on CMT or any other potential causes, feel free to send them my way. I’m a researcher and serve on an IRB, so I’ll gladly geek out on any peer-reviewed studies sent my way! 🤓
 
@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/
 
@martypdji This is a great answer! Our son has mild/moderate muscular torticollis. He’s now 6 months old and we’ve done a lot of bodywork since he was 3 weeks old…PT (with cranial sacral) and chiropractor. Because of this, he rolled left and right quite early and didn’t have issues with side preference for rolling etc. We now do PT 1-2X a month (we went weekly for first 5 months), and do stretches on our own when we notice his preference happening. Some days he’s way tighter than others. Anyway… this was a great answer so just wanted to give it a thumbs up
 
@sandra142 The first couple weeks, I noticed that my daughter would consistently sleep with her head to one side. By 2 weeks it turned into the classic “wry neck” presentation where her head literally looked twisted and bent to one side.

My son was less obvious and less severe. He actually would newborn scrunch so hard due to his overall body tightness that he was always sleeping on his left side in the fetal position despite me putting him down on his back. His body relaxed and straightened out with some bodywork, but his head would always go back to the left even with me repositioning to the right.

You want to just watch your child and make sure they’re looking even really. I’ve been told they should be looking both ways with similar frequency and range of motion, ideally sleeping with their head at midline, keeping head in car seat at midline, feeding at midline, etc. For example, my son would nurse trying to turn his head to the left, so he was never in proper nursing alignment until we started therapy. Once they get older, if you see rolling only over one side, reaching with only one arm, uneven crawling, even cruising in only one direction, things like that, those all probably warrant an evaluation
 
@jmh1232003 That’s so great that you’re seeing such great progress! We also take my son to craniosacral and chiropractor. He is pretty high tone so it’s been a huge help for him to release some of that in his body along with PT. My son is 5 months now and we’re still working on rolling, so that makes me really happy to hear you haven’t had issues now at 6 months! We were still resolving tightness by 6 months with my daughter, so rolling without tightness is honestly a little bit of uncharted territory for me. The commitment to PT is not exactly easy, but it’s obviously so worth it!
 
@martypdji This is a perfect answer. Our torticollis was missed and my son didn't start PT until almost 6 months. We went through about six months of PT, and when we finished they asked us to come back when he was walking to ensure there was symmetry when he was walking/climbing. Our PT also recommended getting his eyes checked because sometimes torticollis can cause one of the eyes to drift to the side since that's how their vision developed. Our NP laughed at me and said "The doctors know best, not PTs" but yet now at two have an opthamologist appointment in March for a potential lazy eye 🙄
 
@blauaugen Yes, I remember my PT and pediatrician checking my daughter’s eyes all the time! I’m sorry you felt brushed off by your NP. Hopefully that was just a fluke and won’t happen again! I also hope the appointment in March goes well and no lazy eye!

It’s crazy something that’s defined as basically “neck tightness” can show up in so many places. Bodies are wild and also very cool. I actually forgot until right now that the most surprising asymmetry for us was cruising and that was months after we started PT! My daughter would cruise around her bedroom in circles, but would only go clockwise because that was her preferred side. It didn’t even register in my brain until the PT asked about it. We were even close to being discharged until that started happening! She walked soon after so it ended up not really being an issue after that.
 
@emilyjackt If baby has shoulder dystocia, you should be seeing PT and/or OT no matter what. I know you said it looks like CMT but there are other, more serious things that can have a similar presentation so please make sure you get a professional evaluation ❤️
 
@emilyjackt Others have mentioned reversing/moving things to focus on the nonfavored side. We ended up moving some furniture, too.

A big one for us was holding baby with right arm because we’re both right handed and tended to hold baby with left arm.

We got physical therapy through early intervention services in our county (in USA). They came to the house and eventually daycare.

Our pediatrician suggested gently holding and turning head to the nonfavored side and holding there for a few seconds during diaper changes (to link it to another activity/habit) and things had improved quite a bit. I would suggest waiting until a qualified person tells you to do something like that. This helped so much that we almost didn’t qualify for early intervention services.

We also clipped new toys on the nonfavored side of the changing table. They were only there, we didn’t move them around. Lamaze Captain Calamari or Freddie the firefly, IIRC.
 
@emilyjackt My daughter had Torticollis with a preference to turn her head to the left and tilt it to the right. Like you, we caught it early and she recently graduated from physical therapy around 6 months. If it’s okay with you, I can dm you the print outs our PT have is that have pictures and explanations of the exercises and stretches we did with her. Let me know if you would like them! Would also recommend getting her into physical therapy though if you are able to!
 
Back
Top