Premature Baby Has Congenital Torticollis? Try These Simple Stretches

Congenital Torticollis

This is a fairly common condition that affects 1 out of every 250 babies born in the United States. If your baby has this condition you will notice that she keeps her face turned toward one side of her body more than the other. In addition, her head will tilt or bend to the opposite side. Parents of infants with this condition have also reported that they were able to feel a small but noticeable lump in the center of the Sternocleidomastoid Muscle (SCM) on the side of the baby’s neck. The SCM is a large rope-like muscle that begins on the scapula and ends on the base of the skull. This muscle is responsible for tilting and rotating the head.

How is Congenital Torticollis discovered?

Congenital Torticollis is usually found during a routine examination by the baby’s pediatrician within the first month or two after the baby’s birth. Most cases of Congenital Torticollis are subtle and often go unnoticed by parents who may not know what to look for. Once your doctor has ordered X-rays to confirm the diagnosis, he may also recommend that your baby receive physical therapy.It’s important to begin treatment as soon as possible for this condition because if left untreated Torticollis could cause your baby to develop Plagiocephaly (Flat Head Syndrome), a condition that causes the back or side of baby’s head to become flattened due to prolonged pressure on the same part of the skull. Premature babies are especially susceptible to Plagiocephaly because their skulls are softer than the skulls of full term babies.

How is Congenital Torticollis treated?

This condition may be corrected using simple stretches and positioning at home. In addition, Torticollis may be resolved by turning your baby’s face to the opposite side each time you put her to sleep.

1. The “Head Turning” neck stretch

  • Put your baby to lie on her back on the couch with her head close to your body.
  • Hold a brightly colored toy about 4-6″ in front of her face and move it from side to side so that she has to turn her head to track the toy.
  • As your baby turns her head to look at the toy, move the toy down to the surface of the couch so that she has to turn her head in the opposite direction from the side that she normally keeps her head turned toward.
  • Put your hand on the side of her head to keep her head turned towards her non-favorite side for as long as she can tolerate it.
  • Rub her tummy and talk to her to keep her calm during this exercise.

2. Football Stretch (For Right Side Torticollis)

  • Hold your baby with her back against your chest.
  • Tilt her body so that she is leaning at a 45 degree angle with her head towards your right arm.
  • Slide your left arm between her legs and up across her chest and hold down her right shoulder with your left hand.
  • Use your right hand on the right side of her head and gently tilt her head sideways until her left ear touches the top of her left shoulder.
  • You are now stretching the right Sternocleidomastoid muscle.
  • If your baby has left side torticollis reverse the above directions to stretch the left Sternocleidomastoid muscle.

3. Stretching while bottle-feeding (Right Side Torticollis)

  • If your baby has right side Torticollis then she would have difficulty turning her head toward her right side.
  • Hold baby in your left arm and begin feeding her with a bottle.
  • When she is feeding comfortably remove the nipple from her mouth.
  • Touch the nipple to the right side of her mouth and cue her to turn her head to the right to get the nipple back into her mouth.
  • Repeat this process of removing the nipple from her mouth and coaxing her to head to the right side to get the nipple back into her mouth until her head has turned all the way to the right side.
  • Complete her feeding with her head turned all the way to the right side and this will stretch her right SCM muscle.

This condition should gradually resolve itself if you stretch your baby’s tight neck muscles 4-5 times every day.

4 Great Techniques To Help Your Baby Learn To Creep

Most babies typically begin creeping around the six- to seven-month mark. However, the range of age is wide in terms of when this may actually occur. Some babies begin to creep as early as five months, while others may take as long as eight or nine months. Creeping requires a considerable amount of trunk and upper/lower extremity strength, so have some patience and don’t rush your little one! We have provided a few techniques below to help you help baby get moving.

Please note: if you are worried that your baby is not as active as she should be, talk with your pediatrician. Trust your instincts!

Before we get to the techniques, let’s define the difference between two terms that are often used interchangeably: creeping and crawling.

Creeping isdefined as moving around on the floor with the stomach in direct contact with the ground. Some babies develop the ability to creep in a circle first; while others, whose arms are stronger than their legs, are able to creep backwards first.

Crawling is defined as moving on hands and knees with the stomach up off of the ground. One type of crawling, known as commando crawling, may be seen when an infant moves around on the floor on forearms while dragging his hips behind him.

The following are some strategies for initiating and developing creeping skills in your baby:

Tummy Time

One often overlooked aspect of developing the ability to creep is time spent on the floor. As long as your baby has adequate head control then she should be spending at least one hour each day, every day, on the floor. This activity has many benefits such as building strength of the arms and chest muscles as baby pushes her chest up off the floor. While in this position, baby will also have an opportunity to strengthen her neck muscles as she lifts her head to look around the room. Some babies may not like or be able to tolerate tummy time for extended periods. If this is your baby, start small and gradually increase the amount of time spent on the floor. Your baby will be able to tolerate being on her stomach if she sees you doing it with her, so lie down on your stomach face-to-face with your baby and show her how much fun tummy time is!

Once your baby is able to tolerate being on her stomach for an extended length of time, you are ready to help her to start moving.

Creeping in a Circle

  • Position baby on the floor propped on her forearms.
  • Place a small, brightly colored toy directly in front of her just out of reach.
  • Move the toy towards your baby’s side in a semi-circle so that she has to turn her head to continue looking at the toy.
  • Encourage her to shift her body weight from one hand to the other and try to reach the toy by pivoting on her stomach.
  • As she begins moving towards the toy, move it so that it is just out of her reach. Continue moving the toy until she has crept in a complete circle towards one side of her body. Allow her to play with the toy for a short amount of time and then repeat this process towards the opposite side of her body. Repeat this activity so that baby makes five complete circles to both the right and left sides of her body.

Practice creeping in a circle every day for about one week. Once baby is confident in her ability to complete this activity, she is then ready to attempt to creep forward.

Creeping Forward (Double Leg Assist)

  • Position baby on her stomach on the floor with a small toy just out of reach.
  • Once she is engaged with the toy, kneel behind her and slightly bend both of her knees.
  • Place your hands under the bottom of her feet and provide her with a firm surface from which to push off of.
  • Encourage her to reach forward to get the toy by dragging herself forward with her hands and pushing off of your hands with her feet.

When baby is able to creep forward using the above technique, she is ready to move forward and attempt to creep with assistance provided to one leg at a time.

Creeping Forward (Single Leg Assist)

  • Place baby on her stomach with a brightly colored toy in front of her just out of reach.
  • Once she is interested in and focused on the toy, bend one of her knees.
  • Place your hand under the foot of the leg with the bent knee and encourage her to push off from your hand as she reaches for the toy by extending or straightening that leg.
  • When baby has moved forward, switch to her other leg and bend that knee and repeat the above process.
  • Continue forward alternating between her right and left legs.

After about a month or two of practice on the floor creeping in a circle and creeping forward, baby should be ready to start learning how to crawl. Stay tuned for future articles on techniques for helping your baby through this next stage of development.

Infant Development – Teach Your Baby How To Crawl

Crawling is the term used to describe moving around the floor on hands and knees with the stomach up off of the ground. This type of mature movement is different from creeping, which is defined as baby dragging her body around with her stomach in direct contact with the ground.

Crawling typically appears after a baby has learned to creep on the floor. Don’t be surprised though if your baby skips creeping and pushes herself up onto her hands and knees and begins to attempt to crawl first. Most babies will acquire the ability to crawl around the nine to ten month mark. However, some babies begin to crawl as early as six or seven months. Others may take as long as twelve to thirteen months before crawling. If you are worried that your baby is not crawling, a conversation with your baby’s pediatrician would be in order. As an alternative, you may contact your local Early Intervention program and request a physical therapy evaluation to determine if some type of intervention is necessary. In the meantime try these simple techniques for immediate results.

Rocking front to back on hands and knees

  • Place your baby on her stomach.
  • Kneel behind your baby and gently but firmly grasp her around her trunk, with one of your hands on either side of her body.
  • Gently use your fingers to raise her hips up off the ground and bring her knees under her trunk so that she is on her hands and knees.
  • Use one of your hands for support under her trunk, if necessary.
  • Gently rock her front to back while maintaining the hands and knees position.
  • Once she is stable on her hands and knees, kneel on the floor in front of her and show her how much fun rocking on hands and knees is.

Reaching while on hands and knees

  • Position your baby on her hands and knees as described above and support her under her trunk with one hand.
  • Place a toy in front of the baby and tell her to reach for the toy with one hand.
  • Increase the support under her trunk as needed to help her maintain her balance on both knees and one hand while she plays with the toy using the other hand.
  • Allow her to play with the toy in this position for about one minute.
  • Move the toy close to her other hand and encourage her to switch hands and play with the toy with her other hand while you provide support under her trunk as needed.

Crawling forward with assistance at hips

  • Position your baby on hands and knees as described above, but this time place her favorite toy in front of her, just out of reach.
  • Kneel on the ground behind her and gently move her right knee forward about 2″, then move her left hand forward 2″.
  • Move her left knee forward 2″, then move her right hand forward 2″.
  • Keep alternating her hands and knees for her until she reaches the toy.
  • Move the toy out of reach and encourage her to move forward on hands and knees to get the toy once again.
  • Provide assistance to her knees as needed to help her move forward.
  • Practice crawling on the floor daily until your baby is able to crawl on her own.

In the next module of this training series I will discuss some simple tips and tricks to help improve your baby’s sitting balance.

Premature Baby Has Congenital Torticollis? Try These Simple Stretches

Congenital Torticollis

This is a fairly common condition that affects 1 out of every 250 babies born in the United States. If your baby has this condition you will notice that she keeps her face turned toward one side of her body more than the other. In addition, her head will tilt or bend to the opposite side. Parents of infants with this condition have also reported that they were able to feel a small but noticeable lump in the center of the Sternocleidomastoid Muscle (SCM) on the side of the baby’s neck. The SCM is a large rope-like muscle that begins on the scapula and ends on the base of the skull. This muscle is responsible for tilting and rotating the head.

How is Congenital Torticollis discovered?

Congenital Torticollis is usually found during a routine examination by the baby’s pediatrician within the first month or two after the baby’s birth. Most cases of Congenital Torticollis are subtle and often go unnoticed by parents who may not know what to look for. Once your doctor has ordered X-rays to confirm the diagnosis, he may also recommend that your baby receive physical therapy.It’s important to begin treatment as soon as possible for this condition because if left untreated Torticollis could cause your baby to develop Plagiocephaly (Flat Head Syndrome), a condition that causes the back or side of baby’s head to become flattened due to prolonged pressure on the same part of the skull. Premature babies are especially susceptible to Plagiocephaly because their skulls are softer than the skulls of full term babies.

How is Congenital Torticollis treated?

This condition may be corrected using simple stretches and positioning at home. In addition, Torticollis may be resolved by turning your baby’s face to the opposite side each time you put her to sleep.

1. The “Head Turning” neck stretch

  • Put your baby to lie on her back on the couch with her head close to your body.
  • Hold a brightly colored toy about 4-6″ in front of her face and move it from side to side so that she has to turn her head to track the toy.
  • As your baby turns her head to look at the toy, move the toy down to the surface of the couch so that she has to turn her head in the opposite direction from the side that she normally keeps her head turned toward.
  • Put your hand on the side of her head to keep her head turned towards her non-favorite side for as long as she can tolerate it.
  • Rub her tummy and talk to her to keep her calm during this exercise.

2. Football Stretch (For Right Side Torticollis)

  • Hold your baby with her back against your chest.
  • Tilt her body so that she is leaning at a 45 degree angle with her head towards your right arm.
  • Slide your left arm between her legs and up across her chest and hold down her right shoulder with your left hand.
  • Use your right hand on the right side of her head and gently tilt her head sideways until her left ear touches the top of her left shoulder.
  • You are now stretching the right Sternocleidomastoid muscle.
  • If your baby has left side torticollis reverse the above directions to stretch the left Sternocleidomastoid muscle.

3. Stretching while bottle-feeding (Right Side Torticollis)

  • If your baby has right side Torticollis then she would have difficulty turning her head toward her right side.
  • Hold baby in your left arm and begin feeding her with a bottle.
  • When she is feeding comfortably remove the nipple from her mouth.
  • Touch the nipple to the right side of her mouth and cue her to turn her head to the right to get the nipple back into her mouth.
  • Repeat this process of removing the nipple from her mouth and coaxing her to head to the right side to get the nipple back into her mouth until her head has turned all the way to the right side.
  • Complete her feeding with her head turned all the way to the right side and this will stretch her right SCM muscle.

This condition should gradually resolve itself if you stretch your baby’s tight neck muscles 4-5 times every day.