What are head preference and torticollis?
Head preference means a baby likes to rest or look to one side, though the neck still moves freely both ways. Torticollis means a tight neck muscle that holds the head tilted to one side, with the chin turned the other way.
Both are seen in newborns and young babies. Both respond well to early, gentle handling, which is why it helps to ask sooner rather than later.
How can I tell at home?
Watch your baby at a calm moment, then try these checks. Do not force anything.
- Does your baby always turn to the same side when lying on the back?
- Does the head tilt, with one ear closer to the shoulder?
- When you call from the other side, does your baby find it hard to turn?
- Does your baby feed more easily from one side than the other?
- Is there a flat area on one side of the back of the head?
- Does one side of the face or eye look different?
If you answer yes to some of these, a short physiotherapy assessment is worthwhile. If you feel a lump in the neck, tell your doctor.
Why does it happen?
It is not anyone’s fault. The position in the womb, a tight space during pregnancy or birth, or a muscle that tightened on one side can all play a part. Babies who rest on the same side for long hours may also develop a preference.
In some babies there is a reason in the hips, eyes or spine. This is why a physiotherapist looks at the whole baby, not only the neck, and refers to a doctor when needed.
What happens at a home visit?
Babies are at their best in their own space. We visit at a time that suits feeding and nap, and the baby stays on the familiar mat or cot.
We watch how your baby lies and moves. Then we gently check neck movement both ways, the feel of the neck muscles, the shape of the head, and hips, shoulders and spine. We also see how your baby reaches, rolls and lifts the head on the tummy.
You get a short, kind plan with a few small handling changes and play positions. A tired parent should not leave with a long list, so we start with what makes the most difference.
What can I do at home?
Small changes through the day add up.
- Give awake, supervised tummy time on a firm mat, a few short sessions a day, short and happy.
- Place toys, mobiles and the light on the side your baby turns away from, so they look that way.
- Switch the side you hold the baby on when feeding, carrying or burping.
- Change the direction the baby lies in the cot from time to time, so the interesting things appear on the other side.
- Limit long stretches in car seats, bouncers and carriers.
Always put a baby to sleep on the back, on a firm flat surface, as your doctor advises. Do not prop a baby with pillows or rolled cloths to change the head position.
Who helps in the first weeks?
In most Ipoh homes, grandparents, a confinement lady or a helper hold the baby as much as the parents do. If everyone holds the baby the same way, the baby keeps turning the same way.
We can show everyone at home the same handling. A family member who lives in KL or Singapore can see the plan by message and ask questions. Our guide to baby milestones explains what to expect as your baby grows.
When should I see a doctor first?
See a doctor promptly if the baby has a lump in the neck, fever, vomiting, poor feeding, unusual drowsiness or seems unwell. Also tell the doctor if the eyes do not follow things evenly, or if the tilt began suddenly after a few months of looking normal.
For everything else, a physiotherapy visit is a good first step. Read more on paediatric physiotherapy and how home physiotherapy works. Our Canning Garden centre, near Fatimah Hospital, is opening soon; prices are quoted on WhatsApp.