Many parents first notice it in photos: their baby’s head is always tilted to the same side, or they always look the same way. Others notice it when feeding is easier on one breast, or when a flat spot starts to appear on the back or side of the head.
This is often torticollis, sometimes called wry neck. It’s common, it’s usually very treatable, and the earlier it’s looked at, the better it tends to go.
What is torticollis?
In babies, torticollis usually means that a muscle on one side of the neck, the sternocleidomastoid (SCM), is tight or shortened. That pulls the head into a tilt towards one side, with the chin turned towards the other.
It can be:
- Congenital muscular torticollis: present from birth or noticed in the first weeks. It’s linked to position in the womb and sometimes to a difficult delivery. Occasionally you can feel a small, firm lump in the neck muscle. It usually goes away with treatment.
- Positional: a preference that develops after birth, often because a baby spends a lot of time lying in one position.
Signs to look out for
- Head tilted to one side, or always turned the same way
- Difficulty turning to look one way, or getting upset when you try
- Preferring to feed on one side
- A flat spot on the back or one side of the head (positional plagiocephaly)
- One side of the face looking slightly different from the other
Why it’s worth acting early
Babies’ necks and skulls change quickly in the first months. A baby who only looks one way spends more time lying on the same part of the head, which can make a flat spot worse, and a flat spot then makes it more comfortable to keep lying that way. Breaking that cycle early is much easier than later.
How it’s treated
The foundation of treatment, whoever you see, is stretching, positioning and play that encourages your baby to use both sides. A practitioner’s job is to assess properly, treat what can be treated hands-on, and teach you what to do at home.
In my practice that means:
- A careful assessment first. That includes checking hips, which are sometimes linked with torticollis, and ruling out anything that isn’t muscular, which needs a doctor.
- Gentle hands-on treatment: soft tissue work for the tight muscle, light mobilisation, and assisted stretching. It’s very gentle, and nothing like an adult adjustment.
- A home plan: simple stretches built into nappy changes and feeds, and positioning tips.
Torticollis is often managed by paediatric physiotherapists too, and if your baby would be better served by a physio, a paediatrician, or both, I’ll refer you.
Things you can do at home today
- Tummy time, several short sessions a day while your baby is awake and supervised. Start with a minute or two and build up.
- Make them look the “hard” way. Put toys, mirrors and your face on the side your baby doesn’t turn to. Change which end of the cot or changing mat their head goes, so the interesting things (the door, the window, you) are on their less-favoured side.
- Alternate sides for feeding and carrying.
- Limit time in car seats, bouncers and swings outside of travel. They keep pressure on the back of the head.
- Always put your baby to sleep on their back. Never use pillows or wedges to position a sleeping baby.
See a doctor promptly if
- The tilt came on suddenly, or your baby also has a fever, is unusually drowsy or irritable, or is vomiting
- Your baby is floppy, stiff, or not using one arm or leg as much as the other
- The lump in the neck is getting bigger, or there’s a lump anywhere else
- Your baby’s eyes don’t seem to line up, or they tilt their head to look at things
These need a medical assessment first.
Read next: is chiropractic safe for babies and children? or visit the children’s chiropractic page.
Questions parents and patients ask
Will my baby grow out of a head-turning preference?
Mild cases often improve, but it's not worth waiting to find out. Torticollis responds best when it's treated early, ideally in the first few months, so have your baby assessed as soon as you notice a consistent preference.
Can a chiropractor treat torticollis in babies?
A chiropractor with paediatric training can assess your baby and use gentle stretching, soft tissue work and mobilisation, alongside teaching you positioning and home stretches. The core of treatment is daily stretching and positioning at home, whoever you see. If your baby needs a paediatrician or a physio as well, I'll refer you.
Does tummy time really help?
Yes. Supervised tummy time while your baby is awake strengthens the neck and shoulders, encourages turning both ways, and takes pressure off the back of the head, which helps prevent flat spots. Always put your baby to sleep on their back.
This guide is general information, not a diagnosis. If you're worried about yourself or your child, get checked by a health professional. In an emergency, call 10177 or 112 from a cellphone.