Infant Torticollis : not to be overlooked!
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Infant Torticollis : not to be overlooked!

Infant Torticollis : not to be overlooked!
Torticollis in infants is much more common since one layer babies on their backs. This muscle tension is often accompanied by a deformation of the skull, called plagiocephaly. Update on infant torticollis with experts in the field.

Far from being benign, the torticollis, plagiocephaly Association infant may have a significant impact on the future health of the child, including orthopedics disorder. Hence the importance of treating torticollis early and prevent deformation of the skull.

Torticollis and plagiocephaly in infants: very common disorders

Congenital torticollis in infants is a condition characterized by a contraction and / or more or less retraction of sterno-mastoid muscle (neck muscle). It is manifested by the inclination of the head to one side and the chin facing away from the tilt.

The majority of  torticollis  baby torticollis in infants (80%) are called muscular torticollis. They are due to shrinkage of the sterno-mastoid and limit rotation of the neck amplitude. This type of torticollis is present at birth or appears within the first weeks of life. “It muscular torticollis is related to the position in the womb of the mother – especially when twins with a breech presentation or when there is little amniotic fluid – or trauma during childbirth, especially when ‘there is use of forceps or suction cups, “informs Dr. William Captier , pediatric surgeon, University hospital (Montpellier). “There are often associated lesions that muscular torticollis: malposition of the feet, asymmetry of hip abduction,” added Véronique Callens 2, physiotherapist at Compiegne.

The remaining 20% ​​are so-called postural torticollis: the child has a preferred position – he always puts his head on one side, usually the first days of life – which causes muscle imbalance and muscle contracture on the side sollicity.

Associated with sleeping on the back, the presence of a stiff neck, whether muscular or postural, causes plagiocephaly, ie posterior cranial deformation. “The fact of always having the same position due to the presence of a stiff neck is the open door to the flat head on one side,” says Dr. Thierry Marck 3, a pediatrician in Paris. Torticollis the left and leads to a flattening of the right side of the skull, and vice versa.

 

The prevalence of torticollis and plagiocephaly has increased in recent decades. “There are 20 years the prevalence of plagiocephaly was 2%, today it is 35 to 40% and as many plagiocephaly is linked to a stiff neck, we can say that it is increasing “informs David Dessauge .

Sleeping  on your back recommended for twenty years to reduce the risk of sudden infant death is partly responsible for this explosion of cases. This non-physiological position for a baby just born favors the positioning of the head in rotation. But ongoing clinical studies also suggest another rationale for this increase. “We think of societal factors: the age of the mother, the high number of twin pregnancies, which cause the fetus is less room in the belly, birthing techniques …” quotes David Dessauge.

 Torticollis baby: the importance of early treatment

Muscular torticollis are treated in a multidisciplinary way with sessions of osteopathy and physiotherapy. It takes 3 to 4 sessions of osteopathy and twenty physiotherapy. “The goal is to find a joint and muscle symmetry, postural alignment and correct motor development,” says Véronique Callens. If this therapy is performed before the age of 3 or 4 months, studies show excellent results in almost 100% of cases. However, after 6 months, there is less than 40% of good results. When the muscle retraction is installed, it is necessary to intervene surgically, but this is rare. “Only 5 to 10% of children with muscular torticollis are operated,” said Prof Captier.

 Prevention from plagiocephaly

“It is essential to prevent plagiocephaly when an infant has a postural torticollis” hammer our specialists. This regresses spontaneously effect after a few months but the cranial deformation will persist, with the possibility of occurrence of subsequent disorders listed above. The treatment ? Acting on postures! Either stimulate the least used (sound stimulation, visual) side, alternate the position of the head in the bed, ensure proper alignment head-trunk-basin in the cozy deckchair, bottle feeding or feeding the side opposite the lesion, baby wear in different ways (back against itself, tilted on its side, lying on the forearm …).

These prevention techniques can be combined with physiotherapy and osteopathy if the child needs to be supported to a greater extent. “If we put up these good gestures very early, muscle imbalance is absorbed and there is no appearance of plagiocephaly,” says Véronique Callens. “This work on the child’s posture is valid in case of muscular torticollis, in parallel rehabilitation” she says. “The ideal is to prevent postural torticollis” concludes Dr. Marck. Yes but how ? “First the baby by lying on the side, alternately, the first two weeks, or, if the layer on the back, changing the head position after each feeding or bottle feeding, and avoiding putting too long in a cozy or a sunbed, “advises pediatrician. Do not hesitate also to put the child on the stomach several times a day when in waking stage – under supervision of course.

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