Author: Deirdre M.
Date: September 22, 2023
In my nesting phase of my first pregnancy, during peak COVID in 2020, I started following the typical parenting and mom Instagram accounts. At some point in my many hours of scrolling, I stumbled upon a pediatric physical therapist account. This account had a lot of great info about tummy time and motor development milestones, which was helpful for me to have an idea of what my baby should be doing physically and when. This account also specialized in sharing information about motor delays and other physical issues one might see in babies and kids at all stages.
One issue I learned about was something called torticollis, which is when a baby's neck muscles are tight on one side (typically due to in utero positioning) causing their head to twist and/or tilt to that side. I learned that there are varying degrees of the tightness and tilt that characterize torticollis, so it’s sometimes not obvious. One way to recognize it is if the baby leans to one side when sitting or has a preference to only roll in one direction.
Knowing about this ahead of time really came in handy when my son was born and I could spot it in him. This is especially because, as I realized later, the motor development checks at the pediatrician are not always involved enough to be able to catch subtle signs of torticollis. In our experience, the pediatrician observes the baby perform maybe one roll and watches the baby sit for a moment, but otherwise mainly gets their information from asking the parents questions such as “Do they sit up unassisted?”, “Do they roll both directions?”, etc. It would never have occurred to me to pay attention to how often he rolls in each direction had I not seen this on the pediatric physical therapist’s page.
At our four month pediatrician appointment I said to the doctor, “See when he sits up how he’s leaning to one side? He’s always leaning that way. And he only ever rolls over from belly to back in that direction. Could that be torticollis?” The doctor suggested we see a physical therapist for an evaluation, which later resulted in a torticollis diagnosis and six months of weekly physical therapy. The torticollis was affecting our son’s muscle strength on his tight–and hence weaker–side, which also led to a delay in crawling. We had a wonderful experience with our physical therapist, and with her help we learned how to do stretches and exercises at home and incorporate them into our play throughout the day.
If you have a hunch your child may have torticollis, ask your pediatrician about it at your next check up. Based on your conversation, they may refer you to a pediatric physical therapist for an evaluation and regular PT sessions.
The at-home work that the physical therapist assigns is probably the most important part, because one hour a week of working on strengthening at PT sessions is not going to make enough of an impact given how fast little babies’ bodies are growing.
What was key for us was finding a way to make these small movements still feel like playing.
This is a lot more important than we realized at first. Contrary to some mainstream messages on social media these days, you actually do need the noisy, flashy, brightly-colored toys that will really grab their attention to get them to lift their head, roll, reach, etc.
You also need a good rotation because babies do get bored of the same toys! Incorporating the exercises into playing was critical for us to get our baby to want to transition from sitting, to belly, and back to sitting multiple times on each side.
Good old fashioned clapping, praise, and encouragement also helped a lot!
Whenever your child finishes the official PT treatment plan, continue monitoring and follow up again with your PT if needed.
Work with your child to even out his strength, transition from the floor to sitting, and eventually crawl at 10 months.
We stopped his physical therapy once he started crawling but continued to monitor and message with the physical therapist as he got closer to the walking milestone. He was standing and cruising along furniture for a while before walking on his own at 15 months.
Be in charge of your and your baby’s own health. We hear over and over again, whether it be for ourselves or our children, that you have to be in charge of your own health. I’ve also heard “you have to be the CEO of your own health,” because there's a lot of work involved with advocating, researching, finding specialists, scheduling appointments, etc.
Have a pediatrician who you trust and have a good relationship with. Someone who is modern and open to the idea of people managing their own health and medical journey is helpful.
Find the few resources that you trust and stick with those. Don’t try to research the entirety of the internet, whether that be blogs, Instagram accounts, endlessly Googling, etc.
Trust your gut. If you have a feeling or a hunch, at least push for an evaluation by a specialist. The best case scenario is that they tell you that your child has no issues in their specialty and you have nothing to worry about.
Deirdre lives in Philadelphia with her two boys, one 2 years old and one 9 months old
My favorite thing about being a mom: The unconditional love and the snuggles.
Information contained in this article is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your health physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment, and never disregard professional medical advice or delay in seeking it due to something you read here. Under not circumstances will we be liable for any loss or damage caused by your reliance on information obtained here.