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Torticollis in Newborns: Why It Happens

ByDr. Furqan Aamer
Updated: 16 Oct 2026, 3:00 pm

Torticollis in newborns occurs when a tight neck muscle keeps the head tilted to one side. Early stretching and positioning help most babies recover. Learn the causes, signs, treatment, and when to see a paediatrician or physiotherapist.

Pregatips
Torticollis in newborns is a condition in which the head stays tilted to one side, and the chin points to the opposite side. The most common type, congenital muscular torticollis, is caused by a tight sternocleidomastoid (SCM), the neck muscle running from behind the ear to the collarbone. The exact cause is unknown, but limited space in the womb is suspected. Some babies only have a preferred head position without muscle tightness (positional torticollis). It is usually noticed in the first six to eight weeks, and most babies improve with early stretching and positioning.
In this article:
We got in touch with Dr Sindhu Karthika Ammini, Senior Consultant – Neonatology & Paediatrics at Kinder Hospitals Kochi, for expert insight on this condition.

What Causes Torticollis in Newborns?

The exact cause is unknown. Doctors suspect these factors:

  • Limited space in the womb: A cramped position can shorten the muscle before birth. It appears more often in first-born babies.
  • Preferred head position after birth: Babies who always turn one way can develop tightness.
  • Breech presentation: A baby lying bottom-first in the womb has the head and neck held in a fixed position.
  • Prolonged or difficult delivery: A long labour or the use of forceps or vacuum may stretch or strain the neck muscle, which can lead to scarring and tightness.
  • Birth-related injury to the neck muscle: Bleeding or swelling inside the muscle during delivery may heal as scar tissue, which shortens the muscle.
Torticollis affects about 3 to 20 out of every 1,000 babies. The right side is affected more often than the left.

How Do You Know If a Newborn Has Torticollis?

Parents may notice that the baby:

  • Tilts head to one side, with the chin pointing to the opposite shoulder
  • Has difficulty turning the head in one direction
  • Feeds more comfortably from one breast or one side of the bottle
  • A firm lump, 1–2 cm, in the neck muscle
  • Has a flat patch on one side of the head
  • Has an uneven head or facial shape
The lump usually appears in the first four weeks and fades within six months. Babies with torticollis usually do not feel pain. A baby with torticollis may also develop positional plagiocephaly, in which repeated pressure on one part of the skull causes a flattened area. Torticollis and positional head-shape changes commonly occur together.

Early recognition of the condition is important as most babies respond very well to timely intervention. It’s important not to force the baby’s neck into a particular direction, especially without any guidance.Dr Sindhu Karthika Ammini, Sr. Consultant, Neonatology & Paediatrics, Kinder Hospitals

How Is Torticollis Treated in Babies?

Treatment starts with a paediatrician's examination, sometimes with an ultrasound or X-ray. Physiotherapy started before three months of age is linked to better outcomes.

  • Stretches: A paediatric physiotherapist teaches gentle neck stretches to do several times a day. Do not attempt stretches without this training.
  • Positioning: Lay the baby on their back; they must turn towards the weaker side to see or hear you. Place toys, lights, and your voice on that side.
  • Feeding: Alternate sides during feeds to encourage turning both ways.
  • Tummy time: Supervised tummy time strengthens the neck and reduces pressure on the back of the head.
  • Sleep: Place the baby on the back, with the head turned away from the preferred side.
Parents should avoid forcefully turning the baby’s neck, using unprescribed neck supports or attempting vigorous massage.

Most babies take six months to a year to recover fully. If stretching does not help after a few months, the doctor may consider other options. Surgery to lengthen the muscle is rarely needed.

When to See a Doctor

Consult a paediatrician if:

  • The head tilt is visible in the first weeks
  • A neck lump appears
  • One side of the head looks flat
  • The baby cannot turn the head both ways by two to four months
  • The tilt is associated with unusual eye movements or neurological changes
  • The tilt appears suddenly, or comes with fever, vomiting, or reduced arm movement
Early recognition of torticollis gives babies a better opportunity to develop symmetrical neck movement and reduce associated problems.

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FAQs on Torticollis in Newborns: Why It Happens

  1. Is torticollis in newborns serious?
    It is usually mild and treatable. Early treatment prevents uneven growth of the skull and face.
  2. Can torticollis go away on its own?
    Mild cases may improve with positioning alone. Most babies need guided stretches to recover fully.
  3. Does torticollis cause a flat head?
    Yes, it can. Babies who turn the head one way keep pressure on one part of the skull. The flat spot often improves as neck movement improves.
Medically Reviewed By:
Dr Sindhu Karthika Ammini, Senior Consultant – Neonatology & Paediatrics at Kinder Hospitals Kochi