Any children with torticollis?

[admin]

To try to answer your question, in my sons case, the torticollis was a direct result of the BPI. Torticollis can occur on its own, though. In my sons case, he is ROBPI and favored looking to the right side and tilting his head to the left. I think in most cases, however, the child usually favors looking to the unaffected side. Because my son favored looking to the right and tilting to the left, the muscles in his neck became shorter on one side and therefore causing the torticollis. From looking to the right all the time, the back right side of his head became flat as well. We did many activities and excercises to correct this and it was fairly easy. I think some people have a lot harder of a time, though. Every child is so different and each case is unique, as we all know, so it is interesting to hear what experiences others have had, but this is what happened with us. It is just one more thing to have to deal with having a BPI child. If you have more quesions that I can answer, just re-post and I will continue to answer.

[Karen Hillyer]

My son Gavin also had a Torticollis with his bpi
over here in the Uk we don't brace for it- we are taught to perform very gentle physiotherapy exercises on the baby t help it resolve.
Gavin's Torticollis had resolved by about 6 months of age and it didn't recur following his primary surgery, although his Horners syndrome did recur for about 3-5 months post operatively

[admin]

It is interesting that there is a statistically relevant connection between torticollis, hip dysplasia, large babies and BPI. There might also be a connection to shoulder dystocia.

There are different reasons for torticollis, but one is when the sternomastoid muscle is actually torn/stretched during the birthing process and re-heals in a shortened, fibrous manner which causes the head tilt around 2-4 weeks of age. One theory is that this STM torticollis is a result of a large baby being cramped in the womb during the last few weeks of pregancy. So the neck had already taken on a shortened muscle posture in the womb. Then, while descending the birth canal, where the neck does actually turn and twist as the baby travels down, the shortened muscle gets stretched. This is why torticollis can occur in seemingly non-traumatic births.

The connection with shoulder dystocia is hypothesized to be that this essentially "stiff neck" in one direction doesn't allow the shoulders to fully rotate, so instead of passing through the birth canal at an oblique angle (the widest orientation) they get hung up under the pubic bone.

BPI may be connected because if the muscles on that side are shortened and get torn, they no longer protect the nerves from getting stretched.

Hip Dysplasia may be connected basically due to the same "cramped space" theory but on the other end.

Interesting theories. But of course, they don't excuse the practitioner that deliberately twists and yanks on a baby's head once the shoulders are stuck!

[dmom]

These replies are so interesting, especially with the plagiocephaly info - I had NEVER associated that with BPI, but I can see how it all fits together. And I am encouraged to know (Krista: like with Ella) that there has been resolution. Dawn, I'm glad the Erb's resolved!

So - did any of your children (those who didn't specify) have hip problems, like hip dysplasia?

Janet

[katep]

Our son had torticollis noted at his first "specialist" visit at four days old, though nothing was said to us about his "slight" head tilt. At around 2 weeks it became increasingly noticeable, and at our 4 week ortho appointment, it was extreme - he WOULD NOT and apparently COULD NOT turn his head to the left and his face was looking very lopsided.

The orthopedic surgeon we were seeing explained that it was more than just positional - that the muscles turning his head were actually tight and pulling on the BPI side of his face unevenly. You definitely could see how his left ear was lower, his left side if his face had a puffy, squashed look, while the right side looked flatter and sortof 'stretched'. He told us to do VERY aggressive neck stretching, to basically "just turn his head" and tilt it in the opposite direction, regardless of how much he hated/fought it.

After two days of this torture I had a baby who screamed every time I picked him up and didn't want to be touched . Then, I figured out how to do the stretches aggressively but gently... I would exert pressure, but not force his neck to turn. Each time he relaxed, I would be able to turn and tilt his head a little more, while when he fought it I just held the position. Eventually, he stopped fighting it and his head turned all the way with no problem. By the fourth day, he even started falling asleep during the stretches!

This resolved what had first seemed to be a very fixed torticollis in four days! It felt like a miracle. While he still had a "habit" of looking toward his unaffected side, he now had passive range of motion. What had seemed like practically a contracture in his neck had completely relaxed!

At his two month visit, he no longer had a "significant head tilt", only a "slight bias" towards the unaffected side. His face was more symmetrical. At three months, his torticollis was gone, and his face was completely (well, typically) symmetric.

There is still risk of imbalance, because he sucks only his right thumb, explores mostly on his right side, etc. We have to be careful to position everything to encourage him to look in the stiff direction, lie with his head in that direction, put toys on that side of the crib, etc., to help him develop and stay balanced. But so far (5 months old) he's still very flexible and even.

Kate

[Karen Hillyer]

One helpful tip we were given by a Physiotherapist to help with Gavin's torticollis was this ;
newborn babies responde really well to phtographs of other baby faces, so we placed a cover off a Mothering magazine which had a beautiful baby's face featured on it, really close up - almost life size, into Gavins crib on his affected side, we then laid him slightyl tilted onto his affected side so that he could "look" at the baby - he found this very peaceful and was happy to "watch" the baby for ages before he fell asleep - it all helped to turn his head to midline, along with the exercises of course.
Hope this tip helps someone
Karen

[admin]

To answer the question of hip dysplagia, my son so far has had no hip problems.

[dmom]

Null, thanks so much for the helpful information. Seeing as how my Danny was a 12-pound baby, it's especially noteworthy!
And thanks to the rest of you for posting your experiences. I've printed out the post to save for future reference. I'm so glad we can all stay in touch this way and help each other out!

Janet

[admin]

Nathan had torticollis secondary to his robpi that affected him for his first several months. It resolved with a program of gentle stretching (although he hated it and screamed, so I don't know what he would describe it as! He got so mad at us!), side lying at night (alternating each night in a side lyer), and I put him down for naps at first on my chest, and just held his head to the side that needed to be stretched so that he would sleep for 1 or 2 hours sustaining a stretch that whole time, and when he was a bit older (perhaps 2 months or so) I put him down to nap on his tummy with his head to the side he needed to stretch. I know "Back to sleep" is a huge deal, but putting him down on his tummy for naps to stretch his neck was recommended to us by our neurologist. I actually would have to hold his head while he fell asleep and he would scream for the first while, but then he would get tired of protesting, go to sleep, and get a great 2 or 2 1/2 hour stretch. Once his arm function on his right side became better then his active movements helped his torticollis resolve because he didn't favor looking to his left (and to him, probably more interesting) side so much. But at first when only his left arm/hand moved that was his sphere of interest.

[m&mmom]

It's interesting that another null post is using my mothers name and email address. She knows nothing about this topic.

Cindy