How to Prevent Plagiocephaly and Torticollis in Your Infant

Parents can help their babies to develop neck and shoulder muscles.
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Since 1992, physicians have been seeing an increase in head and neck issues in infants. That was the year that the American Academy of Pediatrics began educating parents to lay children on their backs, in an effort to decrease sudden infant death syndrome (SIDS). Although the "Back to Sleep" campaign has been successful, decreasing crib deaths by nearly 50 percent, deformities such as plagiocephaly (a flattening of the head) and torticollis (constricted neck muscles) have been on the rise because infants, when placed on their backs, have limited opportunities to move and stretch.

James Laughlin, M.D., a pediatrician in Bloomington, Indiana, and a Fellow in the American Academy of Pediatrics (AAP), was the primary author of "Prevention and Management of Positional Skull Deformities," which is the AAP's recent policy statement on the issue of plagiocephaly and torticollis, says there are a number of preventative measures that parents can take. First and foremost, he says, it's important that parents continue placing infants on their backs to sleep.

He offers the following tips:

  1. There's no time like tummy time. Tummy time helps babies develop neck and shoulder muscle control. When they're not on their backs, babies are involved with their own physical therapy, exercising their growing bodies. Aim for 30 to 60 minutes of supervised tummy time, broken up into segments throughout the day. The best time to start is following the child's first visit to the pediatrician's visit. By 4 to 6 months, they'll be rolling over and engaging in tummy time on their own.
  2. Give a gentle massage. If you can tell that your baby's neck muscles are tight, or that he is consistently holding his head in a certain position, try giving him a gentle neck massage to try to relax those neck muscles and get more movement going. Sometimes this can be a little uncomfortable for the child, because he's content holding their head one way and you're shifting him out of his comfort zone.
  3. Get your baby moving. As babies get older, particularly beyond 2 months, they can see and track well. When your baby is awake, move around the room so that she'll have to look a certain way to see what's going on. If you have other children, encourage them to do the same. This provides a kind of passive form of physical therapy, and encourages the baby to exercise her neck.
  4. Engage in play therapy. Grab your child's favorite stuffed animal, pick up a brightly colored toy, or shake a rattle and get moving. The child's eyes -- and neck -- will follow you around the room.
  5. Avoid infant seats and car seats for long periods of time. A baby tends to hold his neck in the same positions when he's lying in an infant seat or car carrier. When he's sleeping, it's better to place him flat on his back, so his neck muscles are in a neutral, stretched position.

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