Local doc details signs of neck disorder in infants

LYNNFIELD – Parental vigilance over their young children can prevent them from literally getting bent out of shape.Torticollis, a medical condition known also as “wryneck,” is when one?s head consistently leans to the left or right, while the chin is turned in the opposite direction, said Dr. Richard Lipman, medical director of the pediatric program at the Braintree Rehabilitation Hospital Outpatient Clinic at Lynnfield. The condition occurs because of tightness in the neck muscle on the favored side, he said.Torticollis is somewhat common among infants, Lipman said, and according to the Braintree Rehabilitation Hospital website, as many as one in 300 babies born in the United States has congenital muscular torticollis.The congenital muscular torticollis develops during the delivery process when one of the neck muscles, which runs from behind the ear to the collarbone, gets overstretched as the obstetrician tilts the head in one direction to deliver the baby, Lipman said. The overstretching causes that muscle to contract and the head to fall to one side.?It doesn?t represent an error on the part of the obstetrician,” Lipman said, adding that tilting of the head can be an unavoidable and necessary step during delivery.However, Lipman said, torticollis in infants can develop in other ways, such as a bony abnormality in the neck, a preference toward one side when lying down or a vision defect that causes the infant to keep his or her head in the direction that favors the better eye.In addition, Sandifer syndrome, which is infantile acid reflux, is also a cause of torticollis, Lipman said.?There appears to be a neurological reflex, for reasons that aren?t entirely clear, [that] cause[s] the muscle on one side to contract and the head to tilt. Many of the babies that I see, probably the majority of them, with torticollis actually have Sandifer syndrome,” he said.Torticollis is easy for parents to miss, Lipman said, because the neck problem subtly gets worse over time. Infants with the condition are also at risk for plagiocephaly, or flattening of the head, because their soft and malleable heads are always resting in one position, he said.If the cause of the torticollis is muscular in nature, Lipman said the course of treatment is stretching exercises, which are performed at places like the Lynnfield outpatient clinic, but he advised that parents first consult a pediatrician.?By starting physical therapy early, it reduces the risk of long-term shortening of the muscle,” he said, adding that the stretching has the possibility of rectifying any plagiocephaly.The physical therapy usually lasts a month or two to get the affected neck muscle back to normal, Lipman said.?It?s not a quick fix,” he said. “It?s a steady series of treatments, and what the therapists try to do is educate the parents, so that every day they can do the stretching exercises at home.”Parents can see if their infants are at risk for torticollis, Lipman said, by putting their children in a new spot in their crib.?If the parent rotates the baby in the crib, so they have to look out the other side, they?re going to see the baby has difficulty with that rotation and the head is going to remain tilted in the original position,” he said.Torticollis has been a known condition for generations, Lipman said, but there was a spike in infants with torticollis starting in the early ?90s when the “Back to Sleep” campaign was introduced by a variety of health groups, including the American Academy of Pediatrics. The campaign advocated that parents place their babies in the crib on their backs to avoid Sudden Infant Death Syndrome.?We started to see a number of babies with flat back of the head, and if a baby had torticollis, you didn?t just see a flat back of the head, you saw the whole head become lopsided,” he said.The infant form of torticollis should not be confused with how the condition occurs in older children and adults, Lipman said.?Those are much more likely to be a nec