Baby Torticollis: Why Your Baby Prefers Looking One Way and What You Can Do
Baby Torticollis at a Glance
Torticollis in babies, sometimes called wry neck, describes an asymmetrical head and neck position. Parents may notice their baby consistently looks one way, tilts their head to one side, has difficulty turning equally in both directions, prefers feeding on one breast, or begins developing a flat spot on their head.
The most common type in young babies is congenital muscular torticollis (CMT). Early recognition is important because persistent neck asymmetry can occur alongside positional plagiocephaly and may influence how a baby explores movement.
Management may include positioning, tummy time, stretching and strengthening exercises, physiotherapy and appropriate assessment of the baby's overall movement and musculoskeletal function.
What Is Torticollis in Babies?
Have you noticed that your baby always seems to look towards the same side?
Maybe you turn their head gently the other way while they're sleeping, only to find they've turned straight back again.
Perhaps breastfeeding is easy on one breast but awkward on the other. Or you've started noticing a little flattening on one side of their head.
These are all things parents commonly notice with torticollis.
Torticollis literally refers to an abnormal or asymmetrical position of the neck. In babies, the most commonly discussed form is congenital muscular torticollis, which typically involves tightness or shortening of the sternocleidomastoid muscle — the large muscle running from behind the ear towards the collarbone and sternum.
The classic presentation is a baby's head tilting towards one shoulder while the chin rotates towards the opposite side.
However, torticollis isn't always dramatically obvious.
Some babies simply have a strong preference for looking in one direction. Others can turn both ways but clearly find one direction easier. Some show their asymmetry most noticeably during feeding, tummy time or sleep.
This is why watching how your baby naturally moves can tell us so much.
What Causes Torticollis in a Baby?
There isn't always one identifiable cause.
Congenital muscular torticollis develops during pregnancy or around the newborn period. Factors associated with CMT can include positioning within the uterus, restricted space, birth factors and changes within the sternocleidomastoid muscle.
Some babies also develop a postural preference without significant muscular shortening.
Rather than focusing exclusively on one muscle, it can be useful to look at the baby's overall presentation.
We might consider:
how baby was positioned during pregnancy
pregnancy and birth history
whether baby was breech
head and neck movement
feeding preferences
head shape
tummy-time tolerance
shoulder and trunk symmetry
hip development
baby's general neurological and developmental presentation.
Importantly, not every head tilt is muscular torticollis.
Visual, neurological, skeletal and other medical conditions can sometimes cause abnormal head positioning, which is why persistent or unusual torticollis deserves proper assessment rather than simply assuming a muscle is tight.
Signs of Torticollis Parents May Notice
Parents are often the first people to recognise asymmetry because you spend so much time watching your baby.
Baby always looks to one side
This is probably the most common observation.
When your baby is relaxed on their back, notice where their head naturally settles.
Do they spend most of their time looking right?
Can they comfortably follow your face towards the left?
Do they immediately return to their preferred side?
A preference doesn't necessarily mean your baby has torticollis, but a persistent preference is worth watching.
Baby has a head tilt
You might notice one ear appears closer to the shoulder.
Interestingly, parents sometimes first notice this in photographs. When we see our babies every day, subtle postural patterns can be difficult to recognise until we look at a photo taken straight on.
Baby doesn't turn their head equally
Try engaging your baby from each side.
Can they follow your face through a similar range in both directions?
We're not trying to force their neck or perform an examination at home — we're simply observing whether spontaneous movement appears reasonably symmetrical.
Feeding is easier on one side
A baby with a neck preference may appear perfectly content breastfeeding on one side but become unsettled, pull away or have difficulty positioning themselves on the other.
This makes sense mechanically because the baby's head and neck need to orient differently depending on which breast they're feeding from.
Of course, breastfeeding difficulties have many possible causes, including attachment, milk flow and oral function. Persistent feeding problems deserve appropriate assessment and may benefit from support from an IBCLC.
A flat spot begins developing
Torticollis and positional plagiocephaly frequently occur together.
If a baby repeatedly turns their head towards one side while sleeping and resting, the same area of their skull receives pressure again and again.
Because an infant's skull is growing rapidly, this repeated pressure can contribute to positional flattening.
Torticollis and Plagiocephaly: Why They're Often Connected
Positional plagiocephaly describes an asymmetrical flattening of a baby's head.
The Royal Children's Hospital Melbourne identifies congenital muscular torticollis as one of the risk factors associated with positional plagiocephaly.
The relationship can sometimes become a cycle.
A baby prefers looking right.
They spend more time resting on the right side of their head.
That side begins becoming flatter.
The flatter position may then become an easier resting position, further reinforcing the preference.
This is one reason we don't only look at head shape when a baby has plagiocephaly.
We also want to know:
Why does this baby keep choosing this position?
Assessing neck movement and general body symmetry can provide important information.
If you're interested in this topic, our separate guide on plagiocephaly and flat head syndrome in babies goes into much greater detail about head-shape assessment, positioning and when helmet therapy may be considered.
Why Does Symmetrical Neck Movement Matter for Development?
Babies learn through movement.
Long before they can speak or intentionally explore their environment, their nervous system is receiving information from their eyes, inner ear, muscles, joints, skin and movement.
Turning the head towards a parent's voice is movement.
Looking towards a toy is movement.
Lifting the head during tummy time is movement.
Eventually these simple experiences become increasingly complex — reaching, rolling, pivoting, sitting, crawling, pulling to stand and walking.
Comfortable movement in both directions gives babies opportunities to explore both sides of their body and environment.
During tummy time, for example, babies gradually learn to lift and rotate their head, bear weight through their arms, shift their weight and eventually reach.
A baby who strongly prefers one direction may practise slightly different movement patterns on each side.
That doesn't mean a baby with torticollis is destined to have developmental problems.
Far from it.
It simply explains why early recognition and encouraging varied, symmetrical movement can be worthwhile.
What I Commonly See in Practice
One of the most common things parents tell us is:
"I thought that was just the side they liked."
And sometimes it really is simply a mild preference.
But when we look more closely, we may notice that baby doesn't rotate quite as comfortably one way. Perhaps one shoulder moves differently during tummy time. Feeding may be noticeably easier from one direction. Or a small amount of flattening is beginning to appear on one side of the head.
That's why, when I'm looking at a baby with a head preference, I'm interested in the whole baby — not just their neck.
How do they move?
How do they tolerate tummy time?
Do they use both arms similarly?
What happens when they follow a face from one side to the other?
What's their head shape like?
How are they feeding?
What was pregnancy and birth like?
Often the little observations parents have already made at home give us some of the most useful information.
What Can Parents Do at Home?
If your baby has significant restriction or diagnosed congenital muscular torticollis, their individual home program should be guided by an appropriate healthcare professional.
There are, however, some simple ways to encourage varied movement.
1. Make the non-preferred side interesting
Babies love human faces.
Instead of repeatedly manually turning their head, try encouraging them to actively choose the other direction.
Position yourself on their less-preferred side.
Talk to them.
Smile.
Sing.
Think about where interesting things are located in the room — windows, siblings, activity, light and doorways.
We want to invite movement rather than constantly forcing it.
2. Build tummy time into the day
Supervised tummy time provides opportunities to develop head control and strengthen the neck, shoulders and upper body.
If your baby hates being placed flat on their tummy, start somewhere easier.
Try tummy time:
on your chest
across your lap
for short periods on the floor
with you lying face-to-face
several times throughout the day rather than one long session.
A minute here and two minutes there can add up.
Remember that tummy time is for awake and supervised play. Babies should be placed on their backs for sleep according to safe-sleep guidelines.
3. Alternate carrying positions
Most parents naturally have a favourite side for carrying their baby.
Try alternating.
Different carrying positions change what baby can see and encourage slightly different head, neck and body movements.
4. Consider the feeding environment
If baby strongly prefers feeding in one direction, an IBCLC may help you experiment with feeding positions that maintain comfortable neck orientation while addressing breastfeeding mechanics.
Sometimes a different hold makes a significant difference.
5. Give baby opportunities for unrestricted floor movement
Car seats are essential for safe travel, but they aren't designed as places for babies to spend unnecessary awake time once the journey is finished.
The same principle applies to swings, rockers and other containers.
Safe, supervised floor play gives babies much greater freedom to kick, reach, turn and explore movement.
Should You Stretch a Baby With Torticollis?
Stretching is commonly included in physiotherapy management of congenital muscular torticollis.
However, this isn't something we'd recommend guessing from an online video.
The direction and cause of the restriction matter.
A healthcare professional experienced with CMT can show you exercises appropriate for your baby's individual presentation.
Evidence-based physiotherapy management can include stretching, strengthening, positioning, environmental adaptation and parent education.
For many babies, the everyday activities parents do repeatedly at home form an important part of management.
Where Can Chiropractic Fit?
Parents sometimes bring their babies to Nomad because they've noticed asymmetrical movement, a persistent head preference, feeding-position difficulties or plagiocephaly and would like their baby's musculoskeletal function assessed.
A paediatric chiropractic assessment is very different from what many people imagine when they think about adult chiropractic.
We may observe things such as:
spontaneous head movement
neck rotation
postural symmetry
spinal and body movement
head shape
tummy-time patterns
age-appropriate developmental movement
relevant feeding history
pregnancy and birth history.
Techniques used with babies are modified appropriately for their age, size and stage of development.
Importantly, we also work within a collaborative healthcare model.
Depending on the baby's presentation, that may mean involving their GP, paediatrician, child health nurse, paediatric physiotherapist, IBCLC or another appropriate practitioner.
Chiropractic isn't intended to replace medical or physiotherapy management of congenital muscular torticollis.
Our role is to assess the baby's musculoskeletal presentation, provide appropriate care where indicated and help families find the right additional support when needed.
When Should You Have Your Baby Checked?
Consider having your baby's neck movement assessed if you notice:
a persistent head tilt
baby nearly always looking in one direction
difficulty turning towards one side
a developing flat spot
marked asymmetry during tummy time
persistent feeding preference or difficulty on one side
a lump within the neck muscle
unusual body asymmetry
concerns about movement or development.
The 2024 American Physical Therapy Association clinical practice guideline for congenital muscular torticollis emphasises early identification and intervention.
Early assessment doesn't mean something is seriously wrong.
It simply means that if your baby does need some additional help, you're addressing it during a period when their body and movement patterns are changing incredibly quickly.
When Does a Head Tilt Need Medical Assessment?
It's important to distinguish the common infant presentation of congenital muscular torticollis from acquired torticollis.
A head tilt that appears suddenly — particularly in an older baby or child — can have very different causes.
Seek prompt medical advice if torticollis occurs alongside:
trauma
significant pain
fever or illness
neurological symptoms
unusual lethargy
difficulty swallowing
problems with balance or coordination
persistent vomiting
sudden onset without an obvious reason.
A persistent head tilt that doesn't fit the usual pattern of congenital muscular torticollis should also be appropriately investigated.
Frequently Asked Questions About Baby Torticollis
1. Can torticollis in babies go away on its own?
Some mild positional preferences improve as babies become stronger and more mobile. However, congenital muscular torticollis involving restricted movement may require targeted positioning, exercises and physiotherapy. Early assessment can help determine whether you're seeing a simple preference or something requiring more specific management.
2. Why does my newborn always look to the same side?
There can be several reasons. Some newborns develop a preferred resting position, while others have muscular tightness or congenital muscular torticollis. Head shape can also reinforce a preferred direction. Persistent head preference is worth discussing with an appropriate healthcare professional, particularly if your baby has difficulty turning the other way.
3. Can torticollis cause plagiocephaly or a flat head?
Yes, torticollis is a recognised risk factor for positional plagiocephaly. A baby who consistently rests with their head turned in one direction places repeated pressure on the same part of the skull. This can contribute to flattening, particularly during the early months when skull growth is rapid.
4. Can torticollis make breastfeeding difficult?
It can contribute to feeding-position difficulties because breastfeeding requires different neck positioning at each breast. A baby may appear comfortable feeding one way but resist the opposite position. However, breastfeeding problems can have many causes, so persistent difficulties should be appropriately assessed, often with support from an IBCLC.
5. What is the recommended treatment for congenital muscular torticollis?
Management depends on the baby's age, severity and underlying presentation. Evidence-based care commonly includes parent education, positioning, environmental changes, stretching, strengthening and physiotherapy. Babies with significant plagiocephaly or atypical findings may require additional assessment or referral.
The Take-Home Message
Torticollis in babies commonly presents as a persistent head tilt, preference for looking one direction or difficulty turning the neck equally both ways.
It can occur alongside positional plagiocephaly and may influence how a baby practises early movement.
Parents can support varied movement through supervised tummy time, changing carrying and feeding positions, encouraging active looking towards the less-preferred side and providing plenty of opportunities for unrestricted floor play.
Persistent or significant torticollis should be appropriately assessed. Physiotherapy plays an important role in evidence-based management of congenital muscular torticollis, while other health professionals may be involved depending on the baby's individual presentation.
Most importantly: notice the preference, encourage variety and ask for help if it persists.
If you've noticed your baby always looks one way, has a persistent head tilt, seems uncomfortable turning their neck, has developed a flat spot or finds feeding noticeably easier in one direction, it can be helpful to have their movement assessed.
At Nomad Chiropractic in Mosman on Sydney's Lower North Shore, we have a particular interest in pregnancy, babies, children and family care.
Our approach is gentle, individualised and collaborative. If something needs additional investigation or another healthcare professional is better placed to help, we'll point you in the right direction.
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Sargent B, Coulter C, Cannoy J, Kaplan SL. Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association Academy of Pediatric Physical Therapy. Pediatric Physical Therapy. 2024;36(4):370–421.
Royal Children's Hospital Melbourne. Clinical Practice Guidelines: Congenital Torticollis.
Royal Children's Hospital Melbourne. Clinical Practice Guidelines: Positional Plagiocephaly.
Royal Children's Hospital Melbourne. Clinical Practice Guidelines: Acquired Torticollis.
Kaplan SL, Coulter C, Sargent B. Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline. Pediatric Physical Therapy. 2018;30(4):240–290.
American Academy of Pediatrics. Guidance and parent education relating to positional skull deformity, tummy time and infant development.
Australian Government Department of Health and Aged Care. Safe Sleep and Infant Health Guidance.
Red Nose Australia. Safe Sleeping and Tummy Time Recommendations.
Raising Children Network. Tummy Time for Babies.
Australasian Society for the Study of Brain Impairment and relevant paediatric rehabilitation literature regarding infant motor development and asymmetry.
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This article provides general educational information only and is not intended to diagnose or treat an individual child. Torticollis can have different causes, and recommendations should be tailored to your baby's presentation. If you are concerned about your baby's movement, development, feeding, head shape or general health, seek advice from an appropriately qualified healthcare professional.
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