Infant Torticollis

While some mothers are fortunate enough to give birth without complications, birth injuries can sometimes occur during labor and delivery. A child’s torticollis injury can stem from multiple complications, and in the worst cases can be the result of medical negligence and malpractice.

Torticollis is a birth trauma complication that can be painful and restrict a baby to uncomfortable positions that affect their posture, feeding, and balance. It can also cause facial deformities and other related head injuries when left untreated for extended amounts of time.

Early treatment of the condition is crucial; when healthcare providers recognize a child’s torticollis condition either at birth or within the first few weeks of life, they should immediately note it and begin strategizing a short-term and long-term treatment plan to address it. When they fail to register it as a serious issue and don’t fail to intervene quickly enough, it can lead to more serious birth complications and be grounds for a medical malpractice claim.

Over the past three decades, the nationally recognized team of birth injury lawyers, registered nurses, and nurse-attorneys at Miller Weisbrod Olesky have established a proven track record of delivering justice for children and families across the United States who have suffered from all types of birth injuries.

We are prepared to meticulously investigate the circumstances of your case, gather crucial medical records, consult with top medical experts, and fight tirelessly to secure the compensation you deserve for your child's injury.

We represent families and their birth-injured children throughout the United States. You can contact us today to schedule your free legal consultation by calling our toll-free line at (888) 987-0005 or by filling out our online request form.

We work on a contingency fee basis, meaning you won't pay any legal fees unless we win your case. We only receive payment once you do.

Torticollis (also sometimes known as wryneck) is a birth complication where the baby’s neck muscles (specifically one of the sternocleidomastoid muscle pairs in the neck) are shortened and constrained, causing their head to tilt to one side. This muscle tightness keeps the baby’s head fixed in this tilted position, limiting their range of motion and affecting their overall posture in the shoulders and spine.

Torticollis is observed in roughly 1 in every 250 newborns. When the condition is severe or left untreated, it can persist into the baby’s early childhood.

Torticollis can be congenital (not caused by trauma) or the result of a birth injury caused by medical errors. The exact cause isn’t always known, but it will typically stem from one of two things:

• Birth trauma during labor and delivery that injures and constrains the neck muscles.
• Fetal injury during pregnancy that causes scar tissue to form and tighten the neck muscles.

A combination of different pregnancy complications and labor and delivery complications can injure the baby’s neck muscles, causing torticollis at birth:

Pregnancy Complications

Most pregnancy complications that cause congenital torticollis affect the way the baby’s head and neck are positioned in the womb. When the baby’s neck is fixed in this unnatural position over time, the sternocleidomastoid muscle begins to shorten.

The following complications that most commonly cause this to happen include:

• Oligohydramnios: The risk of torticollis is increased when the fetus is constrained within the womb. This can occur when there is less amniotic fluid in the womb than normal, restricting movement and increasing the chances of positional deformities that lead to muscle strain in the neck.







• Fetal Macrosomia: Another factor that can constrain fetal movement is fetal macrosomia, a complication where the baby is larger for gestational age than normal. A macrosomic baby in the womb can get into uncomfortable fetal positions that can strain and shorten the neck muscles, leading to torticollis at birth.

Labor and Delivery Complications

Certain issues that are present during the mother’s labor and delivery can make a torticollis injury more likely to occur. This can range from fetal size and positional abnormalities to direct misuse of labor and delivery tools. The most common issues include:

• Abnormal Fetal Positioning at Birth: When the baby is positioned in the womb in an uncommon way (such as breech position or shoulder position), it can complicate delivery through the mother’s birth canal and potentially cause an injury when the neck is compressed in an unnatural angle.







• Shoulder Dystocia: Shoulder dystocia occurs when the baby’s head delivers, but their shoulders remain stuck behind the mother’s pubic bone. It can strain the neck muscles and cause torticollis, along with other injuries to the brachial plexus nerves in the neck and spinal cord.







• Improper Use of Delivery Instruments: In cases of a difficult delivery when the baby is having a hard time passing through on its own, doctors may use delivery instruments like forceps and vacuum extractors to help assist in vaginal birth. However, when excessive force is used and doctors pull too hard on the baby’s head with these tools, it can lead to muscle strains and neck injuries like torticollis.

In very rare instances, certain genetic factors can trigger abnormal development of the baby’s neck muscles in utero, leading to congenital torticollis at birth. This can include uncommon birth defects such as Klippel-Feil Syndrome or cervical spine abnormalities.

Much more often, however, the condition will likely be caused by either a complication that injured the neck at birth or a pregnancy complication that placed the neck in an unnatural resting position for too long.

In cases of congenital torticollis, imaging scans like ultrasounds and MRI scans during prenatal testing can reveal enlargement and swelling of the neck muscles.

As the baby’s muscles contract, it can cause microtears that heal back as scar tissue. This scar tissue accumulates and thickens, eventually forming a small visible knot on the side of the baby’s neck. Healthcare providers can identify this knot through ultrasounds and use it as the first indicator of torticollis.

If the mother is identified to have any pregnancy complications listed as potential risk factors for torticollis (such as oligohydramnios or macrosomia), medical professionals should be aware of the possibility of torticollis and assess for it on the ultrasound.

The baby’s fetal position should be carefully monitored in all pregnancies. If an OB-GYN or another healthcare provider identifies the baby resting in an unnatural position, they should take a note of it and assess the risk of torticollis and other potential injuries.

While attempting to move the baby’s position isn’t always the safest option, it is the responsibility of medical professionals to understand how this position can complicate labor and to then formulate a plan on how to most safely deliver the baby without causing further injury.

Upon birth, symptoms of torticollis will be quite clear. The first and most significant symptom is the fixed tilt of the child’s head to one side. The baby’s movement of their head and neck will be very limited, and one of their shoulders may be positioned higher than the other.

The neck itself may be slightly swollen, and there will often be a pea-sized lump on the muscle that can be felt. In more extreme cases, the baby’s facial features may be slightly uneven on one side.

Apart from observing physical symptoms, doctors may decide to run additional screenings on the baby’s neck such as X-rays, CT scans and MRI scans for further confirmation before diagnosing.

Torticollis can lead to facial deformities where the baby’s features (face, jaw, eyes, and ears) become asymmetrical. This can cause issues with depth perception and balance, as well as vision impairments.

Torticollis can also cause issues to the baby’s skull. At birth, the baby’s skull is still soft and moldable. When an unequal amount of pressure is placed on one side, the cerebral compression it can result in a complication known as plagiocephaly (or “flat head syndrome”).

Issues with jaw malalignment may make feeding more difficult for babies with torticollis. In extreme cases, the baby may not be able to feed regularly and may require G-tube insertion to receive the proper nutrients.

Torticollis may also delay certain developmental milestones when left untreated, such as the baby’s ability to look around, crawl, or sit up on their own. These impairments can make it harder for the child to develop these gross motor skills even after their torticollis condition has improved or been cured.

A baby’s torticollis is treatable and even fully curable with early intervention and consistent treatment. Upon the first few weeks of life, a doctor may recommend a type of birth injury treatment called craniosacral therapy.

Craniosacral therapy is a gentle spine and scalp massaging technique used on infants to release tension and relieve pain. It is a non-invasive, gentle treatment that can bring quick relief to newborns with head and neck pain.

Craniosacral therapy has been proven to relax the infant’s neck muscles and provide relief from soreness. And while it’s not likely to cure a baby’s torticollis condition outright, it is a good first step in the right direction because of its non-invasive nature allowing licensed physical therapists, chiropractors, osteopaths, and massage therapists to provide treatment right away.

Physical therapy has been proven as one of the most effective treatment options for torticollis. Repeated stretching exercises and position changes can assist in slowly lengthening and relaxing the neck muscles.

The primary healthcare provider is responsible for providing the family with a regimen for stretching and recommended movement that should aid in rehabilitation. They may recommend laying the baby with their head positioned on the opposite side when putting them down for naps and at night. They may also encourage laying out toys or other objects nearby to incentivize them to practice turning their neck.

Continued monitoring is crucial during this period to track if the stretching and movement is producing results. If the baby is not improving, further intervention will be necessary.

Further intervention may come in the form of more rigorous physical therapy exercises (likely with a licensed specialist), or in more serious cases it may require a medical procedure to surgically lengthen the sternocleidomastoid muscle.

The American Academy of Orthopedic Surgeons estimates that roughly 10% of children diagnosed with torticollis will require surgery. The operation is typically performed once the child reaches preschool age and after all nonsurgical avenues for treatment have been explored.

Known as a sternocleidomastoid muscle release surgery, a surgeon makes what’s known as a transverse (horizontal) incision through the baby’s neck and into the muscle to release tightness and improve the muscle’s flexibility and range of motion. The surgeon then may potentially reattach the muscle in a new location.

Recent studies have concluded that surgical treatment of torticollis has been linked with significant quality of life improvements. While the surgery has a high success rate, it is typically thought of as a “last resort” option when non-surgical treatment is proven to be ineffective.

Throughout the course of a mother’s pregnancy, delivery, and the period following the baby’s birth, healthcare professionals can make several errors that can leave a mother and family unprepared to handle and help treat a child’s torticollis diagnosis.

Examples of medical negligence in regard to torticollis identification and management can include:

• Failing to identify or treat a pregnancy complication that increases the risk of torticollis.
• Failing to correct an abnormal fetal position when it is safe to do so.
• Applying improper pressure or excessive force in the case of shoulder dystocia, causing a potential neck injury.
• Using excessive force during a forceps or vacuum extraction assisted delivery, leading to a neck injury.
• Failing to identify the signs of congenital torticollis on an ultrasound when visible, leading to a delayed diagnosis and treatment.
• Failing to identify the signs and symptoms of torticollis upon delivery, leading to a delayed diagnosis and treatment.
• Failing to provide instruction on follow-up treatment like stretches and other physical therapy practices, or failing to refer the family to a specialist who can prescribe treatment like craniosacral therapy and at-home exercises.
• Making a surgical error during a sternocleidomastoid muscle release surgery, leading to further complications and injuries.

It’s important to note that it requires a detailed review of the specific facts and timeline of a mother’s birth before making a definitive judgement as to whether medical malpractice played a factor in the child’s torticollis birth injury.

Birth injuries to a baby’s neck can be painful and taxing, causing both physical and developmental complications. When healthcare providers make negligent errors, such as failing to recognize the early signs or causing an injury during labor and delivery, the risk of further injury increases significantly.

If a family believes medical negligence worsened their child’s neck injury, legal support may be an option. A specialized birth injury attorney can review the medical records and circumstances to assess whether a claim exists.

Parents whose children suffer from the long-term effects of birth injuries deserve to know whether it could have been prevented. Our dedicated birth injury lawyers want to help you find those answers and obtain the funds necessary to improve the quality of life for your child.

If your child has been diagnosed with torticollis and you suspect this may have been caused in part by medical mistakes, Miller Weisbrod Olesky will thoroughly investigate the facts and hold the responsible medical providers accountable by pursuing medical malpractice claims against them.

Sometimes families are hesitant to reach out to a medical malpractice attorney or law firm. They may feel overwhelmed by their circumstances or are worried that a law firm will not be able to help them. But the only way to find out if you have a case is to talk to an attorney who understands how birth injuries can lead to developmental delays and other birth complications that require long-lasting medical support.

A statute of limitations (SOL) is a law that sets a time limit on how long an injured person has to file a lawsuit after an accident. It is essential to understand that statutes of limitations vary based on the type of case and the state where it is filed. For instance, the deadline for birth injury claims is typically different from other claims, such as injury to personal property, fraud, contract disputes, and collection of debts.

Generally, the clock starts ticking on the date the injury occurred. However, there are exceptions to this rule, and in some cases, the statute of limitations starts when a person discovers or reasonably should have discovered an injury. When dealing with government agencies, SOLs can become even more complex.

For example, if the party that injured you was:

• A federal employee
• Employed by a military hospital, Veterans Administration facility, or a federally funded medical entity

You may need to file a birth injury claim under the Federal Tort Claims Act (FTCA). In FTCA cases, claimants must go through certain administrative procedures before filing a lawsuit. In some states, if the negligent party was a local or state government hospital or the doctors and medical providers are employees of a governmental entity, the time period in which you must give "notice" may be shorter.

If your case is filed outside of the statute of limitations, it will typically be dismissed, and you will not be eligible to recover compensation for your injuries. Determining when a statute of limitations begins on your case can be tricky. If you're considering pursuing compensation for a birth injury, contacting an attorney as soon as possible is in your best interest.

It takes a detailed expert review of the facts and circumstances of an infant’s torticollis case to determine whether the birth injury was caused or worsened as the result of medical malpractice.

Our Process

At Miller Weisbrod Olesky, a team of specialized birth injury malpractice attorneys, nurses and paraprofessionals uses our detailed medical negligence case review process to assess your potential case. We start by learning more about you and your child and the status of meeting/missing developmental milestones. We then gather medical records to determine what happened before, during, and after your delivery.

We call in skilled medical experts who review your records and let us know if they think medical errors could have caused you or your child's injuries.

If we feel medical negligence caused or contributed to complications with your pregnancy or your child's neck injuries, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors.

At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do. The sooner you reach out to us, the sooner we can begin investigating your case and gathering the evidence needed to support your claim.

We work on a contingency fee basis, meaning you won't pay any legal fees unless we win your case. Contact us today to schedule your free legal consultation by calling our toll-free line at (888) 987-0005 or by filling out our online request form.