Why Does My 6-Month-Old Baby's Head Tilt to the Left?

A six-month-old baby frequently tilts their head to the left side?

Hello, Doctor! Since my baby was born, she tends to tilt her head to the left while lying down, with her face facing right.
The doctor examined her and said there was no torticollis, just a matter of head shape, so I didn't pay much attention to it.
Recently, as she started learning to sit, I noticed that her head still tilts to the left (face forward; friends say she looks cute in photos, but that's not the case).
She often eats solid food with her head tilted as well, but when playing on her stomach, there doesn't seem to be a noticeable tilt to the left.
Now that she can roll over, she can turn her head to the other side while sleeping on her stomach.
Previously, when in a stroller (reclined), her head noticeably tilted to the left, but she quickly adjusted it back.
I've noticed some improvement in her head position over the past few days.
A few days ago, I took her to see the doctor again, and the doctor said there was no issue and no need for any intervention, but I am still a bit worried.
Why does her head tilt to the left when sitting? (Her head can move freely left and right when sitting.) She also has slight asymmetry in her eyes, and her nostrils appear a little different in size, but I understand that it's normal for faces to have some asymmetry.
Do you think this could be torticollis or a cervical spine issue? As a new mom, I would appreciate your guidance.
Thank you!

Ms. Chen, 30~39 year old female. Ask Date: 2021/07/15

Dr. Yin Xinbei reply Rehabilitation

Two physicians diagnosed that there is no torticollis, possibly because the clinical examination of the neck muscles showed no significant lumps or stiffness.
However, you observed that the head tilts to the left and there is asymmetry in the eyes and nostrils (perhaps there is also a difference in the size of the cheeks?).
This may be due to uneven muscle strength on both sides of the neck.
Typically, this condition improves on its own as the baby grows.
If other developmental milestones are normal, it can be monitored further.
However, parents should be attentive and occasionally help the baby correct the habit of tilting the head to the left to prevent long-term postural issues that could lead to facial asymmetry affecting appearance.
If the situation does not improve, further medical evaluation is necessary.

Reply Date: 2021/07/15

More Info

It’s understandable to be concerned about your baby’s head tilt, especially as a new parent. Based on the information you provided, it seems that your baby has been tilting her head to the left since birth, and while initial examinations ruled out torticollis (a condition where the neck muscles are tight, causing the head to tilt), you are still observing this behavior as she grows.

Firstly, it’s important to note that head tilting in infants can occur for various reasons. In many cases, it can be attributed to muscle imbalances or preferences in head positioning rather than a serious medical condition. Since your baby can turn her head freely while sitting and has shown the ability to change positions when lying down, it suggests that there may not be a significant underlying issue.

One possibility is that your baby has developed a habit of tilting her head to the left, which can happen if she has a preference for looking in one direction. This can sometimes be due to the way she was positioned in the womb or simply a comfort preference. As she grows and becomes more mobile, these habits often self-correct. However, it’s essential to encourage her to look in both directions to promote balanced muscle development and prevent any potential asymmetry in her facial features or head shape.

Regarding the asymmetry you mentioned, such as the differences in her eyes and nostrils, it’s common for infants to have some degree of facial asymmetry. This is often due to the natural growth process and the way soft tissues develop. Most of the time, these differences become less noticeable as the child grows. However, if you notice significant asymmetry or if her head tilt persists, it might be worth consulting a pediatric physical therapist who can assess her muscle strength and range of motion.

In terms of your concerns about torticollis or cervical spine issues, since multiple doctors have evaluated her and found no signs of torticollis, it is likely that she does not have a significant problem. Torticollis typically presents with tightness or a noticeable difference in muscle tone, which does not seem to be the case here.
If her head tilt continues or if you notice any other concerning signs, such as developmental delays or changes in her behavior, it would be prudent to seek further evaluation. Regular check-ups with your pediatrician will help monitor her development and address any concerns you may have.

In conclusion, while it’s natural to worry about your baby’s development, the head tilt you’re observing may not be a cause for alarm, especially if she is meeting her developmental milestones. Encouraging her to look in both directions and providing opportunities for her to strengthen her neck muscles through play can be beneficial. If you have persistent concerns, don’t hesitate to reach out to your healthcare provider for further guidance.

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