Torticollis, Feeding Concerns, and Thumb Sucking in Infants

Torticollis vs. Milk Intake vs. Thumb Sucking

Hello, doctor.
What is torticollis? Recently, when holding my baby, I noticed that the baby's head tends to turn to one side.
When I gently turn the baby's head to the other side, the baby does not cry but seems to have a stiff neck and finds it difficult to turn.
However, I sometimes see the baby turning the head left and right on their own.
Could this be torticollis? I apologize for not mentioning earlier that my baby is on formula (I was worried you might think they are breastfed).
I previously saw a doctor mention that the formula intake should be 150cc per kilogram, so for my baby weighing 5.5 kilograms, they should consume about 750cc a day (not counting the 0.5 kilograms).
However, my baby often drinks less than 750cc, sometimes even 200cc less.
Is this still acceptable? I'm sorry, but compared to other babies of the same age, my baby seems to drink less, and since they were born with a lower birth weight, I am a bit worried as this is my first child.
Also, should thumb sucking be considered part of developmental growth? My baby is almost 3 months old (turning 3 months on the 21st) and still does not suck their thumb.
Is this a concern? Thank you, doctor; I really appreciate your help.

Xiao Yu Er, 20~29 year old female. Ask Date: 2005/04/16

Dr. Lin Wenxian reply Pediatrics

Dear Little Fish,
Hello! The muscle on the side of the neck is called the sternocleidomastoid muscle.
It connects downward to the sternum and clavicle, and upward to the mastoid process behind the ear.
There is one on each side.
If this muscle is injured and bleeds, it may lead to fibrosis, resulting in a lump and shortening of the muscle.
If the right side is injured, there will typically be a lump on the right side of the neck, with the head tilted to the right and the chin pointing to the left, and vice versa.
If the baby can turn their head from side to side on their own, there should not be a problem with torticollis.
If you are still concerned, you can consult a pediatrician for an examination.
For a baby weighing 5.5 kilograms, 550 cc of milk is sufficient; there is no need to stress over the exact amount of milk being fed.
Growth and development should be assessed as a whole, rather than focusing solely on whether the baby can suck their thumb.
You can observe if the baby smiles at people, if their head can follow moving objects, if they have made sounds, if their neck has more strength (able to support the head when held upright), and if their hands can open.
If you notice any of these changes, it indicates that they are developing normally.
I recommend utilizing pediatric health check services to have a pediatrician evaluate their development.
Wishing you and your baby good health and all the best!
Sincerely,
Department of Pediatrics, Tainan Hospital, Department of Health, Executive Yuan

Reply Date: 2005/04/16

More Info

Torticollis, commonly referred to as "wry neck," is a condition where an infant's head tilts to one side due to muscle tightness or spasms in the neck. This can result in the head being held in a rotated position, often towards one shoulder. In your case, if you notice that your baby consistently turns their head to one side and has difficulty moving it to the other side, it may indeed be indicative of torticollis. However, the fact that your baby can turn their head independently at times is a positive sign, as it suggests some degree of normal neck mobility. It is essential to monitor this condition closely, as early intervention can lead to better outcomes. If you suspect torticollis, consulting a pediatrician or a pediatric physical therapist for a thorough evaluation and potential treatment options is advisable.

Regarding your concerns about feeding, the general guideline for formula-fed infants is approximately 150 cc of formula per kilogram of body weight. For your baby weighing 5.5 kg, this would equate to around 825 cc of formula per day. If your baby is consuming less than this amount, it could be a concern, especially if they are consistently under the recommended intake. It's important to ensure that your baby is feeding adequately to support their growth and development. If your baby is not showing signs of hunger or is consistently refusing to drink, it may be worth discussing this with your pediatrician. They can assess your baby's growth patterns, hydration status, and overall health to determine if any interventions are necessary.

As for thumb sucking, it is a common behavior among infants and can be considered a normal part of their development. Many babies begin to suck their thumbs or fingers as a self-soothing mechanism. While your baby may not be sucking their thumb at three months, this behavior can develop at different rates for each child. It is not typically a cause for concern if your baby has not yet started this behavior. However, if you have any worries about your baby's development or feeding habits, it is always best to consult with your pediatrician for personalized advice and reassurance.

In summary, if you suspect torticollis, seek a professional evaluation. Monitor your baby's feeding closely, and if they are consistently under the recommended intake, consult your pediatrician. Lastly, thumb sucking is a normal behavior that may develop at different times for each infant, so there is no need for immediate concern if your baby has not started this yet. Regular check-ups with your pediatrician will help ensure your baby's growth and development are on track.

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