I have had several people in a torticollis yahoo group take issue with my post on Torticollis, so let me clarify my thoughts here today.
Certainly, the "back to sleep" program and preferential positioning in bottle feeding are not the only reasons for this condition. Many infants are born with it secondary to uterine positioning with a greater risk when there are multiples due to the "cramped" space in utero. In the past this was the main cause, or thought to be the main cause. There are other infants who present with torticollis and have bony abnormalities of the cervical spine with or without an attachment to a syndrome. As well, there are visual issues that create an environment where the child will tilt the head to better his/her vision (ocular tort).
In school, the main cause was considered the uterine positioning and one was taught to look for the "bulge" or "contusion" that could be found along the belly of the sternocleidomastoid muscle located on the side of the tilt.
I do believe that it is the lack of that presentation in many children today that causes a delay in referral for treatment. With the environmental issues that I presented in my previous post there is no "bulge" or "contusion" along the muscle belly.
Since there is no reason for an increase in "cramped" uterine positioning (other than an increase in multiples due to more successful fertility treatments), or ocular or bony abnormalities one must look to other causes for the increase in presentation for therapy that we see today. I continue to believe that that increase can be traced to such things as the "back to sleep" program and the popularity of bottle feeding (therefore a greater possibility of preferential positioning at least 5-6 times per day for 10-30 minutes at a time.
I do hope that that clarifies the previous post and my thoughts specifically.
Renee
No comments:
Post a Comment