What we check
- Measured neck rotation and side-bending in both directions, recorded so we can compare over time
- The sternocleidomastoid muscle on both sides for shortening, a firm band, or a nodule
- Motion at the top of the cervical spine, where most head rotation occurs
- Head shape from above, including ear position, forehead symmetry, and the location of any flattening
- Jaw and facial symmetry
- Ribcage, pelvis, and hip symmetry, and whether the whole body curves one way
- Whether feeding, sleep position, and container time are reinforcing the preference
- Overall nervous-system tension on an INSiGHT scan
What to expect
The first visit is a consultation, an INSiGHT scan, and a hands-on exam with a first adjustment. Expect us to measure. We record rotation and side-bending both ways so that progress is a number rather than an impression, and we look at head shape from directly above. We will ask about the birth, about whether your baby was breech or in a tight position near the end of pregnancy, and about how much of the day she spends in a car seat or swing. Where we find restriction, we address it that visit with sustained light fingertip pressure. Then we spend real time teaching you the home positioning work, because that is what moves the head shape. At the second visit we review the scan and set a plan with a checkpoint. If we think you need a pediatric physical therapist or a cranial specialist as well, we will say so directly. The initial visit is $200.
Book a first visitTilt, Turn, and Flat Spot Are Three Different Things
Parents often use one word for all three, and the distinction changes what we look at.
- Tilt — the ear moves toward one shoulder. The head is side-bent.
- Turn preference — the chin points consistently one way.
- Classic congenital muscular torticollis — usually both at once: head tilts toward the tight side, chin turns away from it, because the sternocleidomastoid running from behind the ear down to the collarbone is shortened on one side. Sometimes a small firm thickening is palpable in that muscle.
- Flat spot (positional plagiocephaly) — the consequence. Infant skull bones are soft, so a baby who always rests on the same part of her skull flattens that part.
- The parallelogram — when flattening sits at the back on one side, the ear and forehead on that side often shift forward, giving the head a subtle parallelogram shape from above.
- The sequence — tilt, then turn preference, then flat spot. The head shape is the symptom people see; the neck is the thing worth checking.
Why Timing Matters Here
Most of what we see with babies is not urgent. This is the exception, and we would rather be the ones who told you.
- Infant skulls are most malleable in the first months and gradually become less so
- The window in which positioning, therapy, and if needed a cranial helmet make the biggest difference is early — roughly the first half of the first year
- Helmet therapy is typically considered somewhere around four to six months, when it is recommended at all. That decision is your pediatrician’s and a cranial specialist’s, never ours
- Do not wait three months to see if it goes away. Get it looked at, and start the positioning work now
- Early attention usually means an easier, shorter road
What Else Needs Ruling Out
A tilt can occasionally come from something other than a tight muscle.
- Eye problems
- Hip dysplasia
- Reflux posturing
- In rare cases, a spinal issue
- A tilt that appeared suddenly in an older baby, or comes with vomiting, feeding trouble, or a baby who seems unwell, is a medical evaluation first and a chiropractic assessment second
What We Assess
We measure rather than eyeball, and we write it down so we can compare it in three weeks.
- Rotation to each side, side-bending to each side, and the difference between them
- The sternocleidomastoid on both sides for shortening, a firm band, or a nodule, plus the small deep muscles at the base of the skull
- Motion at the top two vertebrae, where a large share of head rotation happens
- Head shape mapped from above — ear position, forehead symmetry, and where the flattening sits
- Jaw and facial symmetry
- Ribcage, pelvis, and hips, because a baby curved through the whole body rarely has a neck-only problem
- An INSiGHT scan for a measurement of overall nervous-system tension
What Care Is Intended to Do
Where we find restriction, we gently address it.
- The intent is more symmetric, comfortable movement
- Parents commonly report their baby beginning to turn the other way and tolerate more varied positions
- We do not claim to treat, correct, or cure torticollis or plagiocephaly
- Head shape change is a positioning outcome that takes weeks of consistent daily work at home — not something that happens on a table
The Home Work
We send you home with a small number of specific things to do, and we show you each one on your baby rather than hand you a printout.
- Tummy time — built up in short, frequent sessions across the day, including on your chest and across your lap if the floor is a fight
- Side-switch everything — which end of the crib her head goes, which arm you carry her in, which side you offer first at feeds. Babies turn toward faces and light, so move yourself and move the crib
- Encourage the harder direction during play — gently, never forcing a stretch she is fighting
- Less container time — car seats, swings, and loungers all press on the same spot. The car seat is for the car
- Share the PT plan — if a physical therapist is already involved, we want their plan so ours does not contradict it
- Many babies with torticollis do well with pediatric PT, and we are glad to be one part of that rather than a replacement for it
See a medical provider right away if you notice
- A head tilt that comes with vomiting, restricted or refused feeding, or a baby who seems unwell — seek medical evaluation promptly
- A tilt that appears suddenly in an older baby who did not have one before — see your pediatrician right away
- Any fever of 100.4°F or higher in a baby under 3 months old — immediate medical care
- A neck that is painful to move, or a baby who cries sharply when the head is turned
- Ridging along a skull suture, a head shape that is worsening rather than plateauing, or an unusually small or bulging soft spot — this needs medical assessment to rule out craniosynostosis
- Uneven eye movement, a droopy eyelid, or a pupil difference alongside the tilt
- Loss of a skill your baby already had, poor head control well past the expected age, or one arm or leg used clearly less than the other
- Any asymmetry in hip creases or a clicking hip — ask your pediatrician to check for hip dysplasia, which travels with torticollis more often than people expect
Common questions
Will my baby need a helmet?
That is not our call and we will not speculate. Cranial helmet decisions are made by your pediatrician and a cranial specialist, based on measurements and your baby's age. What we can do is address neck mechanics and coach the positioning work, which is worth starting regardless of what is later decided about a helmet.
Is it safe to adjust a baby's neck?
The way we do it, yes. An infant adjustment is sustained light fingertip pressure, about the force you would use to test a ripe tomato. There is no twisting, no popping, and no quick thrust. We do not manipulate an infant neck the way an adult neck is adjusted, and we never stretch a baby into a position she is fighting.
Should I see a physical therapist instead?
Often you should see one as well. Pediatric PT for torticollis is well established, and many of our families do both. Bring us their plan and we will work with it rather than around it.
How long does this usually take?
It depends heavily on your baby's age and how long the preference has been in place, and honestly on how consistently the home positioning happens. Rotation often changes faster than head shape does. We set a checkpoint at the start so you are not left guessing whether it is working.
The flat spot is getting worse even though I am doing tummy time. What now?
Tell your pediatrician, and tell us. A head shape that is actively worsening rather than holding steady deserves a fresh look, including confirming that the sutures are normal. That is a medical evaluation, and we would rather push you toward it early.
This page is educational and is not medical advice, diagnosis, or treatment. Chiropractic care does not treat or cure disease; it supports the function of the nervous system and spine. Please speak with your pediatrician or a licensed clinician about your family's specific situation, and seek immediate care for any urgent symptom.