Orthopedic pillows and collars for torticollis in newborns

Causes of the disease

• Abnormal muscle development.
• Scars in the neck area.
• Pathological development of the vertebrae.
• Chronic and acute inflammation of muscle tissue.
• Long-term progression of diseases of the eyes, ears, salivary glands.
• Changes in bone tissue.

Depending on the causes of the disease, congenital and acquired forms are distinguished. A child may be born with a pathology if the mother had severe toxicosis, oligohydramnios, or the threat of spontaneous abortion. Common causes include multiple births, abnormal position and fetal trauma. They can be born with a congenital tilt of the head if there was an entanglement of the umbilical cord, pelvic or transverse presentation, or birth trauma. Source: https://www.ncbi.nlm.nih.gov/pubmed/25419317 Kessomtini W, Chebbi W Congenital muscular torticollis in children // Pan Afr Med J. 2014 Jul 4;18:190 Acquired pathology can manifest at any age . Causes include myositis and sarcoma. There are right-, left- and bilateral torticollis.

To understand how to correct torticollis in a child, you need to determine the mechanism that contributed to the development of the deformity. There are muscular, articular, bone, neurogenic, dermo-desmogenic and compensatory pathologies.

Indications for use

But sometimes the use of specially shaped pillows is considered a necessary and fully justified idea from a medical point of view. For example, you can take the treatment of a pathology such as torticollis. In this situation, the need to use this type of children's pillows depends on the degree of curvature and the general condition of the patient.

Remember! If your baby constantly spits up, he is not allowed to use cushions or other orthopedic products.

• Injuries received during childbirth. A physician may recommend the use of such products if the baby’s cervical vertebrae are damaged during childbirth.
• Problems related to muscle tone in the neck. Quite often, these products are used for increased or decreased muscle tone in the cervical region.
• Irregularities of the skull.

Types of pathology

• Muscular – disorders affected the sternocleidomastoid and trapezius muscles. The reasons may be: insufficient blood supply, tearing of fibers, underdevelopment. Often the defect is aggravated by birth trauma.
• Bone and articular deformation appears with fusion of the vertebrae, the presence of wedge-shaped and accessory vertebrae. The disease can develop with dislocation and subluxation of the median joint, vertebral fracture, as well as deformities caused by tuberculosis, tumor formation, and osteomyelitis.
• Neurogenic - provoked by intrauterine infection, hypoxia, muscle dystonia. The acquired disease develops in the presence of cerebral palsy, previous encephalitis, poliomyelitis, and tumor formations of the central nervous system.
• Dermo-desmogenic - observed with lateral folds on the neck. The disease can develop due to injuries, burns, inflammatory processes in the lymph nodes, and in the presence of scars that form a pathological slope.
• Compensatory – acquired pathology, usually caused by eye problems: astigmatism, strabismus. The cause may be hearing loss. In practically healthy children, torticollis occurs due to improper placement in a crib, being carried in the arms with one side facing oneself, or placing toys on one side.

Baby pillows: a medical view

Despite the huge number of declared advantages, the opinion of orthopedists largely diverges from the position of manufacturers of such products. The established features of human development speak in favor of doctors.

Thus, the formation of the cervical curvature of the child’s spine occurs at a time when the baby learns to independently hold his head in the position he needs. The thoracic curve, along with this, is formed when a person begins to sit down independently. The lumbar region, accordingly, develops during the period of learning to walk.

If you deliberately accelerate the described measures, for example, using the same orthopedic pillows, the consequences can be extremely unfavorable. It is known that in the old days, newborns were not given any pillows at all, and no problems with the cervical spine arose.

In accordance with the conclusions of doctors, it is still better to lay children today without any kind of pillows, because only under such conditions will the necessary processes of physiological changes in the shape of the skull and the formation of the spine be ensured.

Thus, qualified specialists in the vast majority of cases recommend refraining from using any kind of pillows, otherwise the newborn’s neck will be subjected to severe stress, which has a far from beneficial effect on the processes of its formation and development.

Symptoms: how to understand that a child has torticollis?

With bilateral pathology, the baby's head may be pressed to the chest or thrown back, while movements of the cervical spine are limited.

If a child has an osteogenic form , a bend in one direction and shortening are visually noticeable. The head is set low and its movements are limited.

In the case of neurogenic pathology, skeletal muscles have increased tone on one side and decreased tone on the other. On the side where the defect is, the leg is bent, the hand is clenched, while the head moves freely.

Development over time

In the early form, problems are noticeable in the first days, in the late form - in the second week from birth. The child holds his head to one side and a lump is felt to the touch. After 2-3 months, the defect manifests itself in incorrect position of the head, hypertonicity of the neck muscles and back. The legs have asymmetrical folds.

Already by 4-5 months, in the presence of torticollis, the child’s teeth grow more slowly and he reacts worse to sounds. By 7 months, strabismus becomes noticeable, and hypertonicity also appears in the lower part of the body.

By 12 months, a curvature of the spine is diagnosed, the baby lags behind in development, vision and hearing decrease. Facial features change - the eye and ear on the inclined side are located lower. Babies have poor balance, later they begin to sit and walk, and crawl asymmetrically.

By the age of 5-6 years, facial asymmetry is pronounced. On the side of the defect, the cheek is flatter, and disturbances in the development of the jaws are noticeable. In case of a congenital disease, concomitant hip dysplasia, cleft lip, malocclusion, and short frenulum are detected. Problems with the neck provoke hearing and vision impairment on one side, squint, and headaches.

How to choose a Shants splint for a newborn child?

Choose a collar according to size. The distance from the base of the head to the shoulder girdle matters. Only a precisely chosen size guarantees the correct operation of the collar. Otherwise, it will either fix the baby’s head too loosely or too tightly.

Buy products for babies only from professional establishments. “Medtechnika Orthosalon” is an orthopedic store with certified and high-quality Shants collars for children. You can try on the product in one of our many showrooms or make a safe purchase in the online store.

Diagnostic methods

During the examination, the specialist pays attention to the symptoms of torticollis in children: fixation of head tilt and rotation of the chin. If you try to turn your head, it hurts the child and he cries.

To determine the disease, they resort to various studies: x-rays, ultrasound, MRI, electromyography. A biochemical blood test is performed and sometimes referred to a neurologist for consultation. If symptoms of torticollis are detected in a child, it is necessary to consult with an orthopedist, neurologist, ophthalmologist, or otolaryngologist.

Diagnosis is carried out on the basis of anamnesis, examination and instrumental methods. Thanks to an integrated approach, osteoarticular defects are successfully identified: fusions, fractures, the presence of extra vertebrae. To confirm the neurogenic form of deformation, electromyography and electroneurography are performed. To diagnose myogenic torticollis, ultrasound of muscles is recommended, and for dermodesmogenic torticollis, ultrasound of soft tissues is recommended. To exclude concomitant diseases, the doctor may prescribe an ultrasound examination of the hip joints and neurosonography. Source: L.Yu. Khodzhaeva, S.B. Khodzhaeva Differential diagnosis of torticollis in children of the first year of life // Traumatology and Orthopedics of Russia, 2011, No. 3(61), p.68-72

Does a newborn need a pillow?

Of course, store shelves are full of these products, and their manufacturers promise the baby excellent sleep, the correct formation of the spine, the ideal shape of the skull bones and much more.

But let's not be naive. First of all, the production of children's goods is a multi-million dollar business. The manufacturer is interested in promising mountains of gold and selling you their product.

Therefore, we will not rely on the assurances of manufacturers and sellers of baby pillows, because these are interested parties, and we are talking, by the way, about the health of our beloved child!

Instead, we will study the opinions of pediatricians and use common sense and logic.

So, what do you personally use the pillow for? To make it comfortable to sleep on your side. Why is it uncomfortable for you to sleep on your side without a pillow? Because the distance from the ear to the shoulder is significant, and if you lie on your side without anything, the vertebrae become curved, which creates discomfort - you want to put at least your palm under your ear.

Now let's take a closer look at the newborn. What immediately catches your eye? And the fact that the proportions of the baby’s head and shoulders are completely different! Namely, the head is much larger and the shoulders are much smaller than those of mom and dad.

Therefore, it is more convenient for the baby to lie without anything, and he does not experience any discomfort. I'll say more. A pillow for a newborn can even be dangerous, which we will talk about later.

Thus, due to anatomical features, it is convenient for a newborn to sleep on a straight, flat surface. He does not need to put any devices under his head.

How is the treatment carried out?

The choice of method depends on the type of disease. To treat acquired torticollis, they resort to conservative methods: gymnastics, massage. In case of congenital pathology, surgery is recommended. It is advisable to consult a doctor as soon as possible, since conservative treatment of torticollis in children is effective up to a year. Surgery is performed on children aged 2-3 years. Source: A.V. Gubin Algorithm of the surgeon’s actions for acute torticollis in children // Traumatology and Orthopedics of Russia, 2009, No. 1(51), pp. 65-69

In some cases, it is impossible to completely get rid of the problem, then therapeutic measures are aimed at strengthening the neck muscles and preventing the development of deformity.

Treatment begins after diagnosis. The main thing is to give the correct position. To do this, they stimulate the head to turn in different directions, use special styling, and control the correct wearing on the hands.

Exercise therapy, massage and physiotherapy are recommended for muscular torticollis. Doctors prescribe electrophoresis, UHF, paraffin baths and swimming. In some cases, the wearing of a Shants collar and a cervical orthosis is prescribed. Clinics use the Gleason loop traction method. Source: R.S. Alimkhanova Early diagnosis and treatment of congenital torticollis in children // Medicine and ecology, 2008, No. 3, pp. 41-42

What to do when a child has torticollis and conservative treatment is ineffective? In such a situation, if indicated, surgical correction is performed by cutting and lengthening the muscle. Such procedures can be carried out from 1.5-2 years.

For congenital osteoarticular pathology, corrective immobilization is prescribed in several stages. To cure the disease, use a plaster cast, a plastic head holder, and a Shants collar. Devices are selected taking into account the severity of the defect and the age of the baby.

If the subluxation cannot be corrected, spinal fusion (an operation in which the vertebrae are immobilized by fusion) in the cervical region is recommended. When diagnosing neurogenic pathology, pharmacotherapy is prescribed to reduce increased muscle tone and relieve excitability of the nervous system. Massage helps a lot. Dermo-desmogenic torticollis is treated by excision of scars and skin grafting.

It is necessary to understand that the speed of treatment is affected by age - problems in a 2-month-old baby are solved faster than in an 8-month-old baby. The earlier treatment is started, the greater the likelihood of a quick and complete recovery.

Massage at home

It is recommended to perform massage three times a day for six minutes. Movements should be gentle. During the procedure, the legs, arms, chest, muscles on the side of the deformity and the healthy cheek are stroked.

Then they move on to massaging the side of the torso, abdomen, neck, and feet. The child is laid on his stomach and massaged along the back and neck. Turn from one side to the other and finish the procedure by kneading the feet.

Exercises for kids

• Place the child on his healthy side, with his head extending beyond the table. One parent holds the baby, the other holds the head, periodically weakening the support. The exercise should be performed 4-8 times.
• Place your baby on his back with his head off the table. Tilt your head to your shoulders in a ratio of 1:3 - once towards the sick person, three times towards the healthy one.
• Take the baby in your arms in an upright position, holding the head from the back. Gradually reduce support. Once your head reaches your chest, repeat the exercise.

Physical education in water

How to treat torticollis at home? Do simple exercises in the water. Fill the bath, use a special inflatable circle that you need to put on the baby’s head. The beneficial effects of warm water and support promote muscle relaxation.

Start doing gymnastics, it will help relax your body and remove pathology. The baby can be placed on his back, holding him with his hand. You need to move your head in one direction and the other. Turn over onto your stomach and lead along the water, holding your chin. In this case, the sore spot must be kept in water.

Correct body position

Pay close attention to how your child lies. Create conditions so that the baby turns his head in different directions while watching the toys. Before laying down, place the baby on the healthy side first. Place a lamp behind your back or hang a toy to arouse interest and provoke a head turn.

For a baby, it is better to buy a medium-hard mattress. An orthopedic pillow helps a lot. It can only be used with the permission of a doctor and after reaching 6 months. We suggest taking a regular diaper and folding it to use instead of a pillow.

When you carry your baby, hold him in an upright position and make sure his shoulders are level. Place your baby on his stomach more often to improve the condition of the neck muscles.

How to use and choose the right collar for a child?

Shants collars in children are used as prescribed by a doctor. The mode and timing of use of the bandage vary significantly for different pathologies. In addition, even for the same disease, different treatment protocols and, accordingly, different conditions for wearing a collar can be used.

Most often, pediatricians recommend wearing a collar while the baby is active. The duration of wearing the product during the day varies from 1 to 8 hours. At night and during daytime sleep, the collar is removed, since at this time it is better to use special pillows and styling.

Prevention of torticollis

It is impossible to prevent congenital pathology in children. To prevent the acquired form, it is necessary to avoid injury to the neck and undergo regular examination by a surgeon.

If you detect signs or suspect a pathology, do not resort to self-medication - visit an experienced SM-Clinic specialist. Our pediatric surgeon will examine the baby and, if necessary, select treatment.

Sources:

1. L.Yu. Khodzhaeva, S.B. Khodjaeva. Differential diagnosis of torticollis in children of the first year of life // Traumatology and Orthopedics of Russia, 2011, No. 3(61), pp. 68-72.
2. A.V. Gubin. Algorithm of the surgeon’s actions for acute torticollis in children // Traumatology and Orthopedics of Russia, 2009, No. 1(51), pp. 65-69.
3. R.S. Alimkhanov. Early diagnosis and treatment of congenital torticollis in children // Medicine and ecology, 2008, No. 3, pp. 41-42.
4. https://www.ncbi.nlm.nih.gov/pubmed/25419317 Kessomtini W, Chebbi W. Congenital muscular torticollis in children // Pan Afr Med J. 2014 Jul 4;18:190.

Pitsukha Svetlana Anatolyevna Clinic

Author of the article

Pitsukha Svetlana Anatolevna

Doctor of the highest qualification category

Specialty: neurologist

Experience: 24 years

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Basic information about children's orthopedic pillows

Manufacturers of children's products unanimously speak about the invaluable benefits of orthopedic products for newborns. But how true are such statements? Next, you are invited to understand this point.

In fact, the main task of such a pillow is to ensure the correct and uniform development of the cervical spine in a newborn. The product is made taking into account the most important features of children's physiology, helps maintain the user's head and neck in the desired position, due to which the level of stress on the neck is reduced, and blood circulation, as well as muscle tone, returns to normal.

In addition, according to manufacturers, infant orthopedic pillows have other advantages, including:

• the ability to ensure a normal level of heat exchange;
• hypoallergenic properties;
• ease of care;
• long service life without loss of original characteristics.

In theory, an orthopedic pillow for young children is a kind of “magic wand” that allows you to get rid of congenital torticollis and help prevent the occurrence of the acquired form of this disease. But what do doctors say about this?

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