As babies learn to move their bodies and explore their surroundings, you may notice them doing things that are odd or at times even alarming. One of the things you might come to notice is your baby tilting their head to one side or towards their shoulder.
A baby tilting their head to one side could be their way of signaling discomfort or pain around their head and neck. This is more commonly due to minor issues such as teething pain, ear infections, or a strained or stiff muscle. Less commonly, it can be due to a vision, hearing, or muscle problem.
This article provides a list of possible reasons as to why your baby may be tilting their head to one side, as well as some guidance on what to do in case it happens.
Baby Tilting Head to One Side Teething & Other Reasons
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Teething
Babies often experience some level of discomfort while teething and tilting their head may be your baby’s attempt to relieve their discomfort. Gum soreness and pain is most common and most severe in the days before a tooth cuts through the gum surface.
Your baby tilting their head to one side may be a sign of teething if it is accompanied by other teething symptoms such as increased drooling, redness or swelling around the gums, frequent gnawing or chewing, pulling and rubbing their ear and/or cheek, and running a low-grade fever less than 38ºC.
Teething pain can be easily treated at home and does not usually require a doctor or dentist’s attention.
A cold (not frozen) teether can help relieve swelling and soothe your baby’s gum soreness. An over-the-counter pain reliever containing ibuprofen or acetaminophen can help keep them comfortable as well.
Babies 6 months and older can also be given chilled fruits and vegetables like whole apples, carrot and cucumber sticks, and celery stalks to gnaw on.
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Ear Infections
Outer and middle ear infections are fairly common in young children, and are thankfully, easily treatable.
Ear infections in babies are often caused by the same bacteria that cause upper respiratory tract infections. If your baby has recently had a cold or a sore throat, the bacteria can travel through the eustachian tube into the middle ear and cause fluid buildup behind the ear drum.
Frequent water exposure while swimming or bathing can trap water in the ear canal, creating a damp environment that bacteria and certain fungi such as yeast thrive in. Occasionally, allergic reactions to shampoos and soaps can also cause outer ear infections.
A baby with an ear infection may tilt their head towards the affected side in an attempt to reduce the discomfort caused by fluid buildup. They may also pull and tug at their ears or attempt to stick a finger into their ear canal.
Other symptoms that commonly accompany ear infections in babies are fluid drainage from the ear, crying and irritability, fever, and loss of balance. They may be unresponsive or have a delayed reaction to sounds that they normally respond to quickly.
Ear infections and suspected ear infections in babies need to be seen by a pediatrician. While not all ear infections will require antibiotic treatment, it is still best to have your baby seen by their healthcare provider especially if they are less than 6 months old, have a fever, or are in pain.
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Muscle Imbalance
Torticollis or wryneck is a muscle condition that causes the head to be twisted or tilted towards one side or held in an otherwise abnormal position. Babies tilting their head towards the shoulder is a classic presentation of torticollis.
Babies with torticollis may have difficulty turning their head, causing them to have to use extra effort to turn to look at you. You might notice uneven shoulder height and asymmetry in their face. They may also have difficulty breastfeeding on one side.
While it is not certain what causes torticollis, some doctors believe being in a cramped position in the womb during pregnancy or in the birth canal during delivery can cause the muscle to strain or twist.
Torticollis is easily treatable with muscle stretching and strengthening exercises that will create balance between the paired muscles on either side of the neck. In most cases, symptoms should improve within 6 months of starting treatment.
Your child’s healthcare provider may provide you with exercises to release the tight muscle. They may also refer you to a pediatric physical therapist for torticollis treatment.
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Eye or Vision Problems
If your baby is titling their head to one side while watching TV, playing, or reading a book with you, it may be a sign that there is a problem with their eyesight.
Changing their head position by tilting or turning their head to one side and lifting or lowering their chin may be an attempt to compensate for poor vision and improve their ability to see.
Strabismus or “crossed eyes” may result from weakness of the muscles controlling eye movement. Babies with strabismus may tilt their head to one side to reduce eye strain and maintain the alignment of both eyes.
Farsightedness and nearsightedness may also cause head tilting as your child tries to visually focus things that are too close or too far for them to view comfortably.
Vision problems in young children are usually correctible using corrective eyeglasses, eye patch therapy, or eyedrops. In cases where glasses, eye patches, and eye drops do not work, eye surgery may be needed to loosen or tighten muscles causing the eyes to cross.
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Hearing Difficulties
A baby with hearing loss in one ear may tilt their head toward one side to make up for their difficulty hearing certain sounds.
Hearing loss and hearing difficulties in babies can be caused by genetic factors, infections or illness acquired before, during, and after birth, repeat exposure to loud noise, or blockage in the ear canal due to earwax or a foreign object.
Babies with hearing difficulties may have a delayed or abnormal reaction to sounds. They might not react and turn to look when spoken to. They may also have difficulty locating voices or sounds coming from sources not directly in front of them.
Having unaddressed hearing difficulties makes it difficult for babies to develop speech and language skills. Milestones such as babbling, recognizing names for familiar people and objects, and first spoken words may be delayed.
Interventions for hearing difficulties depend on the cause, type, and severity of the problem. Your healthcare provider may provide a referral to an audiologist or hearing specialist to assess your baby’s hearing skills.
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Balance Disorders
A baby with a balance disorder may keep their head tilted to one side to keep from feeling dizzy or off balance. A form of balance disorder known as benign paroxysmal torticollis of infancy (BPT) is often characterized by head tilting.
In babies, balance disorders can appear as clumsiness, frequent falls or spills, crooked crawling, and staggering while cruising and walking.
Other symptoms of balance disorders in babies and young children include irritability, an upward or “distracted” gaze, and complaints of fullness or ringing in the ears.
Many types of balance disorders in children are self-limiting, meaning that they get better on their own and do not require treatment. Some types may require treatment in the form of medication, physical therapy, or surgery.
Your child’s pediatrician or healthcare provider may examine your baby’s eyes and ears, conduct hearing and balance tests, or order imaging such as a CT scan or MRI to rule out or confirm a balance disorder.
Bottom Line
When a baby’s head tilting to one side is caused by an underlying issue, it will usually be accompanied by other symptoms that are more specific, and will help you better determine the cause of your baby’s head tilt.
Talk to your healthcare provider if your baby’s head tilt to one side occurs repeatedly and/or for prolonged periods, is limiting your baby’s mobility, or is causing them pain or discomfort.
You may be asked questions regarding your baby’s symptoms, such as when your started noticing them, their frequency and duration, as well as what causes the symptoms to improve or worsen.
