Physical Therapy Management ofCongenital Muscular Torticollis

Physicians, nurse midwives, prenatal educators, obstetrical nurses, lactation specialists, nurse practitioners or physical therapists should educate and document instruction to all expectant parents and parents of newborns, within the first 2 days of birth, on the importance supervised prone/tummy play when awake 3 or more times daily, full active movement throughout the body, prevention of postural preferences, and the role of pediatric physical therapists in the comprehensive management of postural preference and optimizing motor development. (V, P)

Physicians, nurse midwives, obstetrical nurses, nurse practitioners, lactation specialists, physical therapists or any clinician or family member must assess and document the presence of neck and/or facial or cranial asymmetry within the first 2 days of birth, using passive cervical rotation and/or visual observation as their respective training supports, when in the newborn nursery or at site of delivery. (I, A)

Physicians, nurse midwives, obstetrical nurses, nurse practitioners, lactation specialists, physical therapists or any clinician or family member should refer infants identified as having postural preference, reduced cervical range of motion, sternocleidomastoid masses, and/or craniofacial asymmetry to their primary physician and a physical therapist with expertise in infants as soon as the asymmetry is noted. (II, B)