Congenital torticollis in an infant is MOST commonly associated with which birth factor?

• A. Premature birth
• B. Breech delivery
• C. Genetic predisposition
• D. Maternal birthing position

Answer: (B)

Congenital torticollis arises from injury and subsequent fibrosis of the sternocleidomastoid muscle on one side during birth, which shortens and pulls the head toward that side with rotation away. The birth factor most commonly linked is breech delivery. When the baby is delivered buttocks or feet first, there is increased traction and potential neck region compression as the head passes through, making SCM injury more likely. This explains the classic finding of the head tilted to the affected side and rotated away, often with a palpable tightness in that SCM. Other factors like prematurity, genetic predisposition, or maternal birthing position do not have as strong an association.