“You have to be careful at his age – because the younger a child is, the less able that you’re able to ascertain just how ill they are, just from looking at them.
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– Dr. Mike Ziegler, Children’s Healthcare of Atlanta

A new child is a time for celebration. But the weeks after a birth are also a time of learning for new parents – especially when their infant appears to be sick.

That was the case with 10-week-old Mario. He was brought to the ER after his mom noticed his head was twisted to one side.

Given Mario’s age, the doctor is being very cautious.

“Most of the time this turns out to be something that is not dangerous,” says Dr. Mike Ziegler of Children’s Healthcare of Atlanta, “and will usually resolve with time – and [with] a few, just supportive factors that the parents can provide. But there are a small group of those children who have a very serious problem going on, that can even be life-threatening.”

In very young children, a twisted neck could be due to a virus or a skeletal problem.

An examination shows that Mario isn’t physically injured; he can turn his head if he wants to.

“You have to be careful at his age,” says Dr. Ziegler, “because the younger a child is, the less able that you’re able to ascertain just how ill they are, just from looking at them. “

Mario is taken for some x-rays, to see if the bones in his neck are properly aligned. The doctor also uses the x-rays to check for something else – a painful leak of air into the baby’s chest cavity, which could also cause Mario’s stiffness.

“This x-ray doesn’t suggest that there’s any air in the air spaces of the lung, except where it should be,” he says.” And so we can kind of take that possibility out of the picture.”

Mario appears to have an ailment common to much older people, a simple “crick in the neck.”

But since infants can’t tell you their symptoms, Dr. Ziegler says Mario’s mother did the right thing.

“Anybody who has a child that develops pain or stiffness in the neck, that child needs to be evaluated,” he says. “And the obvious reason is because of the potential for serious disease that can cause that. [The] majority of these children are going to have something that is not dangerous, but it’s the few that you don’t want to miss that require the evaluation. And most people are not going to know which those are, without somebody looking at them pretty closely.”

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• How a sick infant acts may mean as much, or even more, than if they have a fever. If your child has any of the following symptoms, seek medical help immediately: the child barely responds to you; the child cannot be made to smile; the child can’t be fully awakened; the child cries constantly for more than two hours or cries when you move or touch her; the child’s cry becomes high-pitched, or weak, or just a moan; the child doesn’t sleep for more than 30 minutes at a time, or cannot be comforted for more than 30 minutes at a time. (Children’s Memorial Hospital, Chicago)




• While infants can’t directly communicate with us, they do give behavioral signs when they are in pain. Along with crying, your baby may ‘make faces’ – squeeze their eyes shut, grimace, wrinkle their brows, etc. They may also be irritable and fussy, or express pain by their posture and movement. A stiff or tense body, or squirminess – with arms and legs moving in and out – may also be signs of pain in a baby. (University of Michigan Health System)




• Most babies get the common cold six times or more before their first birthday. If your child has a cold and is three months or younger, you should call your doctor. For older children, contact a doctor if the child has had a temperature of 100 degrees Fahrenheit or more for over three days, has a cough that lasts over a week or a green, thick nasal discharge for more than two weeks. Also seek medical advice if your child isn’t wetting as many diapers as usual, has a yellow discharge from their eyes, or seems to have ear or sinus pain. Get medical help immediately if your child has difficulty breathing, is bluish around the lips and mouth, coughs up sputum with traces of blood, refuses to take in fluids or coughs hard enough to cause vomiting or a change in skin color. (Mayo Clinic)

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• American Academy of Pediatrics
• New York State Department of Health

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