Low muscle tone
The official name for low muscle tone is hypotonia, and it can exist by itself (benign congenital hypotonia) or signal a medical condition characterized by loss of muscle tone, such as muscular dystrophy or cerebral palsy.
What is low muscle tone?
It basically means his muscles are softer and weaker than they should be. When he is a baby he may have trouble breastfeeding, as this requires more effort than bottlefeeding – you may notice that he only nurses for a few minutes at a time before becoming exhausted and falling asleep. He’ll also seem floppy in comparison to other babies and his limbs may extend beyond their normal limits. Babies with normal muscle tone can be lifted by placing your hands under their arms, but if your baby has low muscle tone his arms will simply rise up, providing no resistance, and you may get the impression that he’s going to slip through your fingers and fall to the ground.
Although child development varies between individual children, they do tend to reach certain gross motor skills, which enable them to sit, balance and get mobile, milestones by certain ages. However, if your child has low muscle tone his muscles will be weak, meaning he may have developmental delays when it comes to
sitting up, standing and
walking. His
fine motor skills may also be limited, meaning he won’t be as manually dexterous as other children his age. Because low muscle tone can also affect the muscles of the mouth and tongue, his mouth may hang open and his speech also may be affected.
What causes it?
In benign congenital hypotonia, low muscle tone doesn’t have an obvious cause. In this case the effects usually aren’t so severe, although your child will likely acquire gross motor skills such as sitting, walking, running and jumping, later than other children his age. He also may be less likely to
crawl and more likely to scoot along on his bottom once he does get moving.
Low muscle tone can be related to underlying conditions involving the central nervous system, muscle disorders and genetic disorders. Some common causes can include
Down syndrome, muscular dystrophy and cerebral palsy.
How is it diagnosed?
Benign congenital hypotonia usually tends to come to light if a child is particularly floppy in infancy or doesn’t meet his developmental milestones when it comes to pulling up and walking. Your child will likely be referred to your state’s early intervention/early steps program for evaluation, which will include an assessment of his motor and sensory skills, balance and coordination, how he interacts with his environment, reflexes and nerve function.
If your doctor suspects an underlying medical cause for your child’s low muscle tone he may refer him for blood tests and diagnostic imaging with a CT scan, MRI and/or EEG depending on what is thought to be the possible cause.
How is it treated?
Specific treatment for hypotonia will be determined by your child's age, overall health and medical history, how severe the problem is and the underlying cause if there is one. Your child may be referred to a physical therapist for a program of exercise designed to build strength in his muscles and help him reach his physical milestones. If necessary, he may also see an occupational therapist for help with fine motor skills.
It’s vital for your child to be as active as possible if he has low muscle tone, so take him out walking, once he is able, and if he was a late walker get him climbing ladders and steps up to the slide even if he doesn’t seem to have the strength to do it. A simple step can also be a useful prop: get him to step up onto it and down the other side. Rowboat games, where you sit facing each other foot-to-foot, grip his hands and lean back and forwards, as if rowing a boat, is a good activity for strengthening his trunk muscles. The ‘wheelbarrow’ – where you hold up his legs and have him walk forwards on his hands is also good although you shouldn’t over do it and make sure that there is a padded surface or mat under him so he doesn’t hurt himself if his arms give out.
Children with benign congenital hypotonia may need treatment for common occurrences associated with hypotonia, such as recurrent joint dislocations but in general it improves over time although your child may never be quite as strong, agile and coordinated as his peers.
If your child’s low muscle tone is caused by an underlying medical condition his treatment will depending on the specific cause.
The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.
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Last Modified: 19/10/2008
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