Hypotonia - What is that?

You have a newborn. He's adorable and you are so glad he's here. But you notice that he's kind of rubbery and loosy-goosy. He has a hard time sucking to feed. You know newborns need support but in your gut you feel this baby is a really floppy. You may have heard the term hypotonia. Hypo - means low or less than. Tonia - refers to your muscle tone. Muscle tone is the resistance of our muscles to passive quick stretch. We test our muscle tone at rest (usually lying on our back). IF I try to quickly straighten your elbow most likely you will resist that motion a little so I don't jerk your elbow into a fully straight position. Someone who has no tone (or is flaccid) does not resist that quick passive stretch. EX: A patient who has had a stroke may be flaccid. The other end of the spectrum is hypertonia or muscle tone that is tighter than normal and resists passive quick stretch.

Tone is a spectrum and there is a range of normal. Everyone's tone is different but can still be in the normal range. I like to think back to the 3rd grade play ground. There was a child who could clasp there hands and rotate both arms from the front to the back (like a cirque d'soleil performer). There was also a kid who could not touch his toes. Both were on the normal spectrum.

So where does my baby cross the line into hypotonia? Kiddos with hypotonia may have difficulty with feeding. Remember the face is full of muscles and those little muscles can be low tone. You may notice your baby has floppy cheeks, may drool more because they may not have good lip closure. More globally you may notice your baby splays their arms and legs out when laying on his back. His hips may feel very loose.

Here's what hypotonia does NOT mean... It doesn't mean your baby is weak or lazy. I hear that all the time. My baby doesn't want to roll over because he's lazy. Hmmmm - NO, your baby wants to move, be able to hold his head up and look at you, eat and play. Babies are not lazy. If your baby is not trying to move there is a reason and you need to seek a PT evaluation. Babies with hypotonia expend extra energy trying to move and they fatigue quickly. This can lead to frustration and a tired baby. This means feeding can be tiring. Baby can become constipated and have difficulty eliminating stool. And so on. Your baby will also try to stabilize his joints by "fixing" or holding in static positions instead of learning to make transitional movements, weight shift and be mobile.

If your child has hypotonia it does NOT mean they will not meet gross motor milestones. It means you will benefit from a pediatric PT evaluation and treatment as soon as possible. Purposeful play and learning to facilitate the correct muscles to act will be important in helping your child be successful. Use of containers will not give your child the opportunity to work their muscles correctly or help them sit or walk. A pediatric PT will have lots of tricks and tips to help your child meet milestones and participate in their environment.