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Low Muscle Tone in Babies - Causes, Symptoms, Exercises

Baby Health / Last Updated on Jun 21, 2023 / Vetted by Dr. Rukaiya Mithaiwala (PT)
Low Muscle Tone Baby Exercises, Causes, Symptoms

As a parent, it may be troubling to be told that your baby has low muscle tone, also called hypotonia. This may cause you to have several questions in your head as to what this would mean for your baby’s development and what you can do to help your baby. Having low muscle tone may make it slightly difficult for your baby to achieve certain developmental milestones such as crawling and sitting independently. However, with early diagnosis and therapy, your child can develop appropriate strength and coordination. Let us discuss in detail about low muscle tone.

What is Low Muscle Tone?

Muscle tone is the tension present in the muscle at rest. Typically, there is a small amount of contraction present in the muscles even when they are at rest. Functionally, it can be understood as the resistance by the muscle to movement. When we say that a child has hypotonia or low muscle tone, that tension is reduced and the resistance to movement is less. When touched, the muscles feel too relaxed and soft.

However, it is important to remember that muscle tone is a spectrum and each child is affected differently. For some children there is just a mild effect on their growth whereas for others it may hamper their daily lives.

Causes for Low Muscle Tone in Babies

Signals from the brain control the muscle tone. These signals tell the muscles to maintain or release the contraction. If this contact between the muscle and brain is interrupted, there may be changes in the muscle tone. This could occur due to damage to any part of the nervous system including the brain, spinal cord, nerves or even the muscle itself.

Hypotonia may be seen as a symptom of a genetic or neurological condition or may be a condition in itself with some children having idiopathic low muscle tone with no particular cause.

A physiotherapist or occupational therapist trained in pediatric rehabilitation will help to suggest strategies depending on your child's needs.

Low Muscle Tone baby Symptoms

The signs of low muscle tone vary according to the severity of the condition as well as the age of the child. For babies low muscle tone is commonly seen with difficulty in holding their head. Some children may also have limp limbs and difficulty in feeding.

Low muscle tone can manifest as delay in achieving motor milestones such as crawling, sitting, standing independently and walking as the child gets older. They may seem clumsy and have difficulty in keeping up with peers during physical play. Some general signs of low muscle tone are
  • Limbs feel limp when you lift them
  • Limbs extend beyond their limit due to increased flexibility in the joints
  • Greater probability for hip, jaw or neck dislocations
  • Delay in acquired developmental milestones (e.g sitting, standing, walking)
  • Delay with acquiring fine motor skills (e.g grabbing toys, moving toy in the hands)
  • Trouble feeding- the child may face difficulty in sucking, chewing or swallowing
  • The mouth may hang open with the tongue protruding
  • Breathing difficulties - shallow breathing, may get tired easily
  • Delayed speech
  • Poor posture- stooped posture with rounded shoulders
  • Difficulties with balance and coordination

Exercises To Help Your Baby with Low Muscle Tone

If you think that your child has low muscle, or you’re concerned about their physical development, it’s a good idea to see a pediatric physical or occupational therapist.

The treatment will depend on the cause and severity of hypotonia. Early intervention usually includes physical therapy, occupational therapy and speech therapy and is usually effective in minimising long term impairments of low tone and helps your child achieve maximal functional abilities.

Here are some exercises and activities that you can practice at home to help with low muscle tone.

Gross Motor Play Exercises & Activities

1. Deep Pressure and Joint Compression

Providing firm pressure with your hands over the baby's entire body helps in stimulation of the muscles.

To give joint compressions, one hand needs to be placed above the joint and one hand below and then gently push your hands towards each other as if you are trying to bring the joint closer together. Hold this position for ten seconds and release. This can be repeated ten times.

2. Floor Playtime

Encourage floor time play with your baby especially while lying on their tummy. Let them explore the environment and toys in this position.

3. Therapy Ball Play

Gentle bounce and rock your baby forwards and backwards and side to side while holding them firmly in a seated position on a gym ball. You can also make them reach out for toys in different directions while they maintain their balance on the ball.

4. Crawling

Crawling over various uneven surfaces such as couch cushions and soft toys provides the sensory stimulation of touch and also adds a dynamic challenge. The activity can be progressed to crawling up steps.
For older children, bear walking, bunny hops across obstacle courses are a fun and engaging activity.

5. Sit-to-stand Transition

This exercise can be practised by standing up from a parent's lap or a small stool to reach for a toy. Coming up to standing from kneeling through a half kneeling position is also very beneficial.

6. Squatting

Encourage your child to squat down to pick up toys and then come back up to the standing position.

7. High Kneeling

Tall kneeling position in front of a small bench or stool is beneficial to engage your child's core and back muscles. You can read them a book or solve a puzzle game in this position. This can be progressed by giving out toys slightly out of reach in this position and asking your child to come up from sitting to high kneeling to grab the toy.

8. Jumping

Activities like star jumps, jumping forward and backward or jumping on the trampoline are great warm up activities to encourage muscle tone. These activities are particularly helpful prior to performing sitting tasks such as writing and will help your child to maintain a good posture.
These activities can be made more fun by adding music or even using a skipping rope.

9. Ball Games

Playing catch and throw, bouncing a ball or aiming at targets are functional activities that your child will enjoy. To make it slightly more challenging use a heavier ball or even a pillow.

Fine Motor Play Exercises & Activities

1. Playdough

Making shapes with playdough, theraputty or even dough made of flour can be fun and engaging. You can also hide small toys or beads in the clay and ask your child to pick them out.

2. Water Play

You can give your child sponges to squeeze out water and paint. Spray bottles to water plants can also be given to strengthen the small muscles of the hands

3. Clothe spins and Tweezers

Use clothes line pins in different colours to match colour cards as a game. You can also ask your child to help you dry small clothes such as socks onto a clothesline. Make a fun sorting game by asking your child to pick out coloured beads with the help of a tweezer or tongs.

4. Little Handyman

Ask your child to help you with "repair work" around the house by giving him tasks to dig a pit in the garden or use a toy hammer to fix a broken game.
You can also ask them to help you carry, push and pull moderately heavy items around to help you such as carrying shopping bags or moving furniture.

5. Paper Balls

Ask your child to take colourful paper or newspaper and scrunch them up into balls by squeezing them in the palms and fingers. You can up the challenge by asking them to fill these paper balls in a bottle with a small neck so they have to use their fingers to push the balls into the bottle.

Every child is different and will require different techniques of rehabilitation. In collaboration with you, your therapist will set rehabilitation goals for that will meet your child's needs. They also will train you with activities to be practiced at home to achieve the best outcomes.

Frequently Asked Questions

1. Is Low Muscle Tone a disability?

Low muscle tone by itself is not a disability and improved through therapy techniques. However, it can be a symptom of an underlying disabling condition like Down Syndrome or muscle dystrophy.

2. Can a baby with low muscle tone crawl?

Babies with low muscle tone have difficulty in activating muscles and performing coordinated movements such as those required for crawling. Most babies with low muscle tone have a delay in developing motor milestones such as crawling and some may skip crawling altogether and transition from sitting directly to standing and walking.

3. When do low muscle tone babies walk?

There is no fixed timeline for when babies with low muscle tone begin walking. As the muscle strength and coordination is developed they are able to stand and walk independently.

4. Does crawling build muscle in babies?

The weight bearing position of crawling helps activate the large muscles of the hip and shoulder joints. It also helps develop the muscles around the tummy and back and teaches the baby to perform coordinated movements which will later on help in the development of walking.

5. Does low muscle tone cause speech delay in a toddler?

Children with low muscle tone may develop weakness, lack of coordination and reduced range of motion of the motor muscles of the mouth and tongue. Their mouth is often left open due to low muscle tone at the jaw. This may cause speech delay as well as difficulty in chewing and swallowing.

Dr. Rukaiya Mithaiwala (PT)

Education: BPT, MPT (Pediatrics), Yoga Alliance Certified Kids Yoga Teacher, Certification in Autism Intervention
Dr Rukaiya Mithaiwala (PT) is a physiotherapist specialising in the field of Pediatrics. Post her Masters degree, she has worked for over 5 years, with children with developmental concerns. Using her background in the field of healthcare, Dr Rukaiya aims to create evidence-based informative content around child health and early development. She aspires to equip parents and caregivers with the... more

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