Low Muscle Tone in Children

Healthy muscles always have some tension and stiffness, which can be seen and felt as muscle tone. Low muscle tone, also known as hypotonia, is different from muscle weakness, although it may also result in difficulty in using the muscle. Sometimes muscle weakness develops in association with hypotonia. Hypotonia is most commonly detected soon after birth or at a young age. It can also develop in later stages of life. 

What is Low Muscle Tone in Children?

It happens as children's muscles and bodies develop. The length of the resting muscle ends up being longer than normal, resulting in less overlap of muscle fibers and ultimately less connection between the fibers and the muscle. Therefore, the fibers aren't able to pull on the muscle as they typically can. Muscles have to increase their range of motion and use more energy to complete everyday movements.  Increases in energy expenditure lead to lower energy and endurance. Children with low muscle tone also experience slow response because the muscles tend to need more stimulation in order to activate. This can seriously inhibit a child's physical performance.

Signs of Hypotonia

If a child is born with hypotonia, or low muscle tone in children, it is usually noticeable by the time the child is six months old. Children with hypotonia are often described as being "floppy". The signs of hypotonia include:

  • Difficulty holding up their heads due to little control over neck muscles
  • Feeling limp when held, as if they are dead weight
  • Inability to hold weight on their legs or shoulders
  • Legs and arms hanging straight rather than bending at knees or elbows
  • Difficulty sucking or swallowing
  • Weak cry or quiet voice

Causes of Hypotonia

Hypotonia is actually a symptom in itself, as it can indicate numerous underlying health problems. Many causes of hypotonia are genetic. One example is cerebral palsy, which is a brain condition that affects coordination and movement. Cerebral palsy usually occurs after infections like meningitis. Hypotonia can also occur in babies born prematurely, as their muscle tone has not fully developed. In this case, muscle tone should improve as the child ages.

How to Improve Low Muscle Tone in Children

1. Massage

Massaging your child with edible oils, such as olive or coconut oil, can stimulate muscle growth. Also, happiness and bonding during massage can increase sensory awareness. Massage is something simple that can be done every day to improve the muscle tone.

2. Deep Pressure

Stimulating deep pressure points helps to normalize the sensory system. The pressure points are located next to bones and are responsible for pain, muscle tone and mobility. Start with fingers. Squeeze so that your child gives you a little response–you should not squeeze so hard that your child cries in pain, just enough to see an eye flitter. Continue with all the fingers on both hands and move to the wrist. Slowly make your way up the arm, and then the other. Repeat the same process with both feet and legs.

3. Skin Sensors

Feelings of touch, tickling and different textures are related to skin sensors. Just like in the deep pressure massage, work your way up and down limbs, alternating patting and tickling. Wear textured gloves, like bath or manicure gloves available at dollar stores to increase stimulation. Repeat this process, alternating with and without gloves, for three minutes.

4. Cold or Hot Sensors

Low muscle tone in children can also inhibit their ability to sense hot and cold temperatures. For cold therapy you can use a freezable container that is filled with water. For hot therapy you can use a microwavable stuffed animal or bean filled sac. Using a stuffed animal helps increase the pleasure of therapy for your child. Again, start at the fingers and hold the cold material long enough to change the skin temperature. Roll it around, back and forth slowly, until you reach the top of the arm. Repeat with the other arm and legs, trying not to exceed 2 minutes for each temperature.

5. Avoiding Stroller

Carrying your baby in a wrap, sling or carrier instead of a stroller can help increase spatial awareness and build your baby's core muscles. Your baby is forced to readjust and shift their muscles with every movement when they are wrapped up and carried.

6. Exercise Ball

When your child is old enough to sit up, bouncing them on an exercise ball is a good way to build core muscles and increase balance. If your baby isn't able to sit up, laying them on their bellies on the ball while playing with them can have the same effect. Watch the video below to learn how to strengthen your baby's muscle on an exercise ball.

7. Supplements

Supplements can be used to help increase muscle tone for children and increase energy. Some examples of supplements that can help increase muscle tone include:

Carnitine (L- or acetyl-L-carnitine): low muscle tone in children typically presents with low carnitine levels in their blood.

R-Alpha Lipoic: R-Alpha lipoic is an antioxidant that makes vitamins C and E last longer and therefore increases their benefits to your child.

Some examples of supplements that can help increase overall energy level include:

Co-Enzyme Q-10: This enzyme is used in the body cycle that produces ATP, or energy. Increased ATP can help increase your child's stamina.

Vitamin E: this vitamin helps detox your child's body from damage that occurs from inefficient energy production. You can squeeze the oil from the capsule and mix it with foods.

B Vitamins: B vitamins can help increase energy. Low muscle tone in children can be improved by doses of B vitamins that exceed the recommended values, but sometimes these doses can cause crankiness. In the case of crankiness, adjust the dose.

What Do Other Parents Say About Low Muscle Tone?

"My daughter is 18 months old and has low muscle tone in her trunk region. All of the usual developmental signs took her a little longer, holding her head up at 6 months, sitting at 10 months, crawling at 15 months. She recently started pulling herself up to stand using the furniture, but she has trouble letting go and just drops to the floor. She has a special walker from her physical therapist, but she can only use it for 5 minutes at a time before her legs give way. She is making progress and I'm really delighted. Swimming is a great activity that helps her a lot. We are taking a break due to winter weather and her being sick and not being able to go. Her physical therapist helps a lot, too. She showed us exercises that I can do with my daughter every day at home."

"My son has low muscle tone and he is 19 years old. He didn't start walking until he was 4 years old. He can run and walk now. When he was really young, we had a lot of testing done but everything came back normal. Therapy is the prescription most of the time. Low muscle tone causes sensory issues that can benefit from therapy as well. It works by stimulating the nervous system. The earlier you start the therapy, the more you will help your child's outcomes later in life. "

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