Does My Child Have Hypotonia?
As a parent hearing your child has low tone you might be wondering, “What does low tone even mean?” And then you might think, “What does that mean for my child?”
Children who have slouchy postures, who have sensory and motor problems, who have weakness or who fatigue easily are commonly given the label of low muscle tone (or “hypotonia”) by the medical community. It also may be called weak muscle tone, floppy baby syndrome or floppy infant syndrome.
What many pediatric providers don’t tell parents is tone is 100% neurologically-determined which is why we discuss tone in the context of the neuromotor system. Low tone (or high tone) isn’t necessarily the problem, it is simply a sign of a deeper root cause.
This article will give you a better understanding of:
What is tone and why is it important?
What are the common signs of low tone?
What causes low tone?
How we test for low tone
What you can do about low tone
WHAT IS TONE?
Tone is the steady state of muscle tension or contraction, even at rest. Muscle tone is an adaptive function that is required for postural control and movement. Simply put, tone is critical and fundamental to both static and dynamic movement– it keeps us upright, it maintains a state of preparedness for any movement and it allows our muscles to be able to safely perform tasks in a thermodynamically efficient manner.
Why is proper tone important?
Proper tone lays the foundation for even the most basic movements and functions. Basic functions like turning one’s head, sucking & swallowing and overall head and neck control is vital for a nursing infant. Proper regulation of muscular tone from the start of life can affect higher cognitive functions, including speech, emotional & social behavior. We focus on the beginning of life because the newborn’s brain builds the most neural connections or synapses by the age of 2 years old. This network is then “pruned”, a process where the developing nervous system keeps the most used synapses and eliminates the least used synapses. This is why the beginning of life and early childhood is such a critical window when it comes to restoring the health of the neuromotor system, and any other system. It is during this critical window that children have the ability to learn the most and seemingly small changes can make an enormous and lasting impact.
WHAT ARE THE COMMON SIGNS OF LOW TONE?
Because low tone can be detected during infancy, many parents and health professionals are able to spot the signs early. Here are common signs of low tone in an infant.
Signs of Low Tone In Infants
Lack of or difficulty with head control
Limp limbs or not be able to keep their elbows or knees flexed
Difficulty breastfeeding (poor/weak latch, falling asleep before finishing feeding; taking forever to feed or frequent “snacking feeds” (feeding all day)
Poor tummy time endurance
Open mouth breathing/snoring
Will they just grow out of it?
Unfortunately, the parents whose child is struggling are told “they will grow out of it” because there really isn’t anything the traditional health care model can do for tone. And it is true, babies and kids are extremely adaptable but only within the limitations of what they have to work with. But the simple answer is no, they will not just grow out of it. That’s because muscle tone doesn’t really change on its own. Seeing first steps, jumping, and running may seem to suggest that your child’s low tone has resolved itself but that’s not the case. Your child will reach milestones by working within the limitations hypotonia creates but that doesn’t mean the limitations are gone.
Having taken care of children of various ages struggling with tone we have seen a predictable pattern if low tone isn’t addressed. These are the common signs we see in toddlers and kids/teenagers with persistent low tone.
Signs of Low Tone In Toddlers
Developmental delays
Delayed gross motor skills development (crawling, jumping, etc.)
Delayed fine motor skills development (grabbing toys, moving objects between hands, etc.)
Speech delays
Feet rolling in/knocking knees
Potty training issues
Signs of Low Tone In Kids/Teenagers
Difficulties in school, e.g. attention and focus issues
Poor motivation
Walking with wide base
Extra flexible/hypermobile joints
Decreased activity tolerance (they tire very quickly when participating in physical activity)
Clumsiness
Leans on supports
Exhaustion or difficulties keeping up with peers
Because infants and children are the most neuroplastic, if low tone persists into a child’s teenage years, it is likely that child will have one or more of the following as an adult:
Signs of Low Tone In Adults
Incoordination
Trouble with balance
Clumsy
Chronic fatigue due to muscles over working
If we can address improper tone at the beginning of life, work to correct and restore normal tone, it can lessen physical and emotional challenges later in life.
WHAT CAUSES LOW TONE?
Muscle tone is determined by a complex neurological and physiological network of neural circuits and muscular structures that includes the brain, spinal cord and muscle spindles. We won’t get into the weeds of it too much but we do want to nerd out a little with you so you as parents have a better understanding.
As we mentioned, muscular tone is neurologically controlled by the neuromotor system. The neuromotor system is composed of multiple nervous system structures: the brain (the cortex and basal ganglia), the brainstem, spinal cord and nerves. All of these structures are constantly fine tuning your child’s muscular tone. The neuromotor system fine tunes tone by regulating its input and output signals to and from structures in muscles. This means constant communication between the muscle and the neuromotor system is required to maintain the perfect balance of more and less tone.
If there is any dysfunction in the neuromotor system, where there is a break in communication pathways, this will cause abnormal tone, such as increased or decreased tone. The level of dysfunction relates to where on the neuromotor tone spectrum your child falls.
In chiropractic we call breaks in the neuromotor communication pathway subluxations. A subluxation can occur anywhere along the neurospinal pathway, but babies and kids are especially susceptible to subluxations in the upper neck or upper cervical region because they have not developed stabilizing structures in that area yet. Incidentally, the upper neck region is exactly where the major regulatory components of the neuromotor system lie: the brain and brainstem. This means that a child’s neuromotor system is more vulnerable to subluxation and consequently, dysfunction, than an adult’s.
Any trauma or damage to the neuromotor system (brain, brainstem, spinal cord or nerves) can cause subluxation and will disrupt its ability to regulate and maintain proper, normal tone.
The following are some common causes of trauma or disruptions to the neuromotor system:
Intrauterine stress (e.g. breech presentations, extremely fast labors, extended/prolonged labors)
Birth trauma (e.g. cord wrap, forceps-assisted births, vacuum-assisted births, manually-assisted births, Cerebral palsy)
Genetic conditions (e.g. Down syndrome, Prader-Willi syndrome, Tay-Sachs disease)
HOW WE TEST FOR LOW TONE
As neurologically-focused pediatric chiropractors, we focus on the underlying root cause of what a child is experiencing. This is why we use a combination of physical exams, a thorough health history and special scanning technology called INSiGHT Scans. This allows us to test and measure exactly what’s going on.
Just like these scans of an 8 day old baby. This baby was in a side-facing position at the beginning of labor, underwent a manual-assisted birth via a Cesarean section after 40+ hours labor. The parents noted the doctor had to physically push baby back up from the birth canal in order for them to do the C-section. This required the doctor to use torsion and compressive forces. The neurological result of this is what we see on these above: the stress at the beginning of life to the upper neck area created neurological stress and tension to the exact areas where the neuromotor system lies. Along with our physical chiropractic exam, these scans and baby’s birth story demonstrated low tone and dysfunction to the neuromotor system.
You can read more about our 3-Step Clinical Process and the INSiGHT Scans.
WHAT YOU CAN DO ABOUT LOW TONE
Because low tone can be identified so early in a child’s life, care can be started early to restore healthy, normal tone. Getting your child checked and scanned as early as possible can make a huge difference in their health outcomes! Once we can test and measure what is going on, we can create a personalized care plan to meet them where they are at for their exact needs.
While the traditional health care model may try to address the signs of low tone, neurologically-focused pediatric chiropractors address the root cause: the neuromotor system. Our pediatric chiropractors do gentle and specific adjustments to the neurospinal system and each adjustment restores proper input to the neuromotor system. Improved function to the neuromotor pathway = proper regulation and maintenance of tone = better health!
Schedule an appointment with one of our doctors to see how we can help your child today.
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