Hypotonia in a child: causes, symptoms, treatment

Features of muscle function in a newborn

While in the mother's womb, the child needs to feel his position, and the baby receives all these sensations thanks to muscle contraction. When a child is born, muscle tone helps his mental and physical development: due to it, the baby learns to hold his head, tries to grab a toy, rolls onto his tummy and side, and later learns to sit, crawl and walk. In order for all these skills to be carried out one by one and on time, physiological muscle tone is necessary - slight tension in the skeletal muscles even in a state of complete relaxation.

At different ages, muscle tone in a newborn manifests itself differently, and it is especially pronounced in the first months of life. This happens because for 9 whole months the child developed and lived in a cramped space - the womb, where he did not have the opportunity to be highly active. Therefore, by the time of birth, all the baby’s muscles are extremely tense - they are in hypertonicity. Hypertonicity is distributed unevenly across muscle groups - this explains the typical position of the baby: the head is thrown back, and the arms and legs are pressed to the body. The muscles of the thighs have especially high tone in a baby: if you try to spread his legs, you will feel resistance. This muscle hypertonicity in an infant will last for about 4 months, gradually decreasing by two years: at this age, the muscle tone of a child and an adult is approximately the same.

Massage for a child with hypotension

When a newborn baby is born, he does not behave as fully as an adult. This happens because a change in environment for a newborn baby is a huge stress for his entire body; the child develops physiological reflexes, an adaptive reaction that manifests itself in the first months of life. Typically, a newborn baby has muscle hypertonicity, which is due to the fact that the baby was in a constrained state for all 9 months in the womb. But it also happens that parents notice such symptoms in their baby as a decrease in muscle tone, which is expressed in the fact that the child is lethargic, eats poorly, sleeps more often, he begins to hold his head up later than his peers, hold a toy in his hands, sit down, etc. .d. This condition of the baby should not leave parents without attention and requires immediate help from a pediatrician.

Treatment of hypotension is aimed at developing the muscles of the whole body, such as massage and therapeutic exercises. It is better to entrust massage for hypotension in a child to a specially trained massage therapist, strictly following the instructions of a pediatrician or neurologist. Depending on the severity of this pathology, taking into account the age of the child and his characteristics, the massage therapist selects certain exercises and the number of massage sessions specifically for your baby. Massage for hypotonic muscles in a child is aimed at activating the baby’s skeletal muscle system and providing a general strengthening effect. This is done thanks to special exercises that look like light stroking of the limbs, back, tummy, rubbing and pinching, warming up for the upper and lower limbs in the form of effleurage, spreading the arms and legs apart. When performing such exercises, one should take into account the characteristics of the newborn’s body; massage for a child with weak muscles should be performed with light, gentle, but at the same time rhythmic and fairly active movements.

When a massage is performed for hypotonicity in a child, you should periodically change the position of the baby’s body, turning it onto its back, tummy, left and right side. During the massage, the child needs to be in a good mood and it is not allowed to massage a crying child who is in a restless state. If this causes discomfort in the child, then in this case you should refuse massage sessions and repeat them after a certain period of time, because the child grows up and changes his feelings towards the world around him.

Massage for a child with weak muscles is more intense, impulsive; massage movements should be deep and aimed at increasing muscle tone. The massage is performed in such a way that the massage therapist applies weak pressure shocks to both individual muscle groups and active points, which allows the muscles to be excited and the tone in them to be stimulated. The massage therapist performs such movements separately with the phalanges of the fingers, sometimes with the entire palm, taking into account the delicate and miniature features of the structure of the newborn baby.

In order for the treatment of hypotonicity in children to be effective, massage for hypotonic muscles in a child should be combined with special gymnastics, which is a set of exercises that strengthen the weakened muscles of your baby.

This gymnastics can be performed by both a massage therapist and mother after special training, and the following exercises are most often used:

• crosswise - the baby’s arms are moved to the side and brought together so that the left arm goes to the right, and the right one to the left;
• boxing exercise - an adult grabs the child’s arms and performs movements that resemble boxing a punching bag;
• pulling up - the baby is pulled up by the arms, slightly lifting the legs off the table and lowered down;
• stompers - lying on the back, you need to take the baby’s leg and with little effort try to straighten the leg, pulling it towards the gluteal muscles, then the same is done with the second leg.

Caring parents should take care of the health of their baby and approach this with special care and attention. Timely seeking help from a specialist and massage for hypotonicity in a child can help get rid of such unpleasant symptoms for life. Otherwise, the consequences of hypotonicity in a newborn may be reflected at an older age and the child may face problems such as curvature of posture and delayed physical development. Take care of your baby's future health by providing him with proper care and attention!

How to evaluate tone features

Typically, a newborn's muscle tone is assessed by looking at the baby's sleeping position and when he or she moves. Only a neurologist can assess the more subtle features of the condition of your child’s muscles, who will first ask the mother certain questions: about how the baby was born (as a result of physiological labor or cesarean section) and what his presentation was (facial, breech, etc. .). The reason for the increased tone of the neck muscles in a baby, due to which the baby's head is thrown back too much, can be a facial presentation during labor, and increased tone of the legs (when the legs are straightened) often occurs with a breech presentation. But the “embryo” position that the child takes when sleeping is a sign of normal tone. In this case, the child’s arms are clenched into fists and bent at the chest, and the legs with hips apart are bent towards the tummy.

Physiological hypertonicity in the first months after birth does not allow the baby to perform normal human movements: he can quickly move his legs, cross them, push off, bend and straighten them. But the baby also does not yet know how to actively move his arms: he is only able to bend them at the elbows and sometimes unclench his fists. The baby's head is tilted back slightly due to hypertonicity of the neck muscles. A baby's muscle tone may increase sharply when he cries or is worried.

Diagnosis of hypotonicity

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A specialist can easily diagnose the presence of this syndrome in a child, as soon as he carries out some manipulations. The main task of medical action is to identify the presence of any abnormalities in the functioning of innate reflexes in a newborn:

1. Step reflex. The baby is raised above a hard surface so that his legs touch the table with his full foot. Feeling support, the child must show an innate reflex and take small steps. With hypotonia, the child will not be able to straighten his legs and will not be able to take steps or try to sit down. This innate reflex is characteristic of children up to 2 months of age; subsequently it fades away. To check the reflex, the examination must be carried out before the specified period.
2. Sitting down from a lying position. The little one lies on a hard, flat surface in a supine position. An adult takes both hands of the baby and lifts the child to a sitting position. The newborn helps himself with his hands, pulling himself up, straining his muscles. To an adult, on the contrary, it will seem that the child is pulling in the opposite direction. In case of weakened muscles, the child simply hangs on his arms, sticking his tummy forward. The neck muscles barely hold the head, and the back is noticeably rounded.

Self-diagnosis

Is it possible to draw conclusions on your own? Pediatrician Komarovsky believes that for this it is necessary to carefully monitor the baby during the day:

1. Muscle weakness is not the only, although indicative, sign of hypotension. The syndrome affects the general condition of the body. Children with this feature are calmer and have difficulty getting into a state of excitement. Lethargic and slow during periods of wakefulness, they sleep a lot.
2. The arms and legs are completely relaxed and straight during sleep. The characteristic clenching of the hands into a fist, characteristic of all newborns, is absent with this syndrome. The palms are fully open. An unusual and uncomfortable position for other children, with the legs spread to an angle of 180˚, will be absolutely comfortable for a baby with reduced tone. Babies with normal muscle activity keep their legs and arms slightly bent and their hands partially clasped during sleep.
3. Another sign of this syndrome in children is that babies do not eat well, which their mothers often complain about at doctor’s appointments. The toddler sucks the breast sluggishly and uninitiatively or completely refuses breastfeeding.
4. The lack of necessary muscle tone does not allow babies to hold their heads. This feature makes it difficult to learn to crawl, and also complicates other processes: picking up objects, rolling over, or sitting down to a sitting position (we recommend reading:).

If you notice some symptoms, you should not rush to draw conclusions and diagnose your child yourself. A pediatrician will help dispel doubts, and you should consult him. The sooner this issue is raised, the easier and faster the treatment will be or possible pathologies will be excluded.

Symptoms of hypertonicity and hypotonicity of muscles in infants

Increased muscle tone (hypertonicity) in infants can occur due to damage to the nervous system or brain due to:

• birth injuries;
• hemorrhages;
• hypoxia (lack of oxygen) during childbirth;
• meningitis;
• increased excitability in a child.

Symptoms of hypertension:

• great body tension, tightness;
• inability to relax during sleep (fists clenched, arms near the chest, legs near the stomach);
• holding the head immediately after birth due to hypertonicity of the neck muscles;
• restless sleep, colic;
• frequent tremor (shaking) of the chin;
• excessive regurgitation;
• when placing the baby on his feet, he tucks his fingers and tries to stand on his “tiptoes”;
• if you pull a child by the arms, he does not straighten them, but tries to rise with his whole body;
• possible curvature of the neck (if a cervical injury occurred during childbirth);
• the child later begins to crawl, sit and walk.

Hypotonia (decreased muscle tone) in a newborn most often occurs in premature babies and in children with brain problems, as well as with endocrine pathologies and infection:

• when infected in the womb;
• during birth trauma;
• due to intracranial hematoma.

Symptoms of hypotension:

• lethargic and constantly sleepy state of the baby;
• low mobility, poor appetite and slow weight gain;
• the baby does not hold his head up for a long time, his arms and legs are extended along the body;
• the tummy has a flattened shape;
• when spreading the hips, no muscle resistance is felt;
• if you lay the baby on his tummy, he does not try to bend his arms and raise his head, but lowers his face to the surface;
• in severe forms: impaired sucking, swallowing, breathing.

Dystonia (asymmetric tone) of muscles in an infant occurs if the muscles experience uneven tone: some of them are in decreased tone, others are in increased tone.

Symptoms of dystonia:

• the baby takes unnatural positions;
• the child falls on his side, and his body arches;
• skin folds are unevenly located;
• the child’s posture develops with complications: scoliosis, clubfoot, and curvature of the neck may occur;
• psychomotor development is impaired;
• in severe forms - cerebral palsy (cerebral palsy).

Hypotension in children

There are non-drug and drug methods for treating hypotension in a child. For labile arterial hypotension, it is better to carry out therapy without the use of medications. If hypotension is persistent and prolonged, a combination of non-drug therapy and medications is used.

Non-drug treatment consists of:

• normalization of the child's regime
• good sleep at night
• spending about 2 hours outdoors every day
• exercise in the morning
• water procedures after exercise for vascular tone
• eating 4-6 times a day without limiting salt on an optimal water regime

Treatment without medications also includes massage:

- cervical-collar area

- general

- calf muscles

- hands

For hypotension, physiotherapeutic methods of treatment are used - Vermeule electrophoresis on the collar area with solutions of caffeine, magnesium sulfate, bromocaffeine, mesatone. For children and adolescents, water procedures are also relevant as treatment - fan and circular showers, underwater shower-massage. Doctors can recommend medicinal baths, psychotherapy, etc.

If non-drug therapy does not produce an effect, the following drugs are used:

• anticholinergic
• adaptogens
• cerebroprotectors
• nootropics
• antioxidants
• antidepressants
• tranquilizers

In most cases, treatment of hypotension in children with medications begins with adaptogens, most often herbal. These drugs are given to the child once every 24 hours in the morning. Course – up to 3 weeks. The use of nootropic drugs is necessary for children with arterial hypotension, since they often have cerebral insufficiency and immaturity of cortical-subcortical relationships. The following drugs are effective:

• piracetam
• glycine
• cortexin
• phenibut, etc.

If there is a need to improve cerebral hemodynamics and microcirculation, the child is given courses of cinnarizine and vinpocetine. Actovegin and Oxibral have an optimizing metabolic effect. Doctors can prescribe antioxidant therapy and correction of energy-deficiency diathesis for the child. Tranquilizers are prescribed to children with emotional stress, neurotic manifestations, hidden anxiety and phobias. Mainly used are activating tranquilizers, daytime anxiolytics (Grandaxin, trioxazine, etc.)

In any case, treatment requires an integrated approach. Therefore, independent choice of drugs and other methods may not have the desired effect. Be sure to consult an experienced doctor.

Treatment of hypertonicity and hypotonicity of muscles in infants

To prescribe adequate treatment for hyper- or hypotonicity in a baby, you need to contact a neurologist who will conduct a detailed study and prescribe a set of procedures, which include:

• massage;
• osteopathic treatment;
• gymnastics;
• swimming;
• physiotherapeutic procedures, water and mud therapy, magnetotherapy, electrophoresis, ultrasound, heat therapy;
• medications to relieve muscle spasms, vitamins, herbal remedies, homeopathic remedies.

To treat hypertension, it is necessary to relieve excess muscle tension. For simple forms of hypertension, it is recommended to alternate baths with relaxing herbal infusions and massage. If parents have mastered the basic techniques of massage, they can perform it at home on their own: massage movements include stroking (using palms and grasping), light rubbing, rocking on a fitball. Under no circumstances should you use sharp (slamming, chopping) movements, or prevent your baby from using jumpers and walkers ahead of time - all this will only increase muscle tension and the load on the spine.

With hypotension, on the contrary, all the above-mentioned “prohibitions” are permitted, because the main goal of massage is to stimulate muscle function. In addition to a tonic massage, the doctor may recommend swimming classes and special exercises on a fitball to tone the muscles.

As a rule, massage and exercises are enough to correct muscle tone disorders in a newborn. However, if the disorders cannot be corrected and over time you begin to notice strange tensions in some muscles in your baby, as well as a delay in mental development, immediately make an appointment with a neurologist.

Hypotonia in infants: treatment

When a diagnosis of hypotension is made in an infant, there is no need to despair.
Especially if it did not appear against the background of serious illnesses. A competent doctor, active gymnastics and massage, and most importantly timely detection of the disease, help very quickly. It is important to find a competent neurologist who can adequately assess the baby’s condition, take into account his physiological characteristics and confirm the diagnosis. Only taking into account the data obtained can a course of treatment be developed

The course is individual for each young patient. Treatment for hypotonia in infants is effective only when parents follow all doctor’s recommendations. General prescriptions for neurologists include massage and exercise.

In some cases it is prescribed:

• phytotherapy;
• acupuncture;
• physiotherapy;
• physiotherapeutic procedures.

The number of procedures is selected individually. It is necessary to monitor after which treatment methods the baby shows greater progress, and which practically do not produce results. The later the diagnosis is made, the more procedures will be required.

Baby massage for hypotension

It must be remembered that massage for infants with hypotension is mandatory. It should only be performed by a professional as prescribed by a doctor. You need to be prepared for the fact that various manipulations can cause irritation in the child. Forcibly performing sessions is not recommended, as the condition can only worsen. If the child does not like the massage, then its sessions are postponed to a later time. Sometimes you have to delay treatment for more than a couple of months.

Proper massage is not aimed at stimulating muscles and normalizing trophism. The baby should feel that he has muscles and that he can control them. Based on the individual condition of the child, 10-20 massage procedures are prescribed. In some cases, with early diagnosis of the condition, 8 visits are sufficient. If hypotension is detected in an infant closer to one year, then the number of massage sessions can increase to 30. In any case, the neurologist carefully monitors what results the treatment gives.

A child is massaged using stroking, rubbing, sharp pinching, and tapping. The massage therapist performs movements throughout the body: starting from the fingertips on the arms, ending with active rubbing of the back. To increase the effectiveness of the massage, the specialist acupressures each muscle. Do not worry if the procedure is carried out very impulsively. The main thing is that the child’s muscle function is fully restored. And taking into account the fact that some kids are truly delighted with the procedures performed, there is no need to worry. Thanks to a good massage, the baby's hypotonia will go away faster and he will feel all the joy from active movements.

Infant gymnastics for hypotension

Gymnastics is recommended for all newborns and caring parents do it every day, watching the success of their child. When a baby is hypotonic, gymnastic exercises are almost paramount. They become an integral part of the baby's life. By performing fairly simple exercises correctly, you can quickly achieve excellent results.

Gymnastics for infants with hypotonia involves the following exercises:

• Boxing - taking the baby's hands in her fingers, the mother alternately straightens and bends the child's arms in front of her. When the muscles become stronger, the baby will clench his fists and independently take his mother’s fingers. His movements will become sharper and more independent.
• Cross arm swing - taking the child by the arms, actively crossing them, bringing them together and spreading them apart.
• Pull-up - from a lying position, the baby is carefully lifted by the arms. Stronger muscles allow you to lift a baby who has picked himself up independently into a sitting position.
• Bicycle – alternately bending and straightening the baby’s legs.
• Spreading the legs to the sides - the mother alternately crosses the baby's legs and spreads them wide to the sides.

There are many more exercises that allow mothers to speed up the process of restoring the baby’s development.

You should also not ignore massaging your palms, fingers and feet. This procedure stimulates the nerve endings

Hypotonicity in a baby will quickly go away under the strict guidance of a caring mother.