Treatment for Low Muscle Tone in Infants
Not sure if your child has low muscle tone, also called hypotonia; check out this post:
I always consider getting the biggest bang for my buck. When children come to see me they don’t have time to do every possible exercise that I may come up with to address a number of different areas. So I look to do activities that are going to address many areas at once, always thinking how it will stimulate the brain to grow and develop.
Positions that are important for your child to conquer:
Tummy time. Using a ball is more fun, and serves the purpose of stimulating their inner ear (vestibular system) and vision. Gently rock your baby back and forth and side to side, try a circular pattern, vary the speed but make sure you are holding them safely on the ball, and you have a good grip on the ball yourself.
The photo below shows a child lifting their head and arms up nicely. This is fine if done some of the time. It is not fine if this is all your child does, because it does not work their tummy muscles. While this child does not look like they have low muscle tone, in babies with low muscle tone we want to see them pushing up with their hands.
The child pictured below can now play because he can lean one hand on the supporting surface and reach with the other. Once they can do this they will spend more time on their tummy and you won’t have to work so hard.
Check out these two posts: tummy time and five essential tummy time moves for some additional tummy time ideas.
This position is great for your 6-10 month old, it prepares them for crawling.
Check out other ideas for teaching your child to crawl with my three part series on crawling. Don’t let your child with low tone avoid crawling, it is one of the best skills they can learn and will develop their brain and body musculature in many ways.
Equipment that might be needed:
Hip Helpers: Are useful for the child with low muscle tone who has excessive hip mobility. If your child’s hips are floppy and they can do a split or straddle, then these shorts are needed to tighten up their muscles and joints. The shorts will help them strengthen their body and trunk muscles, because their base of support will be smaller as they will have to long sit, or side sit. They will not be able to frog sit or W sit. I don’t recommend wearing them all day, 2-3 hours in the morning and 1-2 in the afternoon. Wearing them for half of their standing time for 4-6 weeks. Once they start to walk fairly well, they should not wear them. These are inexpensive and easy to order.
Classic TLSO (thoracic lumbosacral orthosis) by SPIO : See below. This is a type of compression garment that will give your toddler sensory input, while also giving them some support. The sensory (pressure) input helps give them a sense of where they are in space so they feel more confident moving, and are less clumsy. The support gives them more endurance to stick with a task, or play activity. While the SPIO can be measured and ordered by you, if you go to an orthotist who works with children, he or she will be able to bill your insurance company. The garment can be worn all day, but generally it is recommended to be worn for 2-4 hours once or twice a day. In this way your child will not accommodate to the feel and start to sink into the support, but will stay stimulated by it. Some children need more support than this garment will provide. Your child’s care givers- orthopedist, physiatrist, physical therapist, may recommend one of the following garments as seen on this site, instead: Complex Child
Sensory stimulation that is needed:
The following ideas are to help your relaxed happy baby who is totally content sitting and getting you to do all their work- to change- and become the exploring machine they need to be. These techniques tap into their brain, and important sensory systems ( vestibular and proprioceptive), and will actually improve your child’s muscle tone, and stimulate them to move.
Swing, Rock and Roll
Karen Pryor DPT taught this technique at a course I attended recently. I suggest to parents to do this a few times a week. I am pleased with the changes I see in my patients who’s parents are doing this.
I would not do this technique if I suspected my child had seizures, hydrocephalus, microcephaly, any cervical or cranial problem.
whole body massage. This was also taught by Karen Pryor. This is not a “gentle put you to sleep massage”. This is one to increase alertness, attention, engagement, and body awareness. Gently but firmly with brisk strokes in a downward motion go over your child’s arms, legs, and the front and back of their body. An image I like to use: “After a day at the beach I need to brush the sand off my babies skin.” You can do this daily.
massage vibrator: For infants over 6 months. This will stimulate their muscles and help with body awareness. Generally children with low muscle tone enjoy having a vibrator run up and down their back, arms and legs. Avoid their bellies and heads. This is a fun toy, your baby can grasp it; and feel the vibration up to their shoulders. As toddlers they can learn to turn it on themselves and give you a massage! Here is an image of one that is inexpensive and easy to find at a drug store. I like this general shape because it is easy for young children to hold.
Music: Did you know that music stimulates all parts of our brain? So enjoy singing, to your baby and child. Hold your baby and dance with him as you sing. Or make up arm movements and gently move their arms as you sing “Itsy bitsy spider”, or ” The wheels on the bus”. Nursery rhythms are helpful for language development. Playing music in the car and in your home, is a great way to pass the time, and develop a family culture. Classical music is said to develop our brains in many ways. So mix it up and enjoy yourself.
Bounce your baby on your lap and sing “3 little Monkeys…,” or “Wheels on the bus.”
Pediatric Physical Therapy 