FLOPPY MUSCLES:

Hypotonicity means loose or floppy muscles. Signs of floppy muscles can include but are not limited to; difficulty coordinating arms and leg movements and/or difficulty lifting their head. Some babies have tight muscles and others can have floppy tone. Many babies (especially those who were exposed to more than one substance) may have what is called ‘variable’ tone which means different parts of the body can be tight and other more floppy (e.g. tight arms and legs and floppy truncal (core) tone). Most strategies are useful for both tight and floppy muscles as they tend to ‘modulate’ or coordinate the baby’s muscle tone.

STRATEGIES BY DISCIPLINE

NEURODEVELOPMENT

  • A baby should have muscles that provide just a little resistance but do not feel floppy or loose. This can cause the baby to fall behind in some developmental experiences and it may take long for your baby to build their motor skills (reaching for objects, grasping objects, crawling etc.). For example, if they have floppy arms that stay to the sides, and they don’t engage in bringing their hands to their mouths or in the middle of their body then then begin to miss out on what is called mid-line play and then this delays some of their motor and cognitive (thinking) development.

  • Infant massage will be very important to help the baby with floppy muscles.

  • Tummy time is important and will help the baby to develop better muscle tone and coordination of their muscles. It is important to make sure that the baby is safe in tummy time and to make sure that breathing passages are always clear.

  • Exercises like playing ‘bicycle’ with the baby’s legs and pat-a-cake with the baby’s arms will help with floppy muscles. It will help to make it a part of the daily routine. For example, for 5 minutes after every day-time diaper change.

NEURODEVELOPMENT

  • It is important to determine the root cause. Have the baby’s doctor examine them to evaluate them for any other potential concerns.

  • Frequent and baby safe position changes are recommended.

  • Floppy muscle tone can delay motor milestones like turning over and crawling and pulling to stand or weight bearing. Monitoring tone and doing exercises are very important.

NURSING

  • Infant Massage will be important to help floppy muscles.

  • Chest to chest contact can help muscles be less floppy.

OCCUPATIONAL THERAPY

  • Infant massage is very beneficial for floppy muscles, especially with baby yoga as part of the routine.

  • Certain positions are more helpful to make tone less floppy: tummy time.

SPEECH PATHOLOGY

  • Infant Massage

  • Be very aware of loose muscles and FEEDs – loose muscles around the mouth can result in coughing or choking or poor coordination of the suck/swallow/breathe pattern necessary for safe and productive eating.

  • It will help to teach your baby to use a pacifier. Sucking can help build the muscle tone around the mouth. You will need to teach them to use a pacifier when they are calmer, so they learn to coordinate their sucking rather than just spit it out. “Spitting it out” is due to not being able to coordinate the suck, swallow, breathe (SSB) rhythm resulting in the pacifier fall out and/or frustration.