Hypotonia (Floppy Baby)

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  • Willow
    Advanced Daycare.com Member
    • May 2012
    • 2683

    Hypotonia (Floppy Baby)

    Wanting to bounce some random thoughts off you guys and see what you think.....

    I've got two 8 month old's here right now. One is a straight brute, and I try really hard not to compare the two. Up until now I've sort of excused the physical differences as boys are typically more into the gross motor stuff and girls are typically far more social (in regards to interacting and speech). Eventually they'll even out and catch up to each other.

    Well now it's getting to the point though where some of what I'm seeing is really bothering me.

    Concern number 1 - 8 month old boy is not only crawling but pulling up and cruising while 8 month old girl (nearly 3 weeks older than 8 month old boy) can't really even propel herself forward in an army crawl fashion. She is perfectly content sitting on the floor (which she just mastered about a month ago), playing with the toys around her. Trying desperately not to compare the two but her lack of any/all desire to explore really raised a red flag for me. I try to encourage her by moving toys out around her, and even go so far as to offer her a bit of support under her belly so she'll stay up on all fours for a bit but all she does is cry with frustration when I try to push her outside of her comfort zone.

    Concern number 2 - when I go to pick her up she's unusually limp. You know how most babies you pick up with sort of tighten up under their arms, her's go straight up in the air and even back a bit at an odd angle. Unless I grasp her firmly around her trunk she'd literally slip right through my hands.

    Concern number 3 - she will reach sort of forward for Cheerios in her chair, or like a toy, but she usually turns her body to an angle to get her arm in the right direction instead of pulling her arms across her front and reaching with her hand (hope that makes sense).


    I'm experienced with hypotonia more so when it comes to babies necks, and legs when they get to walking, but I've never seen it in the upper body or arms. What on earth would even cause such a thing?? She wasn't always this floppy, just really started noticing it maybe a month ago or so? I have no idea if this is something I should be pushing to get her in to a doctor for or if it's something I should just make the parents aware of so we can get on the same page working her upper body through play a bit more.


    (If this were my child I'd be having her in for an physical/occupational therapy assessment at the very least and very likely follow through with therapy if it was recommended....but I also recognize I'm extremely proactive as opposed to the wait and see approach many other parents feel comfortable with).
  • NeedaVaca
    Daycare.com Member
    • Mar 2012
    • 2276

    #2
    Hypotonia can also be upper body /trunk. My son has this and went through PT for quite some time. It was free through the state's birth- 3 program. All states have this available. Ask the parents to get a free evaluation

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    • daycarediva
      Daycare.com Member
      • Jul 2012
      • 11698

      #3
      I would ask the parents. Even at 8mo, and even a girl, that sounds abnormal. How is her head control?

      My friend has an 8mo girl who is JUST sitting solo, in the last week or so, and is soo behind it's not even funny. She is ALWAYS, and I do mean ALWAYS, in a baby carrier, she nurses in it, naps in it, and comes out for diaper changes. When she posted pictures on her personal facebook of her dd sitting 'for the first time' she got soooo many "wow, REALLY?" type comments she deleted the picture. She STILL refuses to get an eval.

      Comment

      • MarinaVanessa
        Family Childcare Home
        • Jan 2010
        • 7211

        #4
        This is definitively a toughie. I have a 7mo DCB that has been pulling up onto furniture and "cruising" since he was 6mo and that can now let go and stand for several seconds.

        I also have a drop-in 6mo younger sibling of a current FT 2yo DCB that doesn't even roll over yet, much less sit up. He doesn't play, doesn't try to go for things etc. Personally in this case I chalk it up to the baby being a high needs baby that is held all of the time. I took him on last week for half a day and ended up having to call DCM to pick him up after 2 hours because he only wanted to be held. Didn't want to be put down at all and I simply couldn't provide that type of care.

        I talked about this very same thing (developmental delays) with this DCM and I approached it first by asking how he was at home and how she calmed him down when she put him down. That's when I found out that when she isn't actually holding him he's in a swing or she's wearing him. He is literally only put down when he is sleeping after being swaddled then fed and he falls asleep in her arms. I told her that was a relief to know because I was concerned that he had some concerning signs of delayed physical development. She was a little shocked but it wasn't until she saw her baby next to another 4mo that I care for and compared the differences. The 4mo was MAJORLY doing more than her 6mo.

        Can you approach it similarly?

        Here are the signs of concern that the Mayo clinic lists for an infant of 4-6 months:

        Has stiff or tight muscles
        Seems extremely floppy
        Reaches with only one hand
        Hasn't shown any improvement in head control
        Doesn't respond to sounds or visual cues, such as loud noises or bright lights
        Doesn't reach for objects or put objects in his or her mouth
        Doesn't attempt to roll over or sit
        Has an eye or eyes that consistently turn in or out
        Doesn't laugh or squeal

        Infant development: Milestones from 4 to 6 months

        Comment

        • Willow
          Advanced Daycare.com Member
          • May 2012
          • 2683

          #5
          Originally posted by daycarediva
          I would ask the parents. Even at 8mo, and even a girl, that sounds abnormal. How is her head control?

          My friend has an 8mo girl who is JUST sitting solo, in the last week or so, and is soo behind it's not even funny. She is ALWAYS, and I do mean ALWAYS, in a baby carrier, she nurses in it, naps in it, and comes out for diaper changes. When she posted pictures on her personal facebook of her dd sitting 'for the first time' she got soooo many "wow, REALLY?" type comments she deleted the picture. She STILL refuses to get an eval.

          That's the weird thing, her head control is great. She was lifting her head and looking side to side about the time she started (6/7 weeks). She rolled over from back to front and front to back not long after and she babbles quite a bit. Already has the pincher grasp down when she eats puffs and cheerios. I'd say in every other way she's doing great developmentally.

          I will add when I brought it up tonight to mom she noticed the same thing but wasn't sure what to make of it (they are a great family, super involved and attentive, very open to working with me on any concerns I have). She told me when she took her in last week to see about having her tongue snipped. She is tongue tied and was having trouble eating solid foods - she's still got the tongue thrust reflex so almost everything that goes in her mouth almost immediately gets pushed out. They did a swallow study at the same time to try to pinpoint if it was just her tongue or what and discovered then there is also something up with her esophagus. They are going to put her under next week to snip it and were talking about doing something with dilators and her esophagus? From the time she started she had pretty significant trouble with reflux and grunted and snorted a lot. They're thinking that has something to do with it. I should know more on that next week.

          Comment

          • Willow
            Advanced Daycare.com Member
            • May 2012
            • 2683

            #6
            Originally posted by MarinaVanessa
            This is definitively a toughie. I have a 7mo DCB that has been pulling up onto furniture and "cruising" since he was 6mo and that can now let go and stand for several seconds.

            I also have a drop-in 6mo younger sibling of a current FT 2yo DCB that doesn't even roll over yet, much less sit up. He doesn't play, doesn't try to go for things etc. Personally in this case I chalk it up to the baby being a high needs baby that is held all of the time. I took him on last week for half a day and ended up having to call DCM to pick him up after 2 hours because he only wanted to be held. Didn't want to be put down at all and I simply couldn't provide that type of care.

            I talked about this very same thing (developmental delays) with this DCM and I approached it first by asking how he was at home and how she calmed him down when she put him down. That's when I found out that when she isn't actually holding him he's in a swing or she's wearing him. He is literally only put down when he is sleeping after being swaddled then fed and he falls asleep in her arms. I told her that was a relief to know because I was concerned that he had some concerning signs of delayed physical development. She was a little shocked but it wasn't until she saw her baby next to another 4mo that I care for and compared the differences. The 4mo was MAJORLY doing more than her 6mo.

            Can you approach it similarly?

            Here are the signs of concern that the Mayo clinic lists for an infant of 4-6 months:

            Has stiff or tight muscles
            Seems extremely floppy
            Reaches with only one hand
            Hasn't shown any improvement in head control
            Doesn't respond to sounds or visual cues, such as loud noises or bright lights
            Doesn't reach for objects or put objects in his or her mouth
            Doesn't attempt to roll over or sit
            Has an eye or eyes that consistently turn in or out
            Doesn't laugh or squeal

            Infant development: Milestones from 4 to 6 months
            She has definitely got all of the above list down except for being extremely floppy with her arms.

            Mom is on my facebook and I see they don't have her in carriers or seats much. She has an exersaucer there but aside from that and her carseat she isn't strapped into anything reclining that I'm aware of. Definitely nothing like that here although I do wear all the babies in my care on occasion, not as much now but when she was littler I did quite a bit.

            She's great about occupying herself and doesn't rely on being held. When she's tired she isn't even really a fan of being cuddled, likes to be laid down and she's out like a light. She's just now started getting a bit crabby about the time she's ready to eat but other than that she really never cries or is fussy at all. She's been a very pleasant baby

            That's probably one of the reasons why I'm so concerned. She's been a doll and I just adore her. The family is fantastic. Her sister is 4 and quirky in hilarious ways but normal as heck.

            My gut is definitely telling me something is up, I just always hesitate to jump on that because I realize at times I can be overly sensitive to things like this


            Thank you all for walking me through this, I was so nervous about bringing it up. Thankfully it went over well!

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