What Causes Hypotonia In Babies? – Symptoms, Causes, & Treatment

Also known as floppy infant syndrome, hypotonia is a medical word for low muscle tone. More often, hypotonia is related to other health problems, including spinal cord injury, cerebral palsy, severe infections, brain formation problems in the womb, or brain damage due to lack of oxygen right before or after birth. There are many treatment options for hypotonia, including sensory stimulation programs, speech-language therapy, and occupational and physical therapies. 

Usually, even when bodily muscles relax, they still have some contractions that can provide some resistance to passive movement.

However, the muscles seem floppy with hypotonia because they have little muscle tension at rest. 

So what is hypotonia in babies? What are its signs and symptoms? What causes it? Are there treatments available for this condition? Will my baby recover from hypotonia? I know these questions and more could be haunting you right now. 

At 1happykiddo, we’ll provide you with a more thorough understanding of some vital information about hypotonia in babies. 

What is Hypotonia?

Hypotonia is defined as a lack of muscle tone in babies.

It can be inherited or a symptom of another condition such as down syndrome, Tay-Sachs disease, Muscular dystrophy, or cerebral palsy.

It may also be caused by other degenerative diseases or an injury at birth. 

Muscle tone is the amount of resistance or tension to your muscles’ movements at rest.

It’s the body’s response to force and allows it to maintain the posture to sit and use reflexes like moving the arms and legs.

It also helps regulate the functions of organs in the body. For people diagnosed with hypotonia, their muscles feel soft without any resistance. 

Muscle weakness and hypotonia aren’t the same. Muscle weakness is a lack of strength in your muscles and is often a symptom associated with hypotonia. 

A check-up will reveal a floppy baby whose limbs hang limply like a rag doll.

And as the child grows, they may miss milestones like holding up their head during tummy time and have problems sucking, chewing, swallowing, breathing, or speaking. 

They may also develop poor balance, reflexes, and coordination, like their mouth hanging open.

Babies diagnosed with hypotonia don’t show resistance when joints in their bodies move. 

What causes hypotonia in babies?

Hypotonia is a communication error between the pathways that control muscle tone and movements involving the brain, spinal cord, nerves, and muscles.

It is often a sign of a problem anywhere along the pathway that controls muscle movement.

The causes may include:

  • Hypotonia nervous system issues during fetal development 
  • Brain damage due to lack of oxygen before or right after birth or problems with rain formation
  • Congenital muscular dystrophy 
  • Infections like infant botulism 
  • Congestive heart failure 
  • Congenital myopathies
  • Prader Willi syndrome 
  • Spinal muscle atrophy
  • Down syndrome 
  • Tay Sachs disease 
  • Metabolic diseases 
  • Exposure to toxins 
  • Spinal cord injury occurs at the time of birth
  • Hypothyroidism 

Signs and symptoms of hypotonia

A mother is holding her baby with possible symptoms of hypotonia.

Babies with hypotonia have symptoms where their bodies appear floppy like rag dolls. Other symptoms of hypotonia include: 

  • Your baby feels limp when held
  • Your baby is unable to lift their head during tummy time or control their neck muscles 
  • The baby is unable to place weight on their legs
  • The baby’s arms and legs hang straight at their sides without a bend at their knee or elbow
  • Your  baby has difficulty sucking or swallowing 
  • They show muscle weakness and have a weak cry

Babies diagnosed with hypotonia may have delayed developmental milestones that affect their motor skills, including: 

  • Feeding themselves 
  • Saying their first words
  • Crawling and walking 
  • Sitting upright 

Treatment for hypotonia in babies 

Treatment for hypotonia mainly focuses on providing the child and the family with the support they need to manage the condition.

The treatment can involve various healthcare professionals and practices including: 

  • Occupational therapy 
  • Sensory stimulation 
  • Nutritional counseling 
  • Respiratory support 
  • Physical therapy 
  • Speech therapy 
  • Child neurologists 
  • Geneticists

What to expect at your child’s appointment visit?

A nurse is helping a small girl practice walking as part of her treatment plan for treating hypotonia.

Treatment varies depending on how your baby is affected. Their general health and ability to participate in therapies will shape a treatment plan. 

Some babies frequently work with physical therapists, depending on their ability. Sometimes, your baby may need help with coordination and other fine motor skills. 

Because hypotonia makes joints very loose, it’s common to have a joint dislocation, and babies with severe symptoms may need wheelchairs for mobility as they grow.

Braces and casts can help correct or prevent these injuries. 

The long-term outlook and treatment depend on the underlying cause, age, severity, and the muscles affected. 

Hypotonia is often a lifelong condition and can be challenging but not life-threatening.

It does not affect babies’ intellectual abilities. And apart from therapies, your child will need to learn coping mechanisms. 


Is hypotonia a disability?

Hypotonia as a symptom isn’t a disability, but the underlying diagnosis could be a disability.

But because it affects how a person performs their daily tasks, hypotonia as a condition on its own could identify as a disability. It doesn’t affect a person’s intellectual abilities, though.

Can medical malpractice play a role in neonatal hypotonia? 

Unfortunately, the most common cause of hypotonia in babies is medical malpractice through substandard medical practice during pregnancy or birth.

For instance, neglecting to monitor the fetus during long labor may lead to no discovery of fetal distress.

Babies may also suffer from oxygen deprivation that may cause brain damage under the strain of delivery.
An untreated infection during pregnancy can lead to a preterm birth while allowing labor to go on for too long or misusing birthing instruments to assist a difficult birth are faulty medical actions and decisions that may result in nerve, brain, or spinal cord damage leading to conditions in which hypotonia is a symptom. 


  • https://www.childrens.com/specialties-services/conditions/muscle-weakness-in-children
  • https://pubmed.ncbi.nlm.nih.gov/19078754/
  • https://www.medicalnewstoday.com/articles/307076
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Hello, I am Emelda from Nairobi, Kenya. They simply call me mama Lilly. A fun of long road trips and a very good cook, along with my mommy duties to a super active girl. She inspires and challenges me in equal measure, and that is how I get to share with you our journey of triumph as we grow and tag you along.

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