Floppy infant syndrome: Do your baby's muscles seem weak?

When a baby begins to lose their muscle tone and it feels like they are slipping right through your fingers, the problem could be a sign of the floppy baby or floppy infant syndrome.

Medically known as hypotonia or low muscle tone, the condition can be temporary or permanent and is usually a symptom of one of several diseases or disorders.

Dr Peninnah Musyoka, a Paediatrician at Machakos Children’s Clinic, says most babies who have this syndrome were born normal, but begin showing symptoms of muscle tone loss between the ages of 2-9 months.

“Some begin by losing achieved milestones such that they cannot sit or turn if they already were, may lose neck support although they may smile, feed, or have other interactions with the environment just like a normal baby,” she says.

Although this may not be the same for all the babies with this syndrome, she explains that some may have difficulty feeding, and may get several episodes of pneumonia and or convulsions.

Hypotonia can be caused by conditions that affect the brain, central nervous system, or muscles. For example, Dr Musyoka, a condition called cerebral insult is caused by disturbance of brain blood flow and usually happens during delivery or in utero.

Hypotonia can also be caused by genetic conditions including the Prader-Willi syndrome which leads to a deletion in one region of the father’s chromosome 15 and leads to a loss of function of several genes. In Down’s Syndrome, a child is born with an extra copy of their 21st chromosome, causing physical and mental developmental delays and disabilities.

Another cause could also be when the neuromuscular junction is not working very well such as in congenital myasthenia gravis, a rare hereditary condition caused by a gene change that results in muscle weakness and worsens with physical activity.

In this condition, any muscles used for movement can be affected, including muscles that control speaking, chewing and swallowing, breathing and even walking.

Other causes according to Dr Musyoka could also be a result of spinal muscular atrophy (SMA) which is a disorder affecting nerve cells that control voluntary muscle movement.

“During diagnosis, the doctor will be systematic, first, to get the history of the patient to know how their pregnancy was, whether the baby was active during the pregnancy, whether there was prolonged labour, did the baby cry during delivery, was there difficulty in breathing, when did you realise the baby was not moving, or did not have neck support and if the parent has any other illness,” explains the doctor.

The paediatrician also says that management depends on what causes the condition, balancing the hormones or calcium levels, ensuring they are not aspirating because aspiration makes them get recurrent pneumonia and also finding alternative ways of feeding if they have feeding difficulties.

She advises parents always to check to see if the babies are fine by getting a frequent evaluation by a paediatrician and seek help early because if they get an early diagnosis, management will be in good time.

“In the West, some of these conditions are screened at birth, and I am praying that, as a country, we will get to a point where we can also screen at birth because that way, we can prevent what is preventable,” Dr Musyoka says.