Neuro/Reflexes

Hypotonia

The assessment of tone can be made both from observing the posture, activity of the infant when undisturbed, and by handling the baby. Infants with normal tone will not feel "floppy" when held by the examiner. The infant in the photo above is hypotonic. When this baby was lifted, the examiner had to give much more support to the head and shoulders than is usual to keep the infant from sliding out of her hands. Notice how the both arms fall back (instead of being held in flexion), and the baby's chest seems to drape over the physician's hand.


photo by Janelle Aby, MD

Hypotonia

Here is the same infant held in ventral suspension. Normally newborns do have a convex curvature of the spine in this position, but not to this degree. Here the head drops much lower than one would expect, and the examiner has the sense that the infant could easily slip out of her hand without extra support. In this case, the hypotonia was caused by trisomy 21.


photo by Janelle Aby, MD