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Low muscle tone in infants – symptoms, causes, and impact on walking. Can low muscle tone be cured?

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Klaudia Wyszyńska Klaudia Wyszyńska
August 25 2025
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    Parenthood is a journey fraught with anxiety, especially when it comes to our children's development. One term that can cause concern among parents is "low muscle tone in infants." Does so-called low muscle tone in an infant indicate future developmental problems for the child? Today, we'll dissect this topic, explaining what muscle tone is, the causes of low muscle tone, how to recognize the symptoms of low muscle tone in infants, and answering the question: can low muscle tone be cured?

    What is muscle tone and what does reduced muscle tone in an infant mean? 

    Muscle tension is necessary for every human being to perform movements, overcome the force of gravity, maintain correct body posture, maintain balance and be ready for action - to perform voluntary, purposeful movements. 

    Expert advises

    Muscle tension is not the same as muscle strength — muscles may be strong, but their basic tone may be low, although very often weakened muscle strength accompanies reduced muscle tone in infants, which is also colloquially referred to as low muscle tone. Problems arise when muscle tone – its quantity or distribution in the body - makes it difficult for the child to engage in good quality physical activity.

    Klaudia Wyszyńska
    Klaudia Wyszyńska
    Physiotherapist at the Daily Rehabilitation Center, Institute of Mother and Child

    Muscle tension distribution disorders – when the problem is not the amount of tension but the distribution

    It is not only the "amount" of muscle tension that counts, but also its "distribution" in the child's body, i.e. the so-called distribution of muscle tension and "cooperation" between individual muscle groups. How tension is distributed between different muscle groups has a huge impact on the quality of movement.

    Newborn: "weak" muscle tone in the center, increased around the body's periphery

    In newborns, the so-called is typical. central hypotension, i.e. weak muscle tone in the center of the body (torso), with simultaneous increased tension in the periphery (arms - clenched fists, arms bent close to the body; legs bent, pulled towards the belly). As the central nervous system matures, the center of the infant's body gains stability, and the limbs (arms, legs) - freedom of movement. If this process is disturbed, it may lead to disorders of muscle tone distribution, resulting in disharmonious motor and postural development.

    Diagnosing reduced, so-called weak muscle tone in infants requires a careful, comprehensive assessment, tailored to the baby's age – preferably performed by a pediatric physiotherapist and/or neurologist.

    Causes of lowered muscle tone in infants 

    Reduced muscle tone in infants is a symptom that may have many different causes - from mild and transient, after serious neurological or genetic disordersIn practice, this means that so-called low muscle tone in infants may result from both harmless, often physiological, disturbances in the maturation of the nervous system, or it may be one of the first symptoms of the disease. From a diagnostic perspective, it is worth distinguishing several main categories of causes of low muscle tone in infants.

    🔹 Central and peripheral causes

    In many cases, reduced muscle tone in children has a so-called "central" cause, related to the malfunctioning of the central nervous system, which leads to disturbances in basic postural tone. In turn, peripheral origin is associated with damage to the peripheral nerves or the muscles themselves. 

    🔹 Genetic and metabolic disorders

    Reduced muscle tone in infants may be one of the symptoms of genetic diseases such as Down, Rett, Prader-Willi or Joubert syndromeIn these cases, flaccidity and difficulties with motor development are part of a broader clinical picture.

    Expert advises

    Another group are metabolic diseaseswhich can disrupt the proper functioning of muscles and the nervous system. Neuromuscular diseases include, for example: spinal muscular atrophy (SMA), primary muscular dystrophies and neuropathiesIn some forms of muscular dystrophy, symptoms such as decreased muscle tone, muscle weakness, and contractures may be visible even in newborns.

    Klaudia Wyszyńska
    Klaudia Wyszyńska
    Physiotherapist at the Daily Rehabilitation Center, Institute of Mother and Child

    🔹 Perinatal and acquired causes

    Some babies are born with normal muscle tone, but for various reasons, they develop abnormalities during the perinatal period or in infancy. The most common risk factors and causes of low muscle tone in infants include:

    • perinatal hypoxia – may initially lead to decreased muscle tone in the infant, which may later turn into increased muscle tone,
    • prematurity – immaturity of the nervous system contributes to muscle tone disorders,
    • prolonged jaundice – may affect the functioning of the CNS,
    • intrauterine infections – e.g. meningitis.

    Reduced muscle tone in infants is sometimes one of the first symptoms of cerebral palsy (CP).

    🔹 Idiopathic and functional causes

    In many situations, despite extensive diagnostics, it is not possible to clearly determine causes decreased muscle tone. We then talk about idiopathic hypotensionHowever, it is worth knowing that some children with seemingly unexplained cause of decreased muscle tone may have problems with the one already described in this article, disturbance of the distribution of muscle tone. 

    Symptoms of low muscle tone in infants – so-called red flags that should raise concern

    How to recognize the symptoms of low muscle tone in infants? Although each baby develops at a certain pace, there are symptoms that should alarm parents and prompt a consultation with a doctor or physiotherapist. Here are the most common symptoms of "low" muscle tone in infants:

    • "Limpness" and flowing through the hands – the child seems very loose, without resistance, easily fits into the hands of an adult.
    • Excessive joint mobility – e.g. sitting in splits, excessively flexible limbs.
    • Problems with head control – in the 3rd month of life, the head may still be unstable and may fall when carrying or lifting the baby.
    • "Gluing to the substrate"– the child is reluctant and requires great effort to reach for toys or lifts its legs above the ground when lying on its back.
    • Aversion to lying on the tummy – it's common symptom  disturbances in the distribution of muscle tone. Instead of active, symmetrical support on the forearms, the child may "hang" on the shoulder girdle and passively tilt the head backward.
    • Excessive salivation, poor facial expressions, constantly open mouth, constantly sticking out tongue.
    • Characteristic sitting positions - symptom may be a constantly rounded back, or the child notoriously chooses to sit in a "W" shape.
    • Instead of crawling on all fours a child with muscle tone disorders may choose to move on his buttocks. 
    • Difficulties with feeding and speech - so-called poor muscle tone in an infant may cause difficulties in taking food (in the first days of life - sucking, swallowing) and later may cause delays in speech development.
    • Poor motor coordination, frequent falling – movements are imprecise and the child may have difficulty feeling the body.

    Expert advises

    All the above symptoms of low muscle tone in infants should be addressed. consulted with a physiotherapist or pediatric neurologistAlthough not every reluctance to lie on the tummy indicates a serious disorder, it is worth consulting a specialist just in case – the earlier a diagnosis is made, the greater the chance of effectively supporting the child's development.

    Klaudia Wyszyńska
    Klaudia Wyszyńska
    Physiotherapist at the Daily Rehabilitation Center, Institute of Mother and Child

    Baby's motor development: reduced muscle tone and walking 

    Reduced muscle tone and walking — is a topic that often worries parents, especially when the child later begins to reach further developmental milestones, such as independent going, or his way of moving is different from that of his peers. Reduced muscle tone and gait: low muscle tone is often associated with a delay in independent walking, which may even appear after 18 months of ageThe most characteristic features gait at decreased muscle tension in a child there are:

    🔹 problems with alternating footwork and balance,

    🔹 the gait is not very "elegant", the baby may rock from side to side, stick out its bottom and have a protruding belly — although at the very beginning almost all infants show such features when learning to walk, in children with the so-called poor muscle tone These incorrect movement and postural patterns persist, and the gait does not evolve over time to be more "elegant" and better coordinated.

    🔹 It happens that in children with decreased muscle tone appears hyperextension in the knee joints, often with a tendency to lopsidedness (also while walking).

    The sooner it is implemented physiotherapy intervention – aimed at strengthening muscles, improving coordination and learning correct movement patterns – the greater the chance of developing correct functions, including stable gait and avoiding permanent, incorrect postural habits.

    Can low muscle tone be cured?

    Many parents wonder: can low muscle tone be cured?

    Expert advises

    Although tone itself—understood as the muscle's resistance to stretching—rarely changes completely during treatment/therapy, properly conducted therapy can significantly improve a child's functioning. The goal of treatment is not to cure decreased muscle tone, but improving the quality of movement, postural tension, coordination and body sensation (proprioception)Early diagnosis and appropriate therapy positively impact a child's development and reduce the risk of developing abnormal movement patterns.

    Klaudia Wyszyńska
    Klaudia Wyszyńska
    Physiotherapist at the Daily Rehabilitation Center, Institute of Mother and Child

    So can low muscle tone be cured? 

    In the sense of fully restoring normality – not always. But by conducting therapy that is properly tailored to the child and his/her disorders, the consequences of so-called weak muscle tone can be cured: delays in motor development, e.g., when learning to walk, postural disorders. To sum up – Can decreased muscle tone be cured??

    Not always in the biological sense, but often in the functional sense – through therapy with a specialist, movement and a supportive environment that helps shape correct movement and postural patterns.

     

    Bibliography (access to internet sources from 11.08.2025/XNUMX/XNUMX): 

     

    Author

    Klaudia Wyszyńska
    Physiotherapist at the Daily Rehabilitation Center, Institute of Mother and Child

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