Correct understanding of “early developmental hypertonia in infants”

  The birth of a new baby gives families great happiness, endless joy, and wonderful expectations …… Every move and smile of the baby is always a concern. We find that many parents may regard the normal development of muscle tone as abnormal, or even suspect early cerebral palsy or central coordination disorder, and may be anxious or blindly treated. In view of this, we would like to write an article for your reference so that young couples who are new mothers or fathers can really understand the muscle tone performance during the early development of normal infants to avoid unnecessary anxiety, worry and blind treatment.  The so-called muscle tone refers to the tension of the muscles, which is the basis for maintaining various postures and movements of the body. The state of muscle tone is completely different in normal people when they are quiet and relaxed, performing activities of daily living, and engaging in active sports. The correct determination of whether muscle tone is abnormal must be made by a neurologist or neurorehabilitation specialist after examining the child in person, and not by subjective assumptions made by non-specialists or parents.  Normal infants show increased muscle tone after birth, and throughout the neonatal period, they show increased flexor tone, with the infant’s limbs flexed under the abdomen in a hip-high, head-low position when lying prone, and with the infant’s limbs flexed and head tilted to one side when lying supine, with asymmetrical limb extension, corkscrew-like jerking, and breath-holding, which is more obvious when crying. This phenomenon of increased flexor tone in the limbs is called the first flexion phase of normal infant postural development. 2-3 months old infants will gradually decrease flexor tone and gradually increase extensor tone, and when lying prone, they will lift their heads, stretch their necks, and gradually shift to a head-high-hip-low position; when lying supine, the limbs show asymmetric limb extension, and gradually appear symmetrical hands clasped in front of the chest, eating hands, head tilted to one side or to the midline, turning their heads left and right The retrospective 90-180 degrees, still appearing to thrash and tilt the head back when crying, but the head and neck can be flexed forward when pulled up in a quiet state, the dystonic phenomenon at this age is called the first extension period of postural development. At 4-6 months of age, infants again show increased flexor tone, elbow support in the prone position lifts 90 degrees and flexes the head and chases the eyes left and right, the front chest leaves the bed or gradually appears hand support; in the supine position, the limbs are symmetrically flexed, both hands and feet are leaning on the midline, able to eat hands or grasp objects on the side of the hand, no longer have asymmetrical posture, active head and neck forward flexion when pulling up, elbow flexion sits up, this period is the second flexion period of postural development.  In any of the above stages of muscle tone development, when parents apply external force to move the baby’s joints, they will encounter the baby’s reflexive countermovement, resulting in the feeling of “increased muscle tone”, the more external force is applied, the more frequently and the greater the resistance will be, and repeated reinforcement will inevitably lead to artificially higher muscle tone, therefore, it is not advocated to do too much or excessive baby passive exercises, but Therefore, it is not advocated to do too much or excessive passive exercises for infants, but to conduct more sensory stimulation such as visual, auditory, tactile and active ability induction exercises.  Early infant muscle tone development characteristics should not all be misjudged as abnormal or hypoxic, not to mention seeking excessive medical treatment for this reason, causing unnecessary trauma to the baby’s young mind. The following are some golden tips to help you: 1. Carefully check your baby’s performance, as long as it is not accompanied by backward development of ability level, abnormal neurological reflexes and abnormal movement quality/posture, most of the simple increased muscle tone belongs to the normal infant development.  2.If you are not sure, you can take the children of your friends and relatives as a reference, and compare a few of them at the same age, and the development level of the little ones will be good for each other.  3, premature birth, twin births or other perinatal brain injury high-risk factors of infants, or parents are particularly unsure of the muscle tone problem, must find a specialist to help look at.  4, find a trustworthy institution or doctor for regular neurodevelopmental monitoring is not the best policy, can make the baby and family minimize the loss.