Hypotonia, or low muscle tone, is usually identified at birth or early childhood. One of the most evident signs is when the baby or child seems weak at birth and later on cannot stay on their knees or keep their elbows bent. It is often the case that they have problems feeding themselves or experience motor difficulties as they grow.
There are various diseases and disorders that can cause the symptoms of hypotonia, and the key thing is to identify the cause so the best possible treatment can start. Causes include problems with the nervous or muscle system, an injury or disease, or an inherited disorder, but sometimes a clear cause cannot be identified.
In some cases, children are born with benign congenital hypotonia, a milder variation of the disease that can be mitigated through therapy (physical, occupational or vocal), though its limitations can last for quite a long time.
What difficulties do children with hypotonia have when it comes to traveling by car?
Generally speaking, these children tend to have flaccid limbs, with restricted movement or mobility, and muscle weakness. In some cases they have limited control of the head or can find it difficult to sit up straight on their own. This affects the child's posture and positioning in a car seat.
If you're traveling by car, the first thing you need to do is guarantee your child's safety with a good approved child restraint system suitable for their height and weight, and always placed in the back seat. However, in addition “children with hypotonia have special needs, and these children should not only enjoy the same degree of safety as all other children but also have an additional level of safety if their degree of hypotonia warrants it, as their bodies are more sensitive and fragile than those of children with normal musculature," explains Lucía Villacieros Hernández, pediatrician and child neurologist at the Pediatric and Neonatology Unit of the Hospital Quirónsalud San José.
For this reason, regardless of whether the medical condition is temporary or permanent, children with hypotonia should always travel in child restraint systems suited to their individual condition (e.g. with adequate support in the head area by side cushions if they are unable to support their own head properly).
There is no specific treatment for hypotonia; “treatment depends to a large extent on what the causal illness is, and if there is a known treatment the focus will be on this. Whatever the case, it is very important to stick to a psychomotor stimulation program, including physiotherapy and rehabilitation, always with the guidance of your neuropediatrician,” notes Dr Villacieros.
A rear-facing position is the safest for any child, but especially for children with underdeveloped musculature, this being the case with hypotonia. Maintaining their posture for as long as possible is also highly recommended to ensure the safety of these children.
In more serious cases of hypotonia, the child may need a wheelchair to get around as well as the assistance and support of orthopedic devices to prevent (or correct, where applicable) injuries such as hip and shoulder dislocations.
It should be borne in mind that in most cases of hypotonia, one of the biggest challenges is lifting and moving the child. This also makes it difficult when it comes to fitting the child in its CRS, which is when you need to ensure that he/she is in the right position to avoid any discomfort and, in the worst case scenario, an injury.
As in other cases of children with special needs, the specific measures you take will depend on the specific health issue of the child and their general condition; it may be the case that you cannot change their normal routine much and they may even require a special child seat.