Floppy Infant Syndrome
- “Floppy infant” refers to the newborn/infant presenting at birth or early in life with hypotonia, a symptom of diminished tone of skeletal muscles associated with decreased resistance of muscles to passive stretching.
- Hypotonia can be caused by abnormalities of the CNS (central hypotonia), peripheral neuromuscular system (peripheral hypotonia), or combined abnormality involving both (combined hypotonia).
- Nonspecific transient hypotonia occurs in nonneurologic conditions and may suggest gastrointestinal (GI), cardiac, pulmonary, infectious, renal, or endocrine disease.
No comprehensive prevalence known, owing to presence of hypotonia as a feature of many distinct disorders; overall, central hypotonia is more common than peripheral hypotonia.
Substantial proportion (>50%) of infantile hypotonia cases accounted for by genetic-metabolic disorders.
Causes may be divided into two major categories:
- Central: hypotonia with decreased alertness, developmental delay, and lack of (or minimal) weakness; caused by upper motor neuron defect
- Peripheral: hypotonia with weakness, paucity of antigravity movements, decreased or absent deep tendon reflexes (DTRs), and visual alertness; caused by lower motor neuron defect (i.e., disorders of anterior horn cell, peripheral nerve, neuromuscular junction, or skeletal muscle)
Commonly Associated Conditions
- Respiratory problems (apnea/hypoventilation)
- Feeding/swallowing difficulties
- Hip dislocation/contractures/joint laxity
- Seizure disorder
- Cognitive/developmental delay
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Cabana, Michael D., editor. "Floppy Infant Syndrome." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617038/all/Floppy_Infant_Syndrome.
Floppy Infant Syndrome. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617038/all/Floppy_Infant_Syndrome. Accessed June 3, 2023.
Floppy Infant Syndrome. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617038/all/Floppy_Infant_Syndrome
Floppy Infant Syndrome [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2023 June 03]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617038/all/Floppy_Infant_Syndrome.
* Article titles in AMA citation format should be in sentence-case
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