Problem: A four-month-old has a noticeable tremor of arms, legs and other body parts. The kid is in constant motion
Often, parents at a doctor's appointment hear about an increased or decreased tone in a baby. What is it and how dangerous is it?
Let's start by saying that in itself tone is not a diagnosis or disease. Tone is a slight constant prestressing of a muscle that allows it to be ready for intentional contraction at any time. The regulation of muscle tone is a very complex neurophysiological process, closely related to congenital and acquired reflexes, the correctness of which depends on many factors. Regulation of tone is carried out at the reflex level with the participation of all parts of the brain: the trunk, subcortical nuclei and cortex.
In a newborn, the overall tone of all muscles is evenly increased compared to adults and older children. This gives his body a characteristic appearance: arms and legs are pressed to the body, the head is slightly thrown back, it is not possible to completely separate the limbs. All this is absolutely normal and will pass over time.
As the child grows, the tone of his muscles weakens, which gives the child the opportunity to start actively moving. He begins to move his arms, legs, take objects, raise his head. It is important that the changes in tone occur correctly and simultaneously in all muscles. If, for example, the upper limbs are in an increased tone for a long time, it will be more difficult for the child to use them, and the corresponding skills will appear later. Prolonged hypertonicity of the lower extremities can cause problems with the development of walking.
Until about 3-4 months, muscle tone remains high, then it begins to decrease - first in the flexor muscles (the arms and legs are straightened at the same time), and by 5-6 months all the muscles relax evenly, which gives the child the opportunity to make more complex movements - sit down, get up and walk. By the age of 18 months, the muscle tone of the child becomes comparable to that of an adult. If the baby lags behind in development from peers, the cause may be a violation of muscle tone.
What are the reasons for the violation of tone
The vast majority of tone disorders are associated with trauma and hypoxia during childbirth. Most often, the head and cervical spine of the baby are injured, which leads to disruptions in work nervous system: cerebral cortex and subcortical structures. Trauma can occur during rapid and violent childbirth, as a result of unskilled obstetricians, the use of the Christeller technique (pressure on the abdomen during childbirth is prohibited in most countries, but in Russia it is periodically used), after labor has been stimulated with oxytocin, the application of a vacuum and forceps.
Prolonged oxygen starvation during childbirth also leads to damage to the nervous system and, primarily, the cerebral cortex. The more severe the injury or the longer the hypoxia has been, the more severe the problems in the newborn. The most severe cases refer to the manifestations of cerebral palsy - infantile cerebral palsy, in which the child is practically deprived of the opportunity to develop normally.
How can a mother suspect a tone disorder?
Hypertonicity in newborns up to a month old, it is physiological, that is, normal. Violation can be suspected of excessive tightness and stiffness of the baby, not age appropriate. If the tone is increased in the upper limbs, the baby does not reach for the toy, does not unbend the arms, his fists are tightly clenched most time, often in the form of a "fig". Hypertonicity of the lower extremities can be suspected if the child's hips cannot be spread apart so that the angle between them is 90 degrees.
Low tone manifested by lethargy, weak movements of the arms or legs, drooping limbs (frog pose), sluggish movements and late development of age-related skills. If the tone is disturbed on one side, it is easy to notice by the asymmetry that occurs on the limbs of one and the other side, as well as by the asymmetry of the folds. If you suspect that your baby has a violation of tone, then first of all contact your pediatrician.
How the doctor assesses the tone
It can determine with high accuracy whether your baby's tone is disturbed or not. In doubtful cases, he will refer you to a pediatric neurologist. To check, the doctor will examine the baby externally, check his posture on the back and stomach, how he holds the head and moves his arms and legs. Then the doctor will check the baby's reflexes - they usually increase at the same time as the tone. Reflexes such as crawling, grasping, and sucking are present in young children and pass by the age of 3 months. If they persist for too long, it could indicate a problem in the nervous system.
Next, the doctor will feel the baby's limbs with his hands, determining how tense the muscles are. He will try to bend and unbend the legs and arms of the child, and also check the symmetry of these movements.
Norm
- muscle tone and reflexes are age appropriate, both sides are developed symmetrically.
Hypertonicity
- increased muscle tone, the child is constrained, moves with difficulty.
Hypotension
- decreased tone, muscles are relaxed, cannot contract with the required force, the child is lethargic.
Muscular dystonia
- some muscles are in hypertonicity, others - in hypotension. The child assumes unnatural postures, movements are also difficult.
Why are tone disorders dangerous?
At the heart of any violation of tone is a problem in the nervous system. Tonus is just one of its manifestations, the first and most obvious thing that can be noticed in a baby, since examination of vision, hearing and other more adult functions is not available for him. Toning problems are always the result of a violation of the basic reflexes that regulate body movement. This means that, together with the tone of such children, coordination will be impaired, age-related skills will develop worse, they will lag behind their peers in development.
Later, due to a violation of tonic reflexes, deviations in the musculoskeletal system occur: scoliosis, flat feet, clubfoot, etc. The severity of developmental delay and other disorders depends on the degree of brain damage. This is not always proportional to the severity of hypertonia, which is why the child must be shown to a pediatric neurologist.
How to treat tone disorders in a child
In most cases, tone disorders respond well to treatment. The earlier the problem is identified, the better it is possible to cope with it, therefore it is very important to undergo scheduled examinations by a pediatrician and a neurologist on time. To exclude a serious problem, the doctor may prescribe a study of the brain using neurosonography - for a detailed examination of its structures.
Treatment for violations of tone should be prescribed by a doctor and agreed with several specialists: pediatrician, neurologist, orthopedist. Lack of treatment will not lead to anything good, the child will not "outgrow" this problem. If the violation of tone is not treated, it will lead to developmental delays, problems with the musculoskeletal system.
Your doctor can prescribe a variety of methods of treatment
... Here is some of them:
Massage is a very common and often effective way to improve the condition of a baby in case of tone disorders. It is suitable for both hyper and hypotonia, but at the same time it is performed according to different methods. With hypertonicity, a relaxing massage is prescribed, with hypotonia - tonic. It is better if the massage is performed by a specialist, but the mother herself can also learn about hygienic massage. Performing a light massage every day will be a very useful addition to a specialist's course.
Aquagymnastics - useful for any tone disorders. Warm water relaxes muscles, cool water stimulates. The child learns to coordinate, to control his body, all muscles are involved in the process.
Physiotherapy - it means exposure to heat (paraffin applications), electrophoresis, magnets.
Medication - becomes necessary if the muscle spasm is very strong and cannot be removed by other means.
Osteopathy is an extremely effective method of working with children after birth injuries, including those with manifestations of hypertonicity. Allows you to bring into the correct position the bones of the skull and cervical spine of the newborn, displaced during childbirth. As a result, the shape of the skull is normalized, the mechanical causes of cerebral dysfunctions are eliminated, and pathological reflexes pass. Osteopathy has a mild effect, it can be used in children from birth, does not require long courses.
Every mother listens to every breath and looks closely at every, even minor movement of her newborn baby. But why is the baby constantly pulling with arms and legs? How to deal with this? The movements of newborns will be discussed in our article.
Why does a baby constantly jerk his legs and arms?
Although it sometimes seems to us that the first weeks after birth, the baby mostly sleeps and does not move much, but this is not so. Trying to adapt to new circumstances and get to know his body, the baby moves his arms and legs.
How to understand when everything is within the normal range, and when to see a doctor?
In the table, we have collected the most common reasons why the baby jerks his arms and legs violently.
| Increased tone of the limbs | After a long stay in the embryo position, the baby needs some time for the flexor muscles to relax and the extensor muscles to return to their normal physiological state. Therefore, after birth, the baby will constantly move its arms and legs. Movement, as a rule, is bilateral in nature, that is, with two arms or two legs at the same time. Everything should be back to normal by two months ... If there are deviations, then they speak of a reduced or. In this case, it is necessary to undergo a course of treatment. |
| Digestive system work | New food and the associated increased stress on the stomach, intestines and other organs leads to discomfort, which is still difficult for the baby to cope with, and this leads to chaotic movements of the arms and legs, which are often accompanied by crying. The crumb tries to press the legs closer to the tummy and thereby help digestion, but he cannot fix it, so he tugs them and cries. |
| In the process of digesting food, babies often have colic, gas, and pain in the tummy. Because of this, newborns squeeze or, conversely, stretch their legs, jerk their arms and cry. Such conditions, as a rule, disappear by 3-4 months, in some children by 6 months . | |
| Central nervous system pathology | This is what all mothers are afraid of. Such terrible diagnoses as: encephalopathy, epilepsy, cerebral palsy. In these cases, the baby's movements are very different from the norm and are accompanied by other symptoms. Chaotic eye movements / gaze at one point, protruding tongue, convulsive sucking movements. Such movements are called seizures, and this is the reason for immediate medical attention. . |
How to help a kid if he jerks his arms and legs violently?
In order to properly help the baby, you need to establish the exact reason. You should consult a pediatrician, surgeon and neurologist.
Each of the specialists will examine the baby and give his recommendations:
- Pediatrician will conduct a general examination and give recommendations on how to improve the work of the digestive system, and will also refer you to other specialists.
- Surgeon check motor activity and tummy.
- Neuropathologist will give his opinion on the baby's nervous system.
What methods will help the baby, and in what cases it is necessary to apply this method of treatment, we will consider in the table below
| An excellent remedy both for colic in the tummy and for relieving muscle tone. If the baby does not have any serious health problems, then the young mother can do the massage at home herself. In the case of muscle tone, massage is good in the morning and in the evening after water procedures ... Moreover, in the morning it is more intense, alternating stroking and patting with light exercises, gently bending and unbending arms and legs, massaging fingers. In the evening, this can be a light relaxing massage in the form of stroking the back, arms and legs, as well as the tummy. With colic, doctors and experienced mothers advise gently stroking the baby's tummy clockwise for several minutes. | |
| Gymnastics | If you have increased muscle tone, you may be advised to consult a physiotherapist ... The specialist will tell you what movements, how and in what sequence it is worth doing so as not to injure the baby. |
| Breast swimming | The procedure itself is very useful, both for babies with problems in physical activity, and for absolutely healthy children. During water procedures, the heart rate increases, the blood is saturated with oxygen ... Many doctors, answering the question of when to start swimming with a baby, say: as soon as the umbilical wound heals. Just as in the case of gymnastics, in the morning swimming can be more intense, teach the baby to relax muscles in warm water, at the end turn on cool water, thereby tempering the crumb, and in the evening, simple splashing in warm water with the addition of chamomile decoction, mint, lemon balm or lavender. Pleasant scents will calm your baby and set him up for a sound sleep . |
| Medications | Only after consulting with doctors. If the above methods can be applied, albeit with caution, but to all children, then no medications can in any case be prescribed independently ... Many neurologists prescribe very serious drugs when toned, such as Cerebrolysin, Cavinton, Actovegin, etc. For colic, Sab Simplex, Plantex, Dill water, Espumisan are most often prescribed. |
| Physiotherapy | With muscle tone in a newborn, a neurologist may prescribe paraffin and electrophoresis on legs or arms as physiotherapy . |
Of course, not a single mother wants to think about bad things, but, unfortunately, the statistics are inexorable.
Today, more than 50% of children are born with some kind of problems of the nervous system. Therefore, if the behavior of the baby worries you, you should consult with a neurologist.
Make an electroencephalogram, neurosonogram. Perhaps, in case of unsatisfactory results of examinations, the doctor will prescribe magnetic resonance imaging. Or, on the contrary, the results of examinations will not reveal pathologies, then the doctor will prescribe nootropic drugs designed to stimulate the nervous system, or sedatives to relieve stress.
Regardless of the test results and doctors' predictions, mom should stay calm. The child's body is very plastic, most of the problems can be solved, modern achievements, both in medicine and in pharmaceuticals, allow to compensate, and often completely cure very many diseases associated with the nervous system.
For advice from a speech therapist
Oksana Makerova
The child is developing. How?
Psychomotor development of a newborn child
Dear Readers! In the questions you ask me, you often ask whether it is normal that a child at a given age does not know how to do something, does not utter certain sounds, does not know how to do something, etc. Therefore, I decided to devote the next few articles to the norms of psychomotor and speech development of a child from birth to 5 years. Development parameters of premature babies will be separately noted.
I would like to start a conversation not from the moment of birth, but from the moment of development of the fetus, since this is the most important moment in the development of the child.
Most modern research showed that, starting from the 4th month of pregnancy, the human fetus is conscious. He “knows” what is going on around him, he feels, hears and understands everything in his own way. When he doesn't like something, he tosses and turns, kicks. After many years of research, American experts have prepared information about the "consciousness" of the human fetus of the fourth month of pregnancy, I bring this data to your attention.
- The fruit has a sense of taste and, like all children, loves sweets. The introduction of, for example, glucose into the fetal waters accelerates his swallowing movements, and the injection of iodine, on the contrary, slows them down, and the face of the fetus bends with disgust.
- The fetus reacts to external stimuli. For example, touching the lips causes him to suck.
- A 5-month-old fetus moves its head, if it is stroked with a hand, pouring cold water on the mother's abdomen causes anger in him, and he kicks with his legs.
- The fetus duplicates the actions and even the mood of the mother. When the mother is calm and in a good mood, rested, then the fetus behaves calmly.
- Unborn children learn whole words and expressions.
- The fruit reacts to light. A bright light shining on the mother's belly makes him want to hide. He rolls over in his stomach, squeezes his eyes shut.
- Unborn babies react to their mother's words and intonation. When a mother or father addresses them, they calm down, their heart rhythm returns to normal. Doctors, including speech therapists, advise the mother to talk to the child as often as possible.
Also, long before the birth of a child, his muscles begin to form. It was found that already at 8 weeks of gestation, the fetal muscles begin to contract. By week 20, there is a surprisingly “rich repertoire” of targeted movements, including arm, leg, and head movements. This is not new, because expectant mothers, long before the birth of a child, feel his physical activity, feel how he toss and turn in his little world, move and push.
At 10 weeks, the fetus begins to move its limbs, after another 2 weeks it turns its head, after another week it opens its mouth, sticks out its tongue, makes attempts to breathe and swallow on its own.
By the 15th week, he performs an action from which many babies are weaned for months - he begins to suck his own thumb.
After another 3 weeks, he begins to actively explore his own body - head, trunk, limbs with his hands.
By week 20, the fetus has well-coordinated movements, wiggles the fingers of both hands and feet, and even (!) Moves the eyelashes.
And this is only the first half of pregnancy, the most responsible half, when all systems of the unborn child's body are being formed!
But then the baby was born. You were discharged and you came home. Young mothers, and even those who have children, always have questions: is our baby developing correctly, is everything so?
Neuro-motor development from 0 to 1 month
| Skull perimeter newborn equal to 34-35 cm, and the weight of the brain is 335 g. |
The position of the trunk and limbs
A. Lying on back (dorsal decubitus)
All 4 limbs are bent and symmetrical. The head is usually turned to the side. The body follows the turn of the head (“whole”). The upper limbs are next to the body, slightly bent at the elbow joint. The fingers are partially clenched in the "pronation" position (slightly open with the palm down), the thumb is brought to the palm. The lower limbs are bent as follows: thighs on the abdomen, lower legs on the thighs (due to bending of the knees). The state of flexion of the limbs partially resembles the intrauterine position, it is an increased tone of the flexor muscles of the limbs.
If a newborn lies in a position of too pronounced flexion (flexion) or extension (elongation), motionless, “numb” (the body is elongated, without any flexion of the lower or upper limbs) this means that it is a violation of its development. In this case, an urgent consultation and examination by a neurologist is required.
B. Lying on your stomach (verntral decubitus)
And in this situation, the bent position prevails. The knees are placed under or next to the torso. Starting from 2 or 3 weeks, the newborn manages to turn his head and even raise it for a short time, in order to put it on the other side. Occasionally he tries to make crawling movements; these movements become more active when we touch the feet of the newborn, the legs are bent at the knees.
If in this position the child cannot move his head at all, which remains with the “chin falling on the chest”, if the child cannot turn his head to the side, cannot breathe freely, then it is necessary to show the child to the doctor and the sooner the better, because. to. there is a danger of suffocation.
B. Pulling up in the supine position.
If the newborn is grasped by the arms and pulled slightly up and forward, the shoulders remain bent and the head tilted back. When the child reaches an upright sitting position, the head falls forward and dangles from one side to the other.
Symmetry
The position and movement of the newborn is almost symmetrical. Some people notice a slight movement of the head in the “favorite” direction. The symmetry of the position between the right and left extremities is almost constant, whether it is the upper or lower extremities. If the mother notices an asymmetry between the two homologous limbs, this may be pathological.
Reflexes
A child is born with certain primary reflexes. These reflexes disappear by 3-4 months as voluntary movements take their place.
Reflex Moro (named after the German pediatrician who described this reflex in 1917)
Appears only when the newborn is awake. If you hit hard on the table on which the child is lying (or other sudden and sudden movements), then the Moro reflex occurs. The newborn straightens his torso, moves his arms away from the chest, stretches them, extends his fingers, sometimes screams. The next moment there is a return to the resting position. Only a physician can determine the symmetry of the reflex.
Grasping reflex
If the mother runs her finger across the newborn's palm, the fingers are suddenly clenched with such force that the newborn can be lifted off the surface. If you run your toe under your feet, you can feel how he bends his toes.
Cardinal point reflex
It is named so because its research consists of several alternate stimulations (touches) around the mouth: the right corner of the lips, under the lower lip, the left corner of the lips, above the upper lip. The more time elapsed from feeding, the faster the response is. The tongue and lips move to the affected point, sometimes drawing the head into this movement. When the cardinal point reflex is absolutely correct, the newborn sucks and swallows well.
Automatic walking
The newborn is held by the trunk under the arms in an upright position. When the feet come into contact with the table (floor) surface, the corresponding limb is bent, and the other is straightened. From this alternate flexion and extension of the lower limbs, with a slight forward bend of the trunk, a movement resembling walking is obtained.
If all reflexes and reactions are exaggerated, absent or asymmetric, it is necessary to consult a neurologist.
Speech
The newborn may make a small amount of involuntary sounds, laryngeal or laryngeal, especially at night. He screams before feeding, but calms down after being fed. If the bell rings, the child calms down and becomes more attentive.
Social contact
A newborn's face is almost motionless (no facial expressions). At times, a smile "passes" over it for no apparent reason. Sometimes the child looks at the mother. Easily afraid of noise. Motor activity and "mass" movements are reduced if the child's attention is distracted. The baby calms down when he is taken in his arms, comforted when he hears a familiar voice, thanks to the warmth from contact with the mother's body or breastfeeding. When the child is calm, he rhythmically opens and closes his mouth.
Emotional behavior
7-10 days after birth, if the newborn is awake and calm, he seems attentive, lies with his eyes open; at times a “smile” appears.
Often, infants have severe problems with sucking, swallowing, they choke, often rest when they are fed and the feeding is delayed for 30-40 minutes, or even longer. Mothers explain this either by the haste of the baby or by the fact that there is a lot of milk.
But in fact, these violations are associated with discoordination of the work of individual muscles due to oxygen starvation (hypoxia) of the brain stem.
In conclusion, I want to draw a conclusion and summarize what has been written, drawing your attention to the fact that there are no trifles in the development of a child. Every little thing can indicate a developmental disorder.
What should alert the parents of a newborn:
- violation of muscle tone (it is very sluggish or, on the contrary, increased so that it is difficult to straighten the arms and legs);
- uneven movement of the limbs (one arm or leg is less active);
- trembling of arms or legs with or without crying;
- frequent regurgitation, choking when sucking;
- sleep disorders (the child screams, wakes up often);
- torticollis (the head is tilted to one side);
- poor support on the legs, clubfoot.
