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THE PROFESSIONAL Dear Etty: This might sound like a silly question, but what does 'hypotonia' mean. I know that children with Down syndrome are considered 'floppy', but I still don't understand and am embarrassed, after three years, to ask my therapists. Malky T. Brooklyn, NY Dear Malky: I think your question is great and I'll try to explain 'hypotonia' without getting too technical. Muscle tone refers to the amount of tension or resistance to movement in a muscle. Muscle tone is what enables us to keep our bodies in a certain position or posture. Changes in muscle tone is what enables us to move. For example, to bend your arm to bring your hand up to your face, you shorten the biceps muscles, increasing its tone, and lengthen the triceps muscle, decreasing its tone. To complete a movement smoothly, the tone in all muscle groups involved must be balanced. The brain must also send messages to each muscle group to actively change its resistance. Children with decreased tone are said to have hypotonia, or floppiness. When your child has low muscle tone he will have trouble maintaining positions without support because his muscles do not contract enough and are too relaxed. I hope this clarifies things for you. Dear Etty: Is there any benefit to breastfeeding, as opposed to bottle-feeding my baby? I find it stressful but would persist if it were especially beneficial for my child with Down syndrome. Mrs. G. Chicago, IL Dear Mrs. G: The following are benefits that are especially helpful for your child: * Claims have been made that breastfeeding increases the chance of improving a child's IQ (to date there is no proof substantiating this fact) * Nursing your baby will also encourage a preferred oral motor posture for sucking, minimizing a tongue thrust * Substantial savings monetarily * Antibodies unique to your child's needs Having in mind these benefits, you must also take into account your feelings. If it is difficult or you feel anxious or depressed, understand that these negatives far outweigh the positives. You must be a happy and loving mother first and foremost. Dear Etty: Now that our son is walking, does he still need physical therapy? He is 22 months old. Rabbi and Mrs. S. Monsey, NY Dear Rabbi and Mrs. S: The question is not if he is walking, but rather, how he is walking? If he can go up and down steps smoothly, negotiate obstacles and is walking with a nice, narrow base of support, it is possible he may no longer need PT. But if this is not so, then beyond the walking there is still much to address. In order that the child be able to accomplish the already mentioned skills, he will need good motor planning, good balance, good weight shifting and lots of confidence. Therapy should continue if these skills are needed, challenging him in all sorts of standing and walking postures, i.e. balance board, balance beam and obstacle courses. Use your experience and the advice of the therapist to come to a decision as to whether to continue PT or not. As a general rule, any child with a diagnosis expected to affect gross motor skills, such as Down syndrome, can benefit from PT and is not likely to be discharged before age 3. |