Clinical features

Clinical features include:

• posture - a frog's-leg position
• on handling the baby tends to slip through the fingers. During a baby check a normal baby should be able to support itself briefly by gripping its arms on the examiners fingers held under the armpits.
• an alert baby implies that a central cause is unlikely

In the acute setting, features of sepsis such as irritability and poor handling should be sought.

The most important distinction to make is between a paralytic and non-paralytic cause. A useful discriminating clinical test is to hold the baby in a ventral position; a baby with a paralytic cause of floppiness shows much less movement than a baby with non-paralytic floppiness.

The baby should be carefully examined for any dysmorphology.