Shoulder Shrugging in 7-Month-Old Babies: When to Worry

A 7-month-old baby may shrug their shoulders?

Recently, I noticed that my 7-month-old baby occasionally shrugs her shoulders, sometimes on one side and other times on both sides, but mostly it's one-sided.
This happens when she wakes up, during meals, or while playing, but it only lasts for about 1-2 times and then stops.
She doesn't pause her movements when shrugging (for example, she might shrug while crawling), and the frequency is not very regular.
I found some information online about myoclonic seizures, which has made me a bit worried...
However, her gaze seems normal when she shrugs, and there are no other signs of abnormality.
Currently, her overall development is normal, and she is even ahead in some areas; she looks at me and calls "mama," and she can pull herself up to stand.
I would like to ask if there is something wrong with my baby? Does she need further testing, such as an EEG? (Or could it be Tourette syndrome?) Thank you, doctor.

Momo, 30~39 year old female. Ask Date: 2020/09/12

Dr. Pei Rensheng reply Pediatrics

Hello,
1.
Your baby seems to exhibit habitual movements.

2.
Tourette syndrome typically occurs from preschool age to pre-adolescence, with very few cases presenting before the age of one.

3.
Infantile spasms often accompany global developmental delay and usually appear between 3 months and 1 year of age, with a higher prevalence in males than females.

You may record the movements and share the video with your physician for evaluation to determine if an electroencephalogram (EEG) is necessary.

Wishing you health, happiness, and safety!
Sincerely,
Dr.
Ren-Sheng Pei
Attending Physician, Pediatrics
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2020/09/12

More Info

When it comes to observing unusual movements in infants, such as shoulder shrugging in a 7-month-old baby, it is essential to approach the situation with both caution and understanding. The behavior you've described—occasional shoulder shrugging, sometimes unilateral and sometimes bilateral, occurring sporadically during activities like waking up, eating, or playing—can be concerning for parents, especially when they research potential causes online.

Firstly, it’s important to note that infants often engage in various movements that can seem unusual but are typically part of their normal development. At 7 months, babies are exploring their bodies and experimenting with movements as they develop motor skills. Shoulder shrugging can sometimes be a reflexive action or a way for the baby to express excitement or discomfort. In many cases, these movements are benign and do not indicate a serious underlying condition.

Regarding your concerns about conditions like infantile spasms (also known as infantile myoclonic seizures) or Tourette syndrome, it’s crucial to understand the context and characteristics of these conditions. Infantile spasms usually present as sudden, brief contractions of the body, often accompanied by developmental delays or other neurological signs. If your baby is meeting developmental milestones, such as responding to her name, attempting to stand, and engaging with caregivers, it is less likely that her shoulder shrugging is indicative of a seizure disorder.

Tourette syndrome, on the other hand, typically manifests later in childhood, usually between the ages of 5 and 10, and is characterized by repetitive, involuntary movements and vocalizations. It is extremely rare for symptoms to appear in infants under the age of one. Therefore, the likelihood that your baby is exhibiting signs of Tourette syndrome is very low.

Given that your baby’s eye contact and overall demeanor appear normal during these episodes, and she does not seem distressed or stop her activities when shrugging her shoulders, it is likely that this behavior is not a cause for alarm. However, it is always wise to keep an eye on any changes in behavior or new symptoms that may arise.

If you are still concerned, especially if the shoulder shrugging becomes more frequent, is accompanied by other unusual behaviors, or if you notice any changes in her development, it would be prudent to consult a pediatrician. They may recommend a neurological evaluation or an EEG (electroencephalogram) to rule out any seizure activity if deemed necessary. Keeping a video record of the behavior can also be helpful for the doctor to assess the situation more accurately.

In summary, while it is natural to worry about your child’s health and development, the shoulder shrugging you’ve described does not appear to be a cause for immediate concern based on the information provided. Monitoring her behavior and consulting with a healthcare professional if you have ongoing concerns is the best course of action. Remember, every child develops at their own pace, and variations in movement can be part of that journey.

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