Shaking in Newborns: When to Seek Pediatric Advice

Newborn generalized tremors?

Dear Doctor,
My baby is a twin born at 37 weeks.
Over the past week, my daughter has been experiencing noticeable tremors from her chin to her limbs and body while sleeping.
Even when I hold her, the shaking frequency remains high, causing her to frequently wake up and interrupt her sleep.
However, her sister does not have this issue, and she is actually lighter in weight.
Is there a problem with this? Thank you for taking the time to respond.

Hsiu-Hui, 30~39 year old female. Ask Date: 2004/10/04

Dr. Lin Wenxian reply Pediatrics

Director Lin Wen-Hsien of the Pediatrics Department at Tainan Hospital, Ministry of Health and Welfare, responds to Ms.
Hsiu-Hui:
Hello, Ms.
Hsiu-Hui.
The issue of body shaking in infants is a common concern among parents visiting pediatric clinics.
Typically, after a physician's examination, the response given to parents is that it is mostly normal.
There are two possibilities: one is the Moro reflex, and the other is known as jitteriness.
The Moro reflex appears after birth and usually disappears by around four months of age.
When there is a sudden noise or when the infant's position is changed, the infant may extend their arms in a hugging motion and may even shake.
This is a normal response; the absence of this reflex could indicate a problem.
Regarding the situation you described, it may be related to jitteriness, which is a normal phenomenon that can occur in infants, particularly in premature infants.
The shaking can involve the jaw, hands, or feet, occurring at a frequency of about 3 to 5 times per second or slightly more.
Physicians will differentiate this from abnormal seizures (convulsions).
Seizures are caused by abnormal electrical discharges in the brain, which would show abnormal results on an EEG, and they can lead to abnormal limb movements.

The differences between jitteriness and seizures include: jitteriness does not involve altered consciousness or abnormal eye movements.
Jitteriness is mostly symmetrical, and parents can stop the shaking by holding the infant's hands or feet or bending the shaking limbs.
In contrast, seizure-related limb movements often involve alternating flexion and extension at different speeds, unlike the symmetrical and equally paced movements of normal jitteriness.
Seizures in infants may also present with eye blinking, mouth chewing motions, and legs moving in a bicycling motion.
The situation you described may fall within the normal range of jitteriness.
However, if you suspect the presence of characteristics associated with seizures, it would be advisable to consult a pediatrician for further evaluation.
Wishing you good health and all the best from Tainan Hospital!

Reply Date: 2004/10/04

More Info

Understanding shaking or tremors in newborns can be a concerning issue for parents, especially when it involves twins, as in your case. It’s important to differentiate between normal developmental behaviors and potential medical concerns.
Firstly, it’s not uncommon for newborns to exhibit some degree of tremors or shaking, particularly during sleep. This can be due to several factors, including the immature nervous system, which is still developing in the early weeks of life. In many cases, these tremors are benign and may resolve as the baby matures. However, the fact that your daughter is experiencing noticeable shaking that disrupts her sleep warrants careful observation.

Here are some key points to consider regarding your daughter’s shaking:
1. Normal vs. Abnormal Tremors: Newborns may exhibit tremors when they are awake or asleep, especially during transitions between sleep states. These can be rhythmic and may involve the hands, arms, or legs. However, if the shaking is persistent, severe, or accompanied by other concerning symptoms (such as changes in feeding, lethargy, or unusual irritability), it may indicate a need for further evaluation.

2. Possible Causes: The shaking could be due to several factors, including:
- Physiological Tremors: These are common in newborns and usually resolve on their own.

- Hypoglycemia: Low blood sugar levels can cause shaking or jitteriness in infants.

- Neurological Issues: In rare cases, persistent shaking may indicate a neurological condition that requires medical attention.

3. When to Seek Help: It’s advisable to consult your pediatrician if:
- The shaking persists or worsens over time.

- Your daughter shows signs of distress or discomfort during these episodes.

- There are any accompanying symptoms such as feeding difficulties, unusual lethargy, or developmental delays.

4. Monitoring and Documentation: Keep a record of the shaking episodes, including their frequency, duration, and any associated behaviors. This information can be very helpful for your pediatrician in making an accurate assessment.

5. Differential Assessment: Since you mentioned that your other twin does not exhibit these symptoms, it’s essential to assess whether there are any differences in their health, feeding patterns, or environmental factors that could contribute to this issue.
In conclusion, while some degree of shaking can be normal in newborns, the specific circumstances you describe—particularly the frequency and impact on sleep—suggest that it would be prudent to seek pediatric advice. Your pediatrician can perform a thorough evaluation to rule out any underlying issues and provide you with peace of mind. Early intervention is key in addressing any potential concerns, so don’t hesitate to reach out for professional guidance.
Remember, as a parent, your observations and instincts are invaluable. If something doesn’t seem right, it’s always best to consult with a healthcare professional.

Similar Q&A

Understanding Hand Tremors in Premature Infants: What Parents Should Know

Dear Dr. Pei, My child was born prematurely, two months early, on June 6, 2017. As of today, the corrected age is 6 months and 20 days. In the past month, I have noticed that my child's hands are shaking involuntarily, with the left hand shaking more noticeably than the rig...

Dr. Pei Rensheng reply Pediatrics
Hello, Neurodevelopmental disorders in premature infants primarily arise from two categories: 1. Intraventricular Hemorrhage (IVH): Intraventricular hemorrhage is a specific type of brain hemorrhage that occurs in premature infants. The incidence increases as the birth we...

Understanding Shaking in Infants: When to Seek Medical Advice

Hello, doctor. I have a question about my baby who is almost 6 months old. When he drinks milk until he falls asleep, he suddenly starts to tremble and shake all over, but he continues to drink. Even when I call him or touch him, he still trembles and shakes until he finishes the...

Dr. Xiao Kaiwen reply Pediatrics
It seems to be an unusual movement; it is recommended to visit a major hospital's pediatric neurology department for an evaluation to determine if any tests, such as an electroencephalogram (EEG), are necessary.

Understanding Infant Head Shaking: Causes and Concerns for Parents

Hello Doctor: My child is about 5 months old, and I sometimes notice that when he is awake, he unconsciously shakes his head from side to side for about 2 to 3 seconds. What could be the reason for this? Have you encountered this in your clinical practice? Thank you for your resp...

Dr. Xiao Kaiwen reply Pediatrics
As infants grow and undergo neurological development, they often exhibit many behaviors that may seem strange to adults. Many of these are merely temporary phenomena related to the maturation of the nervous system and can be considered normal; however, not everyone will exhibit t...

Understanding Pediatric Neurological Concerns: When to Seek Help

My eldest child is 8 years old and has Asperger's syndrome. He was delivered via vacuum extraction at 42 weeks. During his crawling phase, he exhibited head-banging behavior. Before he turned one, he experienced tremors in his hands while breastfeeding, where he would grab a...

Dr. Xie Degui reply Pediatrics
1. It is recommended to undergo an early developmental delay assessment, which can be done at our hospital's pediatric neurology clinic with Dr. Bao-Ling Chang on Thursday afternoons. 2. Based on the described symptoms, they appear to be indicative of epilepsy. An evaluatio...