Tremors and Developmental Concerns in Infants

When children exert themselves, their hands and feet may tremble?

Hello, doctor.
My children are twins.
One was born at 37 weeks and 2 days, weighing 1750 grams and measuring 48 cm.
Now, almost 1 year old, he is 67 cm tall and weighs 6.5 kg.
He is currently 11 months old and will turn 1 next month.
He eats about 3 to 4 servings of porridge a day, and his milk intake is below 120 ml.
Around 6 to 7 months old, whenever he exerts himself, his hands and feet tremble continuously, resembling the tremors of someone with alcohol withdrawal.
Is his development normal?
The other twin was born weighing 1830 grams and measuring 47 cm.
Now, he is 70 cm tall and weighs 7.5 kg, with a milk intake of about 180 to 120 ml.
His issues are more concerning.
Around 7 months old, he would scream inexplicably.
Currently, when I call him over or ask for a hug, he doesn't respond much.
Sometimes, he avoids eye contact or turns his head down.
However, in noisy environments, he screams continuously.
He previously passed a hearing test and enjoys banging his head.
Whenever we are out of his sight, he cries and fusses, needing to be held by an adult.
Are their behaviors and development normal? A worried mother.

jose, 20~29 year old female. Ask Date: 2010/09/25

Dr. Xiao Kaiwen reply Pediatrics

At 11 months old, if a child is exerting effort but their hands and feet continue to shake uncontrollably, this is not normal.
It is also important to rule out the possibility of muscle spasms.
The behaviors and developmental milestones of both children show abnormal phenomena, so it is recommended to consult a pediatric neurologist for evaluation.

Reply Date: 2010/09/25

More Info

Understanding developmental concerns in infants, especially in the context of twins, is crucial for parents and caregivers. Your concerns about your children’s growth and behavior are valid, and it’s important to approach these issues with a comprehensive understanding of developmental milestones and potential underlying conditions.

Firstly, let’s address the growth parameters of your twins. The weight and height of your children, particularly the one weighing 6.5 kg at nearly one year, are below the average growth percentiles for their age. According to the World Health Organization (WHO) growth standards, a child at this age should typically weigh between 8 to 10 kg. It’s essential to monitor their growth closely and consult with a pediatrician to rule out any nutritional deficiencies or underlying health issues that may be affecting their growth.

Regarding the tremors you mentioned, it’s not uncommon for infants to exhibit some degree of tremor, especially when they are exerting themselves or are excited. However, persistent or pronounced tremors can be indicative of neurological issues, and it’s essential to have this evaluated by a pediatric neurologist. Tremors can arise from various causes, including benign conditions, but they can also signal more serious concerns such as cerebral palsy or other neurological disorders.

For the second twin, the behaviors you described—such as the lack of response to social cues, avoidance of eye contact, and the tendency to scream in certain situations—are particularly concerning. These behaviors could be indicative of developmental delays or disorders, including autism spectrum disorder (ASD). Children with ASD often exhibit difficulties in social interaction, communication challenges, and repetitive behaviors. The fact that he enjoys hitting his head and cries when not in sight of an adult may suggest a need for sensory stimulation or comfort, which is common in children with sensory processing issues.

It’s also important to note that while hearing tests have shown normal results, children can still have difficulties with social communication and interaction that are not related to hearing. The behaviors you describe warrant a thorough developmental assessment. Early intervention is key in addressing developmental concerns, and the sooner you seek help, the better the outcomes can be for your children.

In terms of developmental milestones, by the age of one, children should typically be able to:
1. Respond to their name.

2. Make eye contact and engage with caregivers.

3. Show interest in social interactions.

4. Begin to understand simple commands.

5. Exhibit a range of emotions.

If your children are not meeting these milestones, it is crucial to consult with a pediatrician or a child development specialist. They can provide a comprehensive evaluation and recommend appropriate interventions, which may include physical therapy, occupational therapy, or speech therapy, depending on the specific needs of your children.

In conclusion, while some variations in development are normal, the concerns you have raised about your twins' growth and behavior should not be overlooked. It is essential to seek professional guidance to ensure that they receive the support they need for healthy development. Early intervention can significantly improve outcomes for children with developmental concerns, so do not hesitate to reach out to healthcare professionals for assistance.

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