Babies can exhibit behaviors that cause parents to wonder, “Is this normal?” For example, when a seven month old coughs then smiles upon receiving the parent’s attention, the baby is clearly not choking or ill. These kinds of movements or sounds are often a way that babies imitate others.
When a baby is rolling eyes, this is one such behavior that causes parents to question if it is normal or a sign of a problem. Here, we will distinguish normal versus worrisome eye movements.
My 6-month-old son just started rolling his eyes up in the back of his head yesterday. It looks scary and I don’t know if something is wrong. I have never seen him do it before and he had done it at least ten times yesterday and 4 times already today.
Please help, I’m scared that something is wrong.
Easy Baby Life:
Baby Is Rolling Eyes – Possible Causes and What Parents Should Do
Normal Eye Movements in Babies and Eye-Rolling Without Concern
At birth, infant visual acuity is quite limited. Babies can detect movement, shapes, and patterns, but cannot see clearly. Instead of 20/20 vision, newborns see in the range of 20/200 to 20/400 (source). Because of this, the eyes may occasionally converge and appear to lose focus. These newborn eye-rolling and other eye movements are expected and completely normal. It is also considered normal if your newborn baby is rolling eyes upwards when sleepy.
As vision gradually improves over the first few months of life, parents should notice that their infant begins to make eye contact and follow objects moved across the line of vision.
By six months old, infants have better distance vision and can detect colors (source). They effortlessly focus and follow objects, and eye movements are well coordinated. By this time, the newborn eye-rolling should have disappeared.
In addition, infants begin to learn new eye movements from interactions with others such as blinking, and, yes, situational eye-rolling:
1. Rolling Eyes Because He Can
I can truly understand that you are worried if your baby has just started rolling his eyes. However, keep in mind that babies can do all sorts of strange things just because they’ve figured out how to do it.
One of my children stuck their hands so deep into their mouths that they choked, etc… My youngest kept poaching his eyes with his fingers…
Chances are that your baby is just rolling his eyes because he can! He might be trying to mimic people around him or he enjoys the attention he gets when rolling his eyes.
2. Being Sleepy
Prior to sleeping, eye-rolling can appear along with tired, droopy eyes.
3. Anger and Frustration
Some very expressive infants can roll their eyes while giving a frown or a look of displeasure.
Just like babies can do odd things basically because they have figured out how, they sometimes also use these types of behaviors to soothe their own anger. Here is a Q&A with a toddler that both rolls eyes and throws tantrums.
Other common behaviors related to anger are to bang their heads against the floor or hit themselves.
The key thing to remember in all of these scenarios of situational eye-rolling is that the eye movements are coordinated and purposeful.
Causes of Abnormal Eye Movements in Babies
There are some situations, however, where eye-rolling is a sign of a medical problem. Any rolling of the eyes that is associated with decreased or loss of consciousness warrants immediate evaluation. Other abnormal eye movements may indicate a specific eye problem.
This eye condition is characterized by “back and forth” motions of the eyes. It may be apparent as early as six weeks of age, or develop at six months when vision should begin to normalize (source). Nystagmus occurs because of a nerve signal “block” between the eye and the visual cortex of the brain. Congenital cataracts, for example, can cause this problem.
In this situation, one eye drifts or rolls in a different direction than the other. It is usually due to a problem with one or more of the extra-ocular muscles. The affected eye is commonly referred to as a “lazy eye”. The types of strabismus include those where an eye drifts either toward or away from the nasal bridge (source).
Infant Eye-Rolling due to Seizures
If eye-rolling occurs along with a change in behavior or unusual body movements, it is likely a sign of a seizure. There are several scenarios where such abnormal eye movements may occur.
1. Febrile Seizures
The most benign seizure type is one that is solely caused by a fever. When the body temperature rapidly increases, it triggers a brief episode of eye-rolling, full-body shaking, and a loss of consciousness. These seizures commonly occur during mild viral infections from ages six months to five years old (source). Although febrile seizures are quite alarming, they do not cause damage to the brain or impair cognitive development.
Severe bacterial or viral infections can irritate the brain and its surrounding tissues. Such illnesses can promote seizures that present as eye-rolling and body stiffness or jerking. These infants appear very ill, exhibiting low or high body temperatures, bulging of the fontanelle, and decreased responsiveness (source). They require hospitalization for intravenous seizure medication and antibiotics or anti-viral medications. After the infection has resolved, these infants require follow-up with a neurologist to monitor for persistent seizures and developmental deficits.
3. Infantile Spasms (West Syndrome)
The first signs of this type of seizure may be a repetitive rolling upward of the eyes. Along with these are brief episodes of the head dropping with jerking of the arms and legs. Infantile spasms are caused by some sort of brain abnormality and warrant evaluation by a neurologist. You can read more about infantile spasms here at Epilepsy.com
4. Juvenile Myoclonic Spasms
This type of seizure is characterized by rapid blinking or upward rolling of the eyes. A variety of body jerking movements is possible during the episodes. Although the onset of these seizures is typically around puberty, it is possible to develop them at a younger age (source).
5. Electrolyte Abnormalities
The kidneys of infants do not fully mature until around six months old. Prior to this age, infants are prone to electrolyte abnormalities if given inappropriate fluids. For infants who formula fed, it is very important that the formula be prepared according to the package instructions. If not, low blood sodium or glucose could trigger a seizure (source).
For this same reason, it is not recommended to give water to an infant during the first six months of life. Similarly, ingestion of excessive amounts of water can cause electrolyte imbalances. For this reason, swimming lessons are to be used with caution according to the American Academy of Pediatrics until the age of 12 months (source).
Additional medical reasons and conditions
A baby may be rolling eyes due to head injuries, low blood sugar, or hypoglycemia.
If your baby has recently fallen and he is now rolling eyes, you should take him or her to the ER immediately. You can find more warning signs after a fall here.
This video shows an example of paroxysmal tonic upgaze – is it similar to what your baby is doing?
What to Do if Your Baby is Rolling Eyes
As a parent, seeing your baby roll his or her eyes may create feelings of worry and concern. The best thing to do is to consult your healthcare provider. Taking a video of the episodes is helpful since they may not occur during the office visit.
While waiting for the doctor’s appointment, take notes of both how often and when the rolling occurs (before sleep, after sleep, while eating et cetera), as well as of any other signs of illness.
If, however, your infant is less playful, seems excessively sleepy, and is not feeding well following an episode of eye-rolling, you should contact emergency services.
I really hope your baby is well. Good luck!
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