Baby shivering while feeding

Newborn Reflexes and Behavior

Is this your child's symptom?

  • Normal reflexes, noises and behavior questions in newborns
  • These are normal and not signs of illness
  • Flying and mountain travel with newborns is also covered

Newborn Reflexes - Topics Covered

These harmless behaviors fall into 11 general groups. If your baby is healthy, skip the "What to Do" section. Go directly to the topic number that relates to your question for advice.

  1. Normal primitive reflexes from immature nervous system
  2. Normal jitteriness when crying
  3. Normal sleep movements
  4. Normal breathing sounds and noises
  5. Normal irregular breathing patterns
  6. Normal GI sounds and noises
  7. Normal sleep sounds and noises
  8. Normal feeding reflexes
  9. Normal protective reflexes
  10. Flying with newborns, safety of
  11. Mountain travel with newborns, safety of

When to Call for Newborn Reflexes and Behavior

Call 911 Now

  • Can't wake up
  • Not moving or very weak
  • Weak or absent cry and new onset
  • Severe trouble breathing (struggling for each breath)
  • New moaning or grunting noises with each breath
  • Bluish (or gray) lips, tongue or face now
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Age less than 1 month old and looks or acts abnormal in any way. Examples are a poor suck or poor color.
  • Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
  • Breathing stopped for more than 10 seconds and now it's normal
  • Trouble breathing, but not severe
  • Seizure suspected
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Normal newborn reflexes and behavior
  • Flying or mountain travel with a newborn

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

  • Bellevue
  • Everett
  • Federal Way
  • Seattle

Care Advice for Newborn Reflexes and Behavior

  1. Normal Primitive Reflexes From Immature Nervous System:
    • Startle Reflex (Moro or embrace reflex). Brief stiffening of the body, straightening of arms and opening of hands. Follows noise or abrupt movements. Frequent at birth. Slowly resolves by 4 months of age.
    • Tonic-Neck Reflex (Fencer's Reflex). When head is turned to 1 side, the arm and leg on that side straightens. The opposite arm and leg flexes. Goes away by 4 months of age.
    • Chin Trembling
    • Lower Lip Quivering
    • Jitters or Trembling (see Topic 2)
  2. Normal Jitters or Trembling when Crying:
    • Jitters or trembling of the arms and legs during crying is normal in newborns. It should stop by 1 to 2 months of age.
    • If your baby is jittery when not crying, it could be abnormal. Give her something to suck on. (Reason: Normal trembling should stop with sucking.)
    • Seizures are rare. During seizures, newborns are more than jittery. They have muscle jerking and blinking of the eyes. Babies can also make sucking movements of the mouth. They don't cry during seizures.
    • Call Your Doctor If:
    • The jitters get worse
    • The jitters occur when your baby is calm
  3. Normal Sleep Movements:
    • Sleep is not quiet. Expect some of the following:
    • Sudden jerks or twitches of the arms, hands or legs. If they only occur during sleep, they are most likely normal.
    • How Long: last a few seconds, but can recur
    • Timing: soon after falling asleep
    • Normal at all ages, not just in newborns
    • Suspect a seizure if: jerking occurs when awake or lasts more than 10 seconds
  4. Normal Breathing Sounds and Noises:
    • Throat Noises. Caused by air passing through normal saliva or refluxed milk. These gurgling noises are likely to build up during sleep. Slowly, the newborn learns to swallow more often.
    • Nasal Noises are usually caused by dried mucus in the nose. Your baby most likely doesn't have a cold. A blocked or stuffy nose can interfere with feeding. This is because your baby can't breathe when the mouth is closed with feeding. Therefore, babies need help opening the nasal passages.
    • Nasal Saline. Clean out the nose with saline (salt water) nose drops (such as store brand). If not available, can use bottled water. Use 1 drop at a time and do 1 side at a time. Repeat this several times. This will loosen up the dried mucus. Then, it can be sneezed out or swallowed. If needed, use a suction bulb. Avoid Q-tips which can injure the lining of the nose. Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
    • Tobacco Smoke. Avoid tobacco smoke which can cause nasal congestion or sneezing. Avoid dust or any strong odors for the same reason.
    • Call Your Doctor If:
    • Nasal washes don't work
    • Breathing becomes hard
  5. Normal Irregular Breathing Patterns:
    • Transient Breathing Pauses of Less Than 10 Seconds. Also Called Periodic Breathing. Often, the pause is followed by some faster breathing to "catch-up." These breathing pauses are normal if the baby is comfortable during them. A normal rate should be less than 60 breaths per minute. Usually resolves by 1 month of age. Call your doctor if: Your baby is breathing fast or turned blue.
    • Transient Rapid Breathing. Sometimes, newborns take rapid, progressively deeper breaths. This is so they can expand their lungs all the way. This is normal if the breathing slows to normal within a minute or so.
    • Seesaw Breathing. With breathing, the chest seems to contract when the stomach expands. The cause is the soft rib cage of some newborns. It tends to pull in during normal downward movement of the diaphragm.
    • Yawning or Sighing (off and on) to open up the lungs
    • Call Your Doctor If:
    • Breathing becomes hard
    • Breathing pauses last more than 10 seconds
    • You have other questions or concerns
  6. Normal GI Sounds And Noises:
    • Belching air from stomach
    • Passing gas per rectum
    • Note: Both of these are releasing swallowed air. They are normal, harmless and lifelong. They do not cause pain or crying.
    • Gurgling or growling noises from the movement of food through the intestines
    • Normal grunting with pushing out stools
    • Hiccups. Hiccups are often caused by overeating. They can also be from a little acid irritating the lower esophagus. Give your baby a few swallows of water to rinse off the lower esophagus.
  7. Normal Sleep Sounds And Noises: Normal sleep is not motionless or quiet. Expect some of the following:
    • Moving during sleep transitions
    • Occasional startle reflex or jerks
    • Breathing noises - especially gurgling from secretions that sit in the throat.
    • During light sleep, babies can normally whimper, cry, groan or make other strange noises.
    • Parents who use a nursery monitor often become concerned about these normal sleep sounds.
    • GI tract noises from normal movement of digested food
  8. Normal Feeding Reflexes:
    • Rooting Reflex. When the side of the mouth or cheek is touched, your baby turns to that side. He will open his mouth in preparation for nursing. Present until 6 months of age.
    • Sucking Reflex. Will suck on anything placed in the mouth. This survival reflex does not imply hunger. It is even present right after a feeding. This reflex fades between 6 and 12 months of age.
  9. Normal Protective Reflexes:
    • Sneezing To Clear Nose of Any Irritant. Sneezing helps to open the nose. It's usually caused by dust, fuzz, tobacco smoke or other strong odors. If sneezing becomes frequent, use nasal washes. This is not caused by an allergy.
    • Coughing to clear lower airway
    • Blinking. After spending 9 months in darkness, newborns have light-sensitive eyes. At first, they prefer to keep their eyes closed. They blink often with light exposure.
  10. Flying With Newborns:
    • Never fly during the first 7 days of life. If flying is needed, it's safe to fly after 7 days of age.
    • If your newborn is not healthy, do not fly. Your child's doctor should give medical clearance first before flying.
    • Your baby can be exposed to infections aboard aircraft. Therefore, it is preferable not to fly before 2 or 3 months of age.
  11. Mountain Travel With Newborns:
    • Avoid mountain travel above 8,000 feet (2,438 meters) for the first month of life. (Exception: family lives there year-round)
    • Travel to destinations below 8,000 (2,438 meters) feet is safe.
    • Brief drives over higher mountain passes are safe.
    • If your newborn is not healthy, don't travel above 8,000 feet (2,438 meters). Your child's doctor should give medical clearance first.
  12. Call Your Doctor If:
    • Your baby starts to look or act abnormal in any way
    • You think your child needs to be seen

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/31/2022

Last Revised: 01/13/2022

Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.

Why Do They Do This?

Baby Shakes Head: Why Do They Do This?

Medically reviewed by Karen Gill, M.D. — By Kristeen Cherney on March 10, 2016


Over the course of their first year of life, your baby will reach various milestones related to reflexes and motor skills.

When a baby starts shaking their head, you may be concerned that something is wrong. You might even wonder if your baby is too young to be shaking their head.

Some cases of head shaking are related to neurological or developmental disorders. However, the majority of cases are normal.

Learn why your baby shakes their head and the types of scenarios you should be worried about.

Understanding baby’s motor skills

As a parent, it’s normal to experience protective instincts. After all, your newborn is delicate and unable to defend themselves.

Still, this doesn’t mean that your baby can’t move on their own. According to the March of Dimes, by the end of the first month of life, babies have the ability to move their heads from side to side. This most often occurs when they lie on their sides.

After the first month, head shaking in babies is most often accompanied by playfulness as well as other forms of interaction. Babies who develop “normally” will be able to shake their heads “yes” or “no” by their first year.

During the first few weeks of life, your baby’s movements might be more “jerky” as they develop muscle control.

Shaking head when nursing

One of the first times babies shake their heads is when they nurse from their mothers. This may first occur out of your baby’s attempt to try to latch. As your baby gets the hang of latching on, the shaking may then be a result of excitement.

While your baby might be gaining neck muscles and is able to shake side to side when nursing, you should still support their head for at least the first three months.

You may also find feeding times to be more successful by calming down your newborn’s reflexes so they can latch on more easily.

Shaking head when playing

Beyond the first month, babies might start shaking their heads while playing. In some cases, they might even move their heads around when resting on their tummies or their backs. You may notice that head shaking increases when your baby gets excited.

As your baby grows, they will start to notice behaviors of others and try to interact with them. If you have other children at home, your baby might start to imitate their behaviors through head and hand gestures.

Testing movement

Babies are extremely brave, and they will start to test how much they can move. At around the 4- or 5-month mark, some babies will start rocking their heads. This may move onto rocking the whole body.

While the rocking movements can look scary, it’s considered normal behavior in most babies. In fact, it’s often a precursor to your baby figuring out how to sit up on their own. Rocking and shaking behaviors usually last for no longer than 15 minutes in this age group.

Another cause of worry in many parents is head banging.

According to the American Academy of Pediatrics, this practice is more common in boys. It also starts around 6 months of age. As long as the banging is not hard and your baby seems happy, most pediatricians don’t worry about this behavior.

Head banging usually stops by the 2-year mark.

When to worry

Head shaking and other related behaviors are often considered a normal part of a baby’s development. However, there are instances in which the behaviors might extend beyond simple shaking. Call your pediatrician if your baby:

  • doesn’t interact with you or their siblings
  • doesn’t move their eyes normally
  • develops knots or bald spots from head banging
  • shaking increases during moments of anxiety
  • seems like they want to hurt themselves
  • fails to reach other developmental milestones outlined by your doctor
  • doesn’t respond to your voice, as well as other sounds
  • continues these behaviors beyond 2 years of age

The takeaway

While head shaking is not usually a cause for concern, there are some instances in which you should consider talking to your pediatrician.

Frequency is often a telltale sign of whether the shaking is normal or not. If you find that your baby shakes their head a little during feedings or playtime, this is likely not a medical emergency.

On the other hand, if the head shaking is frequent and lasts for a long time, you should see a doctor right away.

Last medically reviewed on March 10, 2016

  • Parenthood
  • Baby
  • 06 Months 1 Year

How we vetted this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Developmental milestones for baby. (2012, June)
  • Guide to your child’s symptoms: Rocking/Head banging. (2001)
  • Movement: Birth to three months. (2009, August 1)
  • Repetitive behaviors in blind children (2015)
  • Wiessinger, D. (2004, February). The world of latch-on: One leader’s journey. LEAVEN 40(1), 3-6

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Mar 10, 2016


Kristeen Cherney, PhD

Edited By

Nizam Khan (TechSpace)

Medically Reviewed By

Karen Richardson Gill, MD

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Medically reviewed by Karen Gill, M.D. — By Kristeen Cherney on March 10, 2016

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Understanding tongue movement in infants

2 min.

Sept. 2021

This resource is for healthcare professionals

Researchers have used video recording for the first time to see differences in tongue movements between breastfed infants and adults when swallowing.

The tongue is an active muscle and a miracle of coordination. When we drink, the tongue prepares for swallowing by collecting liquid in the mouth, taking the shape of a bowl. It then quickly pushes the liquid back where it is swallowed, while still allowing us to continue breathing.

When we eat, the tongue works by holding the food in the mouth, moving it with saliva and turning it into a lump, which is then pushed back for swallowing. Both adults and infants use a peristaltic type of movement when swallowing.

Language training before birth

Teaching our tongue to do all this work begins in the womb. Before birth, the tongue begins to work by swallowing the amniotic fluid. After the birth of a child, the tongue plays a key role - it helps to squeeze milk out of the mother's breasts, working in conjunction with the jaws and lips.

When the baby is suckled to the mother's breast, the nipple and areola are retracted into the mouth so that the nipple reaches the junction of the hard and soft palate. After the baby has sucked well, the tongue begins to work, rhythmically squeezing the nipple with peristaltic movements that squeeze the milk from the mammary gland into the back of the throat, where it is swallowed. Babies naturally coordinate sucking, swallowing, and breathing.

Bottle feeding

This process changes slightly when a baby is bottle fed. The stiffness of the artificial material does not allow the nipple to stretch and take the shape of the baby's mouth. Peristaltic movements of the tongue are difficult and milk can flow almost without effort on the part of the child.

Parents should remember that during breastfeeding, babies make an effort to get milk. When bottle-feeding, milk often flows very easily and babies can drink the same amount of milk much faster (compared to breastfeeding). This may seem like a good way to save time, but as with many other things in life, slower is often better. If you choose a bottle that works more like a breast, with a slower flow, it allows the baby to stop and pause, the baby enjoys comfortable feeding, and the corresponding satiety signals are developed more slowly.

Research task

Usually everything goes smoothly. But from time to time, babies have difficulty swallowing. This may be due to various problems and they are not always easy to learn and understand.

At the beginning of the atomic era, diagnostics were carried out with the help of X-ray cinematography (filming of X-ray images). For the first time in history, people could see the amazing internal processes in the mouth and observe how the tongue helps to swallow. When concerns arose about the effects of radiation on technicians and patients, the practice was discontinued. Currently, video recording using ultrasound and MRI is often used. However, even with the use of less invasive methods or technologies, scientists still have to find ways to study babies while breastfeeding that do not affect their actions.

Tongue Movement Study

The 2020 study "Quantifying Tongue Movement During Feeding in Infants and Swallowing in Adults" shows patterns. The scientists used ultrasound video to study tongue movements.

“We observed the most organized and rhythmic tongue movements in exclusively breastfed infants, less mobility in those who had conditions that interfere with normal feeding, such as tongue tie, and more “disorganized” movements with bottle feeding than breastfeeding,” the researchers report. “This highlights the key role of tongue movements in breast or bottle sucking.”

Disorganized movements with bottle feeding than with breastfeeding,” researchers report. “This highlights the key role of tongue movements in breast or bottle sucking.” They could also observe differences in tongue mobility before and after treatment in infants with tongue and lip frenulum. And for the first time, pictures of a baby with torticollis during breastfeeding and bottle feeding were obtained. The results showed "slightly less rhythmic sucking than usual during breastfeeding and irregular sucking during bottle feeding."

Although this study was limited, the use of ultrasound video was effective in obtaining objective information about tongue movements. As more scientists use this technique, we'll get more information about how language works and we'll be able to get more accurate information about natural feeding and how to deal with it.

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Genna CW, Saperstein Y, Siegel SA, Laine AF, Elad D. Quantitative imaging of tongue kinematics during infant feeding and adult swallowing reveals highly conserved patterns. Physiol Rep. 2021;9:e14685.

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Peculiarities of infant development

All parents are anxious about the health of their baby. They are especially attentive to the child in the first weeks and months. after his birth: is everything all right with your beloved baby? If the child is the first, then moms and dads may not know about some of his features. development, and sometimes they are surprised or even frightened by the most ordinary phenomena. What worries young parents most often?

The child's arms and legs are tense all the time. Maybe it's hypertension and you need to start some kind of treatment?

One from the manifestations of physiological hypertonicity - incomplete breeding of the hips in the baby. This condition can be up to 4-6 months, after this period, the legs of the crumbs should be bred. If this does not happen, it is necessary to show the child to the doctor, since the difficulty dilution in the hips can be a sign of pathology of the hip joints

Yes, this is hypertonicity - an increased tone of the flexor muscles, but this is a completely normal phenomenon, which exists up to a certain age in all babies. If you look at a newborn, you can see that his arms are bent in all joints, to the body and pressed to the chest, the hands are clenched into fists, the thumbs of the hands lie under the four the rest. The legs of the baby are also bent at the joints and abducted at the hips, dorsiflexion predominates in the feet. Muscle tone usually higher in the arms than in the legs. Attentive parents will see that muscle tone can change, for example, when turning head to the side, it is higher on the side opposite to the turn of the head. Changing tone in the same muscle group called muscular dystonia - this name of mom and dad is often heard at a neurologist's appointment, but you should not be afraid of this, it also quite common in infants. By 3.5–4 months, physiological hypertonicity in children weakens, movements become more coordinated, the hand opens, so-called locomotions develop - body movements in which almost all muscle groups are involved. It is not necessary to treat physiological hypertension, but it can be done general strengthening massage, it will contribute to the development of the muscular system and coordination of movements.

The baby constantly makes some movements, they are very chaotic. Why is this happening?

A newborn baby's nervous system is still immature, which is why he cannot make coordinated movements. nervous the baby's fibers are just beginning to be covered with a special myelin sheath, which is responsible for the speed of transmission of the nerve impulse to muscles. The faster the transfer occurs, the smoother the movements of the crumbs become. In the meantime, the nervous system has not matured, a small child may be in constant motion, which sometimes persists even in a dream. How as a rule, chaotic twitches disappear in the second month of life. Then the movements of the arms and legs gradually become more even and orderly.

The baby's arms, legs, chin are trembling - maybe he is cold or has some kind of neurological disease?

Immediately after the birth of the child, the pediatrician must examine every month, and in 1, 3, 6, 12 months - and specialist doctors: neurologist, ophthalmologist, orthopedist. It is they who will reliably assess the condition of the baby and help parents to control his development

Trembling, or tremor, is a physiological phenomenon that occurs in most children in the first 3 months of life. Tremor appears again due to the immaturity of the nervous system. Shivering usually occurs during crying or after some kind of exertion (for example, after bathing), but sometimes it starts quite suddenly, maybe even at rest. With a tremor, a child usually trembles in the chin and lower lip, arms and legs may still tremble. Tremor can be symmetrical (both arms tremble) or asymmetrical, when different parts of the body tremble separately (for example, chin and arms tremble at the same time, or one arm and one leg tremble). As soon as the parents notice that the baby has a tremor (and he may appear not immediately after birth, but even a month later), they are very worried. However, as we said, this is normal occurrence in young children. Nevertheless, it is necessary to pay attention to the following points: physiological tremor does not last long - just a few seconds. ; if the tremor increases, the episodes become more frequent and longer, it is necessary to show the baby to a neurologist.

The baby often shudders and spreads his arms to the sides. Is this normal or should I take my child to the doctor?

This is a manifestation of one of the innate reflexes - the so-called Moro reflex (spreading the hands with subsequent reduction). He lasts up to 4-5 months and usually occurs in response to sharp sounds or when changing body position. Parents call this reflex wince. Moms and dads notice that if you change the position of the baby in space (for example, lift him out of bed, and then put again), the child will throw up the arms slightly bent at the elbows. The same thing can happen with any sharp sound (clap in hands, door knock). Sometimes the Moro reflex occurs spontaneously, that is, the baby throws up his arms without any stimuli. All these phenomena are completely normal for young children and do not require any treatment. The only thing to watch out for: the Moro reflex should not become more pronounced; after 4-5 months it should disappear.

The child constantly wants to suckle (pacifier, breast, finger), maybe he is hungry and does not have enough milk?

In children under 1 year old, the sucking reflex is pronounced: any irritation of the lips, tongue, the child makes sucking movements. This the very first and most important unconditioned reflex, it is the ability to suck (and therefore satisfy hunger) that ensures the survival of the baby. The sucking reflex completely disappears only by 3-4 years. Even in infants, you can notice the search reflex (it persists up to 2–4 months): when the corner of the mouth is irritated, the baby turns its head in the direction of irritation; proboscis reflex (it can be observed up to 2–3 months): when tapping on the lips, the child stretches his lips with a tube. Before eating, these reflexes appear brighter and are called easier, but by themselves they are not an indicator that the baby is hungry.

The baby spit up a lot, I heard that this may be due to neurological disorders. Is it so?

Regurgitation is a very common complaint in the first months of life. Most healthy children spit up to 3-5 times a day. For regurgitation of infants is more the norm than a pathology, since the structure and functioning of the gastrointestinal tract in them predispose to vomiting. The stomach of newborns is located horizontally, has a rounded shape and small volume - only 5-10 ml: that's why a few drops of colostrum are enough to just the born baby ate. The entrance to the stomach of the baby is relatively wide, and the sphincter (the muscle that closes the entrance to the stomach) underdeveloped. Therefore, the movement of food through the gastrointestinal tract is somewhat slow. Immaturity of some enzymes and lack of coordination in the processes of breathing, sucking and swallowing, more characteristic of preterm infants and small children also predispose to regurgitation.
Also, regurgitation can be associated with overeating, frequent feeding, aerophagy (swallowing air). Yes, they can be a manifestation of some kind of neurological pathology, but this is very rare, especially if there are no other symptoms of the disease.

The baby often "goggles". The doctor said that this is a symptom of Grefe and does not need to be treated. What is this symptom and why does it appear in young children?

Graefe's symptom in infants is a white line that remains between the iris and the upper eyelid when the child looks down. By itself, Graefe's symptom is not indicates the presence of any health problems in children. It is often observed in healthy children with a change in lighting or body position, and also Graefe's symptom may simply be an individual feature of the structure of the baby's eyes (it is often present in children with large eyes). Sometimes this symptom occurs due to the immaturity of the nervous system of the child. In these cases, Graefe's symptom does not need to be treated, it usually disappears during the first 6 months of the baby's life.

Learn more