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Baby trembling 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
  • Virtual Urgent Care

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: 03/01/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

Is It Perfectly Normal or a Reason for Concern? ?

Possible reasons behind chin twitching

In the first few months of parenthood, you’re probably filled with questions about your child’s development. Naturally, you want to ensure they’re healthy and growing, so you’re bound to be on the lookout for any unusual symptoms or behaviors.

At this stage, their neurological system is undergoing some major changes. They’re learning how to move their bodies (after spending several months curled up inside a cramped uterus). Slowly but surely, they’re sharpening skills like muscle control and coordination.

This is why your infant’s brain might be firing off more electrical impulses than necessary. Occasional muscle twitching or small, involuntary spasms are common right now. So you really shouldn’t be surprised to see your little one’s chin quivering, even when they’re not crying.

Often times, these jittery impulses are caused by a hormone called norepinephrine, which their body releases in response to stress. As norepinephrine levels decrease, so will the frequency of your baby’s chin tremors.

Have you also witnessed a chin muscle spasm or two while your newborn’s asleep? During the rapid eye movement (REM) sleep cycle, muscle twitching is to be expected. This is the phase in which their sensorimotor development occurs. Their brain and body are busy integrating what they’ve learned so far, while simultaneously strengthening neural pathways.

Breastfeeding is another possible explanation for chin twitching or jaw quivering. Although it sounds like a straightforward process, breastfeeding actually requires a complex series of muscle movements in the tongue, jaw, throat, lips, and face. It’s especially likely in the first few weeks for your baby’s jaw to quiver or tremble due to muscle fatigue.

Other plausible explanations for chin muscle spasms include:

  • A vitamin D deficiency
  • Hypoglycemia (low blood sugar levels)
  • Hypothermia (due to a sudden drop in body temperature)

If you suspect it could be one of these three things, be sure to consult your pediatrician.

Chin quivering: should you be on the lookout?

So how can you be certain that your baby’s chin spasm is a completely normal part of their development? Chin twitching on its own is usually nothing to worry about. And in most cases, a chin tremor is simply a signal that your little one is close to tears.

Chin quivering should be considered commonplace as long as the following things appear to be functioning properly: 

  • Muscle reflexes during formula or breastfeeding
  • Protective muscle reflexes when they’re startled or surprised
  • Breathing and sleep patterns

However, more pronounced infant tremors – in which larger muscle groups or body parts spasm continuously for several seconds – should not be ignored. It could be an indication of a serious neurological condition. Be on the lookout for occasional jaw trembling that is accompanied by:

  • Difficulty sleeping or breathing
  • Increased fussiness or silence
  • Loss of social interaction cues, such as smiling
  • Lack of learning or developmental growth

If your baby is not in immediate danger, try to record the infant tremors while they’re happening. In certain cases, the spasms could be a sign of epilepsy, Down syndrome, or physical trauma.

These general guidelines regarding chin twitching are intended to be helpful, not to produce unnecessary stress or anxiety. As always, it’s best to make an appointment with your baby’s doctor for further advice and evaluation. 

What if chin quivering doesn’t go away?

As mentioned above, chin muscle spasms are a typical part of your newborn’s motor development and should only last for a few months. In rare instances, infant tremors or muscle spasms may continue until the age of 4. A chin spasm resulting from a hereditary or neurological condition could potentially impact their speech, motor skills, and even behavior.

Consider discussing symptoms with a professional when tremors are first observed. If necessary, blood tests or brain scans might be used to determine the underlying cause. In the event of a movement disorder (such as myoclonic jerks), the sooner treatment begins, the better the outcome.

For most babies, chin twitching is an ordinary reflex which doesn’t lead to any pain or discomfort. It’s merely a sign that their nervous system is progressing exactly as it should.

When should I contact a neurologist? — Articles Research Institute "Indigo Children"

Even the most caring mother, as a rule, does not have a medical education. Therefore, with all doubts about the health of the child, you should immediately consult a doctor. The child does not fall asleep well, shakes his pen, loses consciousness - these symptoms can be signs of serious illness. A neurologist, one of the main doctors in a baby’s life, will definitely pay attention to them.

The competence of a neurologist is the diagnosis and treatment of diseases caused by damage to the nervous system. Among them: various neuralgia, hydrocephalus, epilepsy, etc. Simply put, a neurologist examines the child's behavior and skills, on the basis of which he makes a conclusion about the correct development of the baby. Will a person be socialized, will he be able to find contact with people and will he be able to speak and think at all. It is the nervous system that is responsible for all this, so it is very important to notice and eliminate any violations in time.

The formation of the child's nervous system occurs gradually. Every month of life, the baby acquires new skills: he learns to speak, listen, sit, walk, think. Due to the fact that each child develops individually (sometimes outside the accepted medical framework), developmental deviations can only be noticed at a repeated appointment with a neurologist. The Russian Ministry of Health has defined 4 age stages: 1, 3, 6 and 12 months. But even if there are several weeks left until the next examination, and the child has dangerous symptoms (increased muscle tone, tremors, frequent regurgitation, constant tantrums), you should not hesitate, you should immediately see a doctor.

So, what symptoms should alert parents and become a reason for an unscheduled visit to the doctor.

The child's chin is trembling

Trembling of the chin while crying in a child up to three months old is considered the norm. This is because the nervous system is not yet fully formed. Under the influence of simple emotions, the nerve centers are excited, and a slight tremor appears. Another thing is if the child's chin trembles at rest, and this symptom did not appear immediately, but several months after birth. Please note: in parallel with the trembling of the chin, there may be other symptoms (frequent regurgitation, increased muscle tone, trembling of the entire head). This is a common phenomenon, especially if there were difficult births, hypoxia, or the baby was born prematurely. And yet, if you notice that the baby’s chin often and for a long time trembles, it’s worth talking about it at the appointment with a neurologist.

The child has a tremor (arms, legs)

Trembling of the hands or feet is a symptom of increased excitability, it also appears due to the immaturity of the nervous system. The appearance of this sign without the physical or emotional activity of the child indicates possible serious violations. Tremor in a child appears with very serious diseases, such as encephalopathy, hyperglycemia, etc. Only a competent neurologist at the reception can study the child’s condition, exclude pathology or prevent it from developing.

Increased muscle tone

For newborns, a condition in which muscle tone is reduced or increased is absolutely normal, it happens in more than half of the babies. Usually, after a few weeks, muscular dystonia disappears, and the baby begins to fully develop. However, if muscle tone remains increased or decreased after six months, you need to sound the alarm. Muscular dystonia, if left untreated, will lead to delays in physical and mental development. For example, due to increased muscle tone in the future, a child may develop hyperexcitability, and due to reduced tone, posture will be distorted and even speech will be disturbed.

Decreased muscle tone

There is a similar picture with a reduced tone, but, unlike an increased one (when a child can beat himself with his hands or torticollis is observed), here, on the contrary, the baby is lethargic, motionless, often lies in a frog position. This condition will also negatively affect the health of the child. As a rule, such children develop more slowly than their peers, later they begin to crawl and sit down, they have little interest in the outside world. In addition, this symptom (along with frequent crossing of the legs) can be with cerebral palsy. Even if the doctor did not diagnose this serious disease, increased or decreased muscle tone must be treated. Moreover, it can be easily corrected (massage, physiotherapy).

Child spit up frequently

The first and main reason for frequent regurgitation in children is overeating. Unlike vomiting, this process occurs easily, without gushing, after a short period of time after feeding, in a volume of about 1-2 tablespoons. Usually, regurgitation does not affect the baby's health in any way, it's just that his fragile body gets rid of excess food. It is necessary to build the correct feeding scheme according to age, and this symptom will go away. But if regurgitation continues for a long time, occurs in large volume, the baby does not gain weight, behaves passively - this is a reason to turn to specialists. Frequent regurgitation can be a symptom of bloating, various malformations of the gastrointestinal tract, in children with intrauterine growth retardation.

The child loses consciousness

In such cases, you can not hesitate, you need to immediately call an ambulance! At this time, try to help the baby, note how quickly he came to his senses, whether breathing was disturbed, whether the skin color changed. Loss of consciousness is a very disturbing symptom, it can accompany both completely harmless overheating, dehydration, lack of oxygen, and extremely serious diseases: diabetes mellitus, epilepsy, asthma, vegetative-vascular dystonia, etc. In the case when the child often loses consciousness, you will need a consultation not only with a neurologist, but also with other specialists.

The child has dilated pupils

This condition can have a lot of reasons, ranging from poor lighting in the room where the child spends most of his time, ending with serious pathologies. At the appointment with a neurologist, you need to explain how long the pupils have dilated, whether this condition is changing and what caused it. It is believed that the child may have dilated pupils after he has suffered a strong fright or witnessed a conflict. Nervous breakdown, stress, severe or frequent headache - cause dilated pupils. Also, dilated pupils in a child are one of the signs of a traumatic brain injury. In addition, it is necessary to exclude eye diseases and hypoxia, so a professional examination cannot be avoided.

Frequent tantrums in a child

This condition should not be attributed to the complex nature of the child. Of course, the psychological aspect takes place, especially in 3-year-old children, when the first age crisis occurs. They are not yet able to clearly articulate their desires, so they achieve their goal with the help of hysteria, screaming, and beating with their hands. In this case, the advice of a psychologist will help. Meanwhile, the cause of constant tantrums in a child (especially under the age of one) may be painful sensations against the background of neurological abnormalities. Increased intracranial pressure, hydrocephalus have in their symptoms: tantrums in children, tremors, poor sleep. Do not think that everything will go away by itself when the child grows up. Serious pathologies can result in serious consequences, up to disability.

Poor sleep in a child

Often, children do not fall asleep well due to overexcitation (strong emotions, a new environment, a lot of people around, quarrels in the family). It is important not to lay the baby in this state, but to achieve complete calm with the help of a relaxing bath, warm drinks and close contact with mom in a cozy environment. Otherwise, due to overexcitation, there will be interrupted sleep, and the child will get even more tired. Be sure to follow the regime, including daytime sleep, so the baby's nervous system will be easier to cope with overload. But if the child does not fall asleep well, the sleep is short, the baby twitches in a dream, and when he wakes up, cries, you should look for a good neurologist. At an appointment at the Center for Pediatrics and Neurology, a neurologist examines the child with amplitude-frequency diagnostics and identifies the reason why the child does not fall asleep well.

So, the future of your child now depends on how attentive you are to his health and early development. It is worth adding that any treatment must be carried out under the supervision of a competent doctor. It is better if the baby will be observed by a permanent doctor in a specialized center. At the Indigo Children Research Institute, neurologists and other children's specialists receive appointments: pediatricians, speech therapists, speech pathologists, exercise therapy instructors, massage therapists, psychologists, etc.

Understanding tongue movement in infants

2 min.

Sept. 2021

This material is intended for healthcare professionals

Researchers have used ultrasound video 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 marvel 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 is slightly different when the 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 "Quantification of Tongue Movement During Feeding in Infants and Swallowing in Adults" shows certain 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.

Learn more