Your Baby’s Eyes: 11 Strange (but harmless) Newborn Quirks

Intro

If you know anything about newborns, you know that they aren’t the most interactive little ones during their first several weeks and months of life after birth. Even knowing this, you still might not be able to help yourself from trying to smile into your baby’s eyes the same way you would an older baby, looking for recognition, laughter, connection. What you’re more likely to find, during this early stage of development for your child, is a variety of eye conditions, quirks, and peculiarities that could be alarming if you didn’t know what to expect. Today, we’re going to rapid-fire review many of these quirks so that when you find yourself lovingly staring down into your newborn’s eyes, you’re able to greet them into this world with a few less concerns.

Also, I’m intentionally leaving out information about your baby’s vision. That most certainly has to do with the eyes and it most certainly isn’t up-to-speed at birth. However, today I’m choosing to focus on the physical characteristics of your newborn’s eye, things you can see as you’re looking at your baby. Your newborn’s eyesight itself is a topic for another day.

1. Wandering Eyes

Just as your newborn isn’t born with the knowledge and coordination for clapping, crawling, talking, and eating pizza, so too their eyes do not yet have the experience and strength for coordinated movement, sustained usage, or the ability to process all the input they are suddenly receiving. Your newborn baby’s eyes (and associated brain processes), just like other parts of their body, still have a lot to learn and practice!

One of these initial milestones your baby must learn is how to focus their eyes and have them work together as a pair. Your baby’s eyes may wander, have a hard time focusing on objects, or even move in slightly different directions. Baby should begin to focus better by two months of age and their eyes should have developed the strength and coordination to not wander by three months of age.

If you child still has wandering, crossed, or unfocused eyes beyond these time frames or if their eyes turn in or out consistently (more than a slight wandering) at any point, please consult with your health care provider.

2. Crossed Eyes

Closely related to wandering eyes is crossed eyes. The crossed eyed appearance may result from eye wandering, with each eye moving in slightly different directions as they learn to work together and grow stronger. Another reason for the newborn crossed eye appearance is due to an optical illusion called pseudostrabismus.

“Pseudostrabismus is when one or both of a child’s eyes look misaligned (crossed), but really they are not.” This is to be differentiated from strabismus, which is a true crossed eye situation involving eyes that “are misaligned, and point in different directions…one eye may look forward while the other eye turns in, out, up, or down” (Boyd, 2020a).

The optical illusion of baby’s eyes appearing misaligned and cross, even though both eyes in reality point forward, is due to “baby’s nose having a wide bridge. There are often small folds of eyelid skin on the side of the eye near the nose. These features can make a baby’s eyes look crossed. As a baby grows, these features usually change and pseudostrabismus goes away [usually by 18 months or earlier].”

Strabismus, however, does not resolve on its own and requires intervention by an ophthalmologist (a specialized eye doctor). If you are concerned about your baby’s eye(s) turning in atypical directions, consult your pediatrician. They may then refer you on to the ophthalmologist for diagnosis and treatment of your newborn’s crossed eyes.

3. Puffy/Swollen Eyes and Eyelids

You’ve probably seen many adorable pictures of babies and have an image in your mind of your newborn looking similar to those images. I know I did. What I had failed to fully grasp, although cognitively I knew it, was that newborn baby’s look very different from their counterparts of one and two months old. They even look different from babies who are only a few days older.

Much of this difference in appearance is due to both the trauma of birth and extra fluid baby is carrying around. “A newborn’s face may look quite puffy…[and their] facial appearance often changes significantly during the first few days as [they get] rid of the extra fluid and the trauma of delivery eases” (SickKids, 2009). 

This puffiness may not only impact your newborn’s appearance, for a brief time, but may also make it difficult for them to open their eyes wide or sustain opened eyes for long periods of time. Again, this difficulty should fade over the first several days and weeks of life.

4. Doll’s Eye Reflex

Do you remember playing with dolls when you were younger? Some dolls had eye lids that opened and closed when you lifted them up and laid them flat. Your newborn baby’s eyes do sometimes similar. There is a reflex (an automatic reaction) in newborns called the “doll’s eye” reflex. And it does exactly what it sounds like it should it do: your newborn is more likely to open their eyes when they are held in an upright position.

Just like all newborn reflexes, this will slowly fade with time. However, as KidsHealth reports, you can “tak[e] advantage of your baby’s “doll’s eye” reflex” to help “encourage eye opening”–especially when your little one is struggling on their own due to their newborn eye puffiness.

5. Pupil Size and Light Sensitivity

Ok, I’ve got to be honest with this one: I got mixed/opposing information as I was researching infant pupil size and light sensitivity.

Many sites stated that newborns are not sensitive to light and that it was just fine to have some lights on in your newborn’s bedroom. They went on to say that one month old newborns required 50x more light than an adult to register that light was even present. In this scenario, a baby’s pupils would be large and dark to try to absorb as much light as possible.

Despite this information being found in multiple places on the web, I’m a bit skeptical because they all used very similar wording making me think one person said it and everyone else just blindly copied it as fact, and the sites were mostly from blogs or parenting websites, not academic websites.

The only information I found directly relating to newborn pupils and light sensitivity from a site I deemed to be authoritative, came from the American Academy of Ophthalmology (AAO). They stated practically the opposite phenomenon: “At birth, an infant is very sensitive to bright light. You may notice how small their pupils look, limiting how much light enters their eyes….Within a couple of weeks, as their retinas develop, a baby’s pupils widen.”

Perhaps there is a way that both of these statements are true. Perhaps at birth, a newborn is very sensitive to light but as they mature to a one month old newborn, their retinas are at a point that the opposite is now true?? I researched quite a bit on this topic and didn’t find much to clarify the issue short of potentially reading a textbook on baby eye development.

If you have any insights on this topic, I’d love to hear it! Post it in the comments or reach me via my “contact me” page. In the meantime, I’m still uncertain what’s actually going on with newborn pupils-the statement repeated multiple times by the masses? Or the information found in just one location but written by the AAO?

Either way, the bottom line is the same: infants’ pupils are going to react to light slightly differently than you might expect. Whether that’s to be smaller or larger than expected, you can be the judge with your own little case study. 😉

[See my case study, below, at a few weeks of age-large and dark pupils in a fairly well lit room…]

6. Blood Red/Blood Shot Eyes

We discussed birth trauma earlier, as it applied to swollen and puffy eyelids. There are many other changes to baby’s physical appearance that occur due to birth trauma as well. (I should note that birth trauma does not mean that these things only occur in “traumatic” or extra difficult births. The term “birth trauma” simply means that coming through the birth canal is hard on any baby, even those who come via an “easy” labor and delivery experience).

One of the other potential side effects of the birthing process (birth trauma) is that a baby can be born with blood red/blood shot eyes from a subconjunctival hemorrhage. This occurs when ” blood leaks under the covering of the eyeball due to the trauma of delivery. It’s a harmless condition similar to a skin bruise that goes away after several days, and it generally doesn’t indicate that there has been any damage to the infant’s eyes” (Dowshen, 2018).

7. Red Mark on Tops of Eyelids

Other times you might see red on eyelids as opposed to on the eyes themselves. This is generally due to a kind of birthmark called variously “stork bites”, “salmon patches” or “angel kisses”. This kind of birthmark can also be found on other areas of the face and neck. “They’re caused by a concentration of immature blood vessels and may be the most visible when the baby is crying. Most of these fade and disappear completely by age 18 months,” (Stanford Children’s Health).

As an interesting side note, almost everyone I know who has these birthmarks is a first born child. My first born had/has this birthmark. It was really pronounced at birth and gradually faded, except when he was emotional in some way. Then, it flamed back up. Now, at age three, you can barely tell that it’s there.

8. Tearless Crying

We all know that baby’s cry. That’s one thing that most baby’s are very good at. But one thing that they aren’t good at when they are first born is crying with tears. That’s right. Newborns have tearless crying for roughly the first month of their lives. Their tear ducts are not yet developed. So don’t be surprised or alarmed when you’re rocking your screaming little one and don’t see the tears you expected.

For me, it’s almost the opposite effect, I’m surprised when I finally do see tears. It makes me super emotional and extra concerned. I feel like my poor baby is truly sad the first few times I see real tears in their eyes. I hold them a little closer and wonder what might be going on in their little world to make them so sad!

Well, in reality, what’s going on in their little world is that their tear ducts are finally mature. But, you know, who can explain that to an emotional, hormonal, sleep-deprived new mama?? If you’re like me and just want to hold them a little closer the first few times you see tears, then go for it. Take a minute and bond. 🙂

9. Goopy/Sticky Eye

Related to tearless crying is newborn goopy eye or newborn sticky eye. This goopy/stickiness occurs when the newborn’s developing tear ducts get clogged. This blockage can produce tears, even when your baby is not crying or upset, and/or discharge that can be confused for an infection.

If your baby’s eyes do not look red and swollen and they remain clear, it is most likely due to the clogged tear duct. A warm cloth placed over your baby’s eyes or gently massaging the inner corners of baby’s eyes may help with the blockage. (Speak to your doctor before attempting any massage).

If your baby’s eyes do look swollen and irritated or if any red creeps into the whites of their eyes, it could be conjunctivitis instead. “This is inflammation of the thin layer of tissue that covers the front of the eye. The symptoms are similar to a sticky eye, but the whites of your baby’s eye will be pink or red. Conjunctivitis in your newborn baby can be caused by a blocked tear duct or a bacterial or viral infection,” (Institute of Health Visiting, 2015).

If this occurs, or your baby is continuing to have newborn goopy eye/blocked tear ducts beyond their first birthday, consult with your pediatrician.

10. Eye Rolling in Sleep

As a new parent, we often spend a larger amount of time than we might otherwise looking at a sleeping human. And, in the process, we might notice things that happen to a sleeping human that we haven’t noticed in others before. And some of those things can feel really quirky! Eye movements during sleep is definitely one of them.

There are many stages to sleep and I’ll not go through all of them in this post. We’ll just refer to these sleep stages in general terms of falling asleep, deep sleep, and light sleep. When you baby is in deep sleep, the eyes under their eyelids will be calm and still. This is normal. In light sleep, you might notice your baby’s eyes rolling around under their eyelids, making rapid back and forth movements. This is also normal. Finally, when your baby is falling asleep, their eyes might again roll, but more slowly and often towards the back of their head. Once again, this is normal.

All this rolling of eyes back and forth might look odd but “it is harmless and despite appearances: your child is sleeping!” (Hill, 2018).

11. Eyelids Open while Sleeping

On the topic of sleep, another newborn quirk that might throw you if you’re not expecting it, is the possibility of your newborn sleeping with their eyes open.

The Pediatric Sleep Council states “[m]ost babies close their eyes when they are asleep. This stops light from stimulating the brain and keeps the eyes moist during sleep. A small minority of babies sleep with their eyelids partly open. This has a medical name: physiological lagopthalmos. For most babies with lagopthalmos, the eyes are only partially open by a few millimeters when they sleep….Assuming your baby can close his eyes normally when he is awake, is visually alert and does not have dry, irritated, or red eyes, this is unlikely to be problem. However, if you have any concerns about your baby’s eyes or vision do ask your baby’s health care provider to check this out.”

We experienced this, in combination with eye rolling, with my second son for several months in his newborn stage. His eyes would be partially open as he fell asleep…just exactly the same time that his eyes were rolling back in his head! My goodness! It’s one thing to see your child’s eyes rolling under their eyelids. It’s quite another to actually see their eyes rolling back! lol. We joked about this and it felt a bit odd to us but both the eye rolling and the sleeping with eyes partially open are normal newborn quirks and were nothing to be concerned about.

Signs of Eye Problems

As we’ve gone through this blitz of baby eye quirks, I’ve tried to include examples of when you should be concerned and should consult with your health care provider. I felt like I should also include this list and note from the American Optometric Association, some of which has already been touched on:

“Parents need to look for the following signs that may be indications of eye and vision problems:

• Excessive tearing may indicate blocked tear ducts.
• Red or encrusted eyelids could be a sign of an eye infection.
• Constant eye turning may signal a problem with eye muscle control.
• Extreme sensitivity to light may indicate an elevated pressure in the eye.
• The appearance of a white pupil may indicate the presence of eye cancer.”

Note: “The presence of eye and vision problems in infants is rare. Most babies begin life with healthy eyes and start to develop the visual abilities they will need throughout life without difficulty.”

I love the reassurance of that note. 🙂

InfantSEE

Finally, I’d like to draw your attention to a free infant eye assessment for children 6-12 months of age offered through the American Optometric Association. These assessments are similar to “well-child” check ups at the pediatricians. You can have your child’s eyes examined to know their state of health, even if you have no pre-existing concerns regarding their eyes or their vision. And, if by chance their is a concern, you can head it off and hopefully nip it in the bud due to the free comprehensive assessment your child received early in their life. Visit the InfantSEE website to learn more and locate a participating doctor in your area.

References

American Optometric Association. (n.d.). Infant Vision: Birth to 24 Months of Age. Retrieved August 24, 2021, from https://www.aoa.org/healthy-eyes/eye-health-for-life/infant-vision?sso=y

Boyd, K. (2020, December 5). Vision Development: Newborn to 12 Months. American Academy of Ophthalmology. https://www.aao.org/eye-health/tips-prevention/baby-vision-development-first-year

Boyd, K. (2020a, July 16). Pseudostrabismus. American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/what-is-pseudostrabismus

The Canadian Association of Optometrists. (n.d.). Funny Eye Facts. Retrieved August 24, 2021, from https://opto.ca/health-library/funny-eye-facts

Dowshen, S. (2018, January). Looking at Your Newborn: What’s Normal (for Parents). Nemours Kidshealth. https://kidshealth.org/en/parents/newborn-variations.html

HealthyChildren.org. (2009, November 2). States of Consciousness in Newborns. https://www.healthychildren.org/English/ages-stages/baby/Pages/States-of-Consciousness-in-Newborns.aspx

Hill, C. (2018, November 1). Is it normal for my baby to sleep with his eyes open? Baby Sleep Advice for Parents & Kids. https://www.babysleep.com/sleep-advice/is-it-normal-for-my-baby-to-sleep-with-his-eyes-open/

Institute of Health Visiting. (2015, January 11). Sticky Eye. Hertfordshire Community NHS Trust. https://www.hct.nhs.uk/media/1913/sticky-eye.pdf

Pathways.org. (2021, August 9). Why is Eye Contact Important? https://pathways.org/importance-of-eye-contact/

SickKids. (2009, October 18). Eye Concerns in Newborn Babies. https://www.aboutkidshealth.ca/Article?contentid=456&language=English#/

Stanford Children’s Health. (n.d.). Newborn Appearance. Retrieved August 24, 2021, from https://www.stanfordchildrens.org/en/topic/default?id=newborn-appearance-90-P02691

Hello! I’m Briana!