Is Jitteriness in Newborn Babies Abnormal?

Jitteriness refers to tremors in newborns. It is the presentation of an exaggerated startle response. Tremulousness is often confused for seizures (also known as convulsion and fits), which naturally unnerves the parents.

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Newborn tremors

Tremors in newborn are usually not abnormal.

  • Tremulousness in normal full term newborn babies is their response to stimuli of their new environment.

  • It is the presentation of excited neuromuscular activity in newborns.
  • Jitteriness in newborns is commonly seen as rhythmic tremors of equal amplitude.

  • Normal tremors of neonatal phase usually involve only upper and lower limbs of babies.

  • Jittering is easily initiated in newborns by external stimuli such as handling the baby or loud noise.

  • It can be easily stopped
    1.) Gentle flexing (bending) of the affected limb.
    2.) Just holding the limb firmly and reassuringly.
    3.) Initiating baby's sucking action also stops the jittery movements.

  • The tremulous movements are most frequently seen during first few days of life in normal mature babies.

  • It may extend through out the neonatal period, but usually
    resolves spontaneously by 2 months of age.

  • At times the jitteriness may even go in to a clonus.

What is clonus?

  • Clonus is an involuntary muscular contraction alternated by relaxation in rapid succession.

  • Commonly seen as coarse tremulous movements of ankle or jaw.

  • They are common and less significant in newborn infants than at any other age.

  • Clonus that is accepted within normal limits for newborns tend to occur only when an infant is active.

Is medical consultation indicated for tremulousness?

Persistent and/or exaggerated jitteriness is demands professional evaluation.
Sometimes they could be the manifestation of a variety of neonatal problems:

  • Hypoglycemia; low blood sugar levels.

  • Hypocalcemia; low calcium levels.

  • Drug withdrawal due to drug used by the mother.
    Selective serotonin reuptake inhibitors (SSRIs) prescribed for depression during pregnancy can lead to heightened startle response, tremulousness,  irritability, sleep disturbances, nasal congestion and rapid breathing in the newborn baby.

  • Perinatal asphyxia; childbirth process related compromised oxygen levels in the newborn.

Newborn jitteriness can often be mistaken for seizures in newborns or vice versa. Read a relevant post: Strange behavior of 10 Weeks Old infant, & the related comments.

Neonatal Seizures Vs Jitteriness

Seizures are recurrent sudden abnormal involuntary movements, commonly known as fits or convulsions. There are some distinct differences between neonatal seizures and jitteriness, which are tabulated below.

Differences Between Neonatal Seizures & Jitteriness

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Neonatal seizures

Seizures are also known as fits or convulsions.
Seizures during early infancy are often subtle and so easy to miss.

  • Tongue smacking

  • Blinking of eyes

  • Chewing like movements
Seizures in First Three Months of Life Are Often Subtle
  • Excessive sucking movement without any thing in the mouth to suck on.

    a.) Often mistaken for baby's way of saying that she is hungry.

    b.) It is also called extra-nutritional sucking; thumb / pacifier sucking.

    c.) Extra-nutritional sucking in infants and children is a sign of frustration and stress, or may even be a convulsion.

  • Generalized convulsions

    a.) Tonic and clonic spasms.

    b.) Should be differentiated from innocent spasm - see below.

  • Clonic seizures (convulsions / fits)

    a.) Can be focal or multifocal.

    b.) Multifocal clonic seizures incorporate several body parts and are migratory in nature.

Common causes of seizures in neonatal period

Common Causes of Seizures in Neonatal Period
  • Drugs in mother can have effect on her baby at the time of birth:

    a.) Drug withdrawal from baby due to maternal drug use of narcotic or barbiturates.

    b.) Drug toxicity; lidocaine or penicillin administered to the mother during child birth.

  • Acute metabolic disorders in newborn: 

    a.) Hypocalcemia; lo blood levels of calcium in the body. 

    b.) Low blood sugar in baby secondary to diabetes in the motherc.

    c.) Hypomagnesemia; low blood levels of magnesium in the body.

    d.) Hyponatremia; low blood level of sodium in the body.

    e.) Hypernatremia; high blood levels of sodium in the body.

    f.) Hyperthyroidismg.) Hypoparathyroidism
  • Inborn errors of metabolism, like Galactosemia

  • Pyridoxine deficiency

  • Infections; Neonatal meningitis

What are spasms?

  • Spasms are sudden generalized jerks lasting 1-2 sec.

  • They resemble generalized tonic seizures.

  • Spasms last only for a very short period; less than 2 seconds.

  • Short span of spasms distinguish them from the generalized convulsions.

Twitching in newborns

Causes of twitching

  • Newborns sleep
    Almost 60 percent of newborns sleep is REM sleep; the light sleep.
    REM sleep is prone to dreams; and babies dream just as we adults do.
    This can sometimes cause twitching of different groups of muscles; often mistaken for migratory type of convulsion.
    Also happens to adults: Noted or felt as twitching during sleep or even sudden gross jerky movements (as missed a step or being pushed).

  • Part of moros reflex during sleep may be seen as twitching.

Recommended causes for medical consultation for twitching

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Confused? May be you will find answers here:

  1. Facial Twitching in 2 Month Old Could Be Subtle Seizure of Early Infancy 

  2. Ankle Twitching 

  3. Ankle Clonus in 2 Months Old 

  4. Jitteriness at 3 Months 

  5. Strange Behavior of 10 Weeks Old Infant  

  6. Shivering of Head and All Body While Feeding During Sleep 

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