Baby seizures often look nothing like what most people picture when they think of a seizure. In newborns and infants, the signs can be as subtle as repetitive eye fluttering, rhythmic lip smacking, or brief stiffening episodes that last only a second or two. Knowing what to watch for, and what’s actually normal, can help you act quickly when it matters.
What Seizures Look Like in Newborns
Seizures in newborns (the first 28 days of life) are often called “subtle” because they don’t involve the dramatic full-body shaking most people associate with seizures. Instead, you might notice random or roving eye movements, eyelid blinking or fluttering, eyes rolling upward, or a fixed stare. Repetitive mouth movements are also common: sucking, smacking, chewing, or tongue thrusting that isn’t related to feeding.
Some newborn seizures show up as unusual leg movements that look like bicycling or pedaling, or as thrashing and struggling motions. One of the more alarming signs is apnea, long pauses in breathing where your baby simply stops for several seconds. These pauses may happen alongside other subtle signs or on their own. Because these behaviors can overlap with things healthy newborns do, the key distinction is whether the movements are repetitive, rhythmic, and impossible to stop by gently holding or repositioning your baby.
Infantile Spasms: A Distinct Pattern
Infantile spasms are a specific type of seizure that typically appears between 3 and 12 months of age. They look like a sudden stiffening of muscles where the baby’s arms, legs, or head bend forward. Sometimes called “jackknife” seizures, the body folds forward, the knees pull up, and the arms fling out to the sides. In other cases, the body and legs stiffen while the head is thrown back.
The most important feature of infantile spasms is that they come in clusters. Each individual spasm lasts only about one to two seconds, but they repeat in a series, one after another. These clusters often happen just after a baby wakes from sleep. In milder cases, you might only see a slight head nod or quick eye movement, which makes them easy to dismiss. If you notice any brief, repetitive jerking or stiffening that happens in groups, especially around wake-up times, record it on video. Infantile spasms require prompt treatment, and a video can help your pediatrician make a faster diagnosis.
Febrile Seizures in Babies With a Fever
Febrile seizures are triggered by fever, typically above 100.4°F (38°C), and are the most common type of seizure in young children. They can be terrifying to witness but are usually not dangerous. A simple febrile seizure lasts anywhere from a few seconds to 15 minutes, involves the whole body, and doesn’t repeat within 24 hours. A complex febrile seizure lasts longer than 15 minutes, happens more than once in a day, or affects only one side of the body.
About one-third of children who have a febrile seizure will have another one, with most recurrences happening within the first year. The risk of recurrence depends on several factors, including the child’s age at the first seizure and family history. Children with no additional risk factors have roughly a 14% chance of a second febrile seizure within two years, while those with multiple risk factors can face odds above 60%.
Normal Movements That Mimic Seizures
Not every jerk or twitch is a seizure. Benign neonatal sleep myoclonus is a common condition that gets mistaken for seizures frequently. It involves rapid, lightning-like jerks of the arms, legs, or trunk that happen exclusively during sleep. These jerks can look alarming, especially because they may be repetitive and somewhat rhythmic. They can even intensify when you touch the baby or in response to loud sounds.
The defining difference is simple: these movements stop when the baby wakes up. Seizures do not follow this rule. If you gently wake your baby and the jerking stops, it is very likely benign sleep myoclonus rather than a seizure. This condition has no connection to epilepsy and resolves on its own. Babies also commonly startle (the Moro reflex), have brief trembling of the chin or limbs, and make jerky movements during light sleep, all of which are normal.
What Happens After a Seizure
The period immediately following a seizure is called the postictal state, and what you see in your baby during this time can itself be a clue that a seizure just occurred. Babies may become extremely sleepy or difficult to rouse, unusually irritable, or appear confused and “not themselves.” You might notice muscle weakness, limpness on one side of the body, or a general lack of responsiveness that lasts minutes to hours. Some babies experience nausea, irregular breathing, or loss of bladder control. If your baby seems profoundly exhausted, floppy, or unresponsive after an episode of unusual movements, that recovery period strongly suggests the movements were a seizure rather than normal infant behavior.
When It Is an Emergency
A seizure that lasts longer than 5 minutes is a medical emergency. So is having more than one seizure within a 5-minute period without your baby returning to normal consciousness in between. This situation, called status epilepticus, requires immediate treatment. Call 911 if either of these happens.
Other signs that warrant an immediate call to emergency services: your baby’s skin turns blue (especially around the lips), breathing stops and does not restart after the seizure ends, or this is your baby’s first seizure and you have no prior diagnosis. Even for a brief seizure that stops on its own, contact your pediatrician the same day.
What to Do During a Seizure
Your most important jobs during a seizure are keeping your baby safe and tracking time. Place your baby on a firm, flat surface and gently turn them onto their side with their mouth pointing slightly downward. This keeps the airway clear. Move away any objects that could cause injury. Loosen any clothing around the neck.
Start timing the seizure from the moment you first notice it. If you have a phone nearby, recording a video is one of the most valuable things you can do for your baby’s doctor. Seizure descriptions from memory are often unreliable, but video gives a medical team exactly what they need to identify the seizure type.
Do not hold your baby down or try to restrain the movements. Do not put anything in their mouth. Do not attempt rescue breathing during the seizure itself, as babies typically resume breathing on their own once it stops. Do not offer food or water until your baby is fully alert again. Stay calm, stay close, and let the seizure run its course while you keep the environment safe.
Seizure vs. Normal: A Quick Comparison
- Rhythmic and repetitive: Seizure movements follow a pattern and repeat. Normal baby twitches are random and irregular.
- Cannot be interrupted: You cannot stop a seizure by gently holding or repositioning your baby. Normal startle reflexes and sleep jerks stop with touch or waking.
- Happens during sleep and wakefulness: Seizures occur regardless of sleep state. Benign sleep myoclonus stops the moment a baby wakes.
- Followed by exhaustion or confusion: Babies are typically very sleepy, limp, or irritable after a seizure. Normal movements don’t produce this kind of aftermath.
- Involves eye changes: Sustained eye deviation, fixed staring, or repetitive fluttering during an episode suggests seizure activity. Brief, wandering eye movements in a newborn are often normal.
If you are unsure whether what you saw was a seizure, record any future episodes on video and bring the footage to your pediatrician. Many seizure types in babies are diagnosed based on exactly what the movements look like, and a 30-second clip from your phone can be more useful than any verbal description.