Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Wednesday, March 1, 2017

If You Have Queries About Infant Eye Contact

A number of people have brought up questions about infant eye contact on pages that are so full that no more comments can be published. It's really difficult for me to move those comments to other pages and to be sure you can see them!

If you have recently asked a question on this subject and have had no answer, please put your comment HERE on this page.


  1. Dear Dr. Mercer.

    I have a question about my 9 weeks old daughter. Her motor development, gaining weight, hearing is ok (checked at specialist) . She sleeps almost all night (5 hours) and she sleeps a lot during the day too (3 hours together). I notice (last two weeks) her poor interest in social interactions. She doesn't look at people (she often turns her head away), she doesn't seem interested in human contact (she doesn't seem uncomfortable when people are around, she just doesn't look at them, she likes to cuddle). When I have her on my knees I can get her attention (after some time spending on calling her, making noises, funny faces), she looks in my eyes, sometimes responds. It's the same when I change her diaper. She loves to watch her toy above the changing table (when she is concentrating on it I take it away and sometimes she looks at me afterwards and sometimes "protests" with making some sound or "light cry".) She often just stares somewhere (she's very focused). She rarely or never gaze at her father or little brother. I noticed her "special" hand movement (twisting to face, grasping), especially when she is waking up, meanwhile or after breast feeding. She has trouble with often hiccups, spitting milk (she "drinks a lot of air sometimes). I encourage her social interaction, I try to use toys like "triggers". What is your opinion? Thank you very much for your answer.

    1. I am not sure what you are worried about, J. Are you concerned that these behaviors are signs of autism? Are you thinking that what you have described is not normal for her age, or are you saying that she used to be more social and now has stopped?

      If she was more social and has stopped, I can see why you would be concerned. But if your question is just whether she is developing in a typical way, I don't think there is anything to worry about.

      Babies usually become more sociable and reactive to other people between two and three months, but this does not mean that they change overnight. As is the case for many developmental changes, when a baby shows more social behavior for the first time, that does not mean that she suddenly socializes much more than she used to. Her social responsiveness will develop gradually and will be greater on some days and less on others. Right now, you have to work to get her social attention-- later, you won't need to do so much.

      Do you really think she protests when you take the toy away? That would be a sign of quite advanced development if she noticed the toy was gone and looked at you as the person who took it! If she is really doing that, it's a good sign that she knows you are a person, which is the foundation of social interactions.

      Babies do put their hands to their faces and often hold onto their own ears when awakening or nursing.

      Have I answered your questions, or am I misunderstanding your concerns?

    2. Thank you very much for your quick answer. No, she wasn't more social in the past few weeks. I hope that will improve in the future. Yes, I am worried about early signs of autism or some other developmental issue (as she is not interested in other people). I'll keep on encouraging her. Today I took away the toy after she was watching it again and she looked at me immediately after it (2-3 times, but she didn't protest). When I get her attention she listens to me and looks at me (I can talk to her for 5-10 minutes), but she rarely makes sounds (she just starts opening her mouths or smiles sometimes). But again - she's showing this behavior only with me). Thank you very much!!

    3. Opening her mouth when you talk to her is the first step in her getting ready to reply. She does not have to be interested in everybody, she just has to be interested in SOMEBODY, and it sounds as if she is really interested in you, probably because you're making the effort to work with her.

      If you continue to be very uncomfortable about this and to feel anxiety and depression about her development, it might be a good idea for you to talk to your doctor about your feelings. There is help to make you feel more comfortable-- not that motherhood is not a time of anxiety, but it doesn't have to be so bad.

  2. Dear Dr. Mercer,
    I am writing to you as a Grandma. My daughter, her husband and their baby girl live 1000 miles away from me. Much of what I am reporting to you is hearsay from my daughter, although I have visited many times. Baby was born full term and is now 8 months old. Mother and father are both highly educated.Mother is 32, father is 37, father's brother is severely autistic. Baby had nursing issues initially, and some gastric reflux although now she nurses normally and is eating some solids. Baby sat up at 6 months, is doing the GI-Joe crawl now. Baby is always trying to pull self up and move around. Mother is worried that baby doesn't make enough eye contact and seems to be a whiny baby. Mother reads to her, takes her swimming at the Y, is a very engaging parent. Mother just can't seem to convince herself that baby is okay. Baby makes eh, eh, eh sounds but not many vowel sounds and certainly no consonant sounds. Baby will pull Daddy's glasses off, but doesn't do a lot of interacting in general. Mom thinks baby is "needy"---not a "chill/calm" baby. Maybe Mom is wound up too tight. Any advice you can give to me?
    Worried Grandma

    1. Dear WG--is the concern that the baby will be autistic like the uncle? I think the good motor progress probably argues against that, but as I'm sure you know, it's much too early to tell.

      Do you have any idea of what the mother expects in the way of eye contact, or what she would think was enough? Of course a baby this age should look at other people's eyes sometimes, but she can't be expected to use the gaze the way older people do (to point, for example), nor will she do mutual gaze for many seconds.

      The vocalization seems a bit more problematic. I would expect her to make a lot more sounds by now, but in fact there is a lot of variability in expressive language, and it's more important that she respond to what's said to her-- her name, Mommy or Daddy, the dog's name, etc. Incidentally, I saw this lack of vocalization in one of my own grandchildren and was amazed and worried that he did not even "talk" to himself while falling asleep. He had early intervention for speech when close to two years but almost immediately progressed to speaking well and has continued good development.. so who knows!

      Without knowing any more about the family, let me just put out the possibility for you to consider that the mother's anxiety is driving some of this and can even make her sterling efforts at engagement less successful than you would expect. Do you know whether she has been screened for perinatal mood disorder? She can talk to her ob/gyn about this. She might benefit from treatment.

      It's not totally unrealistic to worry about autism when there is a near relation who is so badly affected, but the chances are very high that there's no problem-- especially because the baby is a girl.

      Just wondering-- does the baby peek-a-boo?

  3. Hi Mercer,

    My baby boy is now exactly 3months. When we smile at him he smiles back and he coos as well he does observe our faces when speaking. all this he will be doing when he is lying on his back.
    when we hold him up or in the sitting position he wont be giving eye contact or he wont even look at the people faces. he wont even pay attention to the new people
    he will be gazing at top of the roof or celling fan or black and while picture hanging on the wall. I am concerned that these behaviors are signs of autism?
    Even raised a concern with Pediatrician she doest seems to be worried about. Am i worrying a lot??
    please do give your valuable suggestions.


    1. Dear Swetha-- I am not surprised that your pediatrician is not worried! There is nothing to worry about here. He sees some new and interesting things, that's all, and having a healthy curiosity he wants to look at them.

      I am going to write a new post about the eye contact issue soon, and perhaps that will help you stop worrying unnecessarily-- which is what you are doing!

      He sounds like a lot of fun, by the way!

  4. Hi, Dr. Mercer,

    I've read through a lot of your posts relating to eye contact and autism. Not sure if you've directly talked about this but maybe you have.

    I have an 8 month old son. He has met all his motor milestones on the early side. He babbles constantly - but not conversationally back and forth. Nanana, dadadada, mamamama. But he doesn't mimic us. He doesn't clap or wave. He doesn't seem to be affected by any sensory things - loud noises or textures. Although he bear crawls on the hardwood because I think he doesn't like putting his knees down on that surface. He gets super excited when my husband or I come home from work and crawls to us. He smiles ALL THE TIME at people and our dog. And daycare and all his doctors and nurses say when does this kid not like to smile? He laughs when we tickle him and laughs when I make silly noises. He smiles when I put the burp cloth over his face and ask where's Graham? He will pull it off and smile at me. He won't do peekaboo himself. He reaches to be picked up when I reach out to him. He responds to his name when he's not super focused on a task or very tired (or chasing the dog). He loves new people and will watch them more intently than he watches me most of the time. He definitely notices when new people enter the room and start talking to him. Anyways! His eye contact has always worried me. From day 1. He makes eye contact from longer distances ranging from changing table to in his play pen looking up at you. The eye contact doesn't last long, it's like 5 seconds or glances. He doesn't stare us down - although he may do that a few times a week mostly when he's feeding himself his bottle and I'm sitting on the floor next to him. The most concerning thing is that he doesn't look at us when we are holding him. He turns his head away and won't look at our faces. He will grab my husbands glasses. I've gotten him to look at me if I make a crazy sound. It is freaking me out. A lot.

    I'm hyper sensitive to all the odd things he does. I'm a physical therapist so I'm aware of his physical milestones but less educated on normal ranges of social milestones. I am also freaked because my husband is mild undiagnosed Aspbergers. He had sensory and social issues as a kid but always met his physical milestones early - walked at 9 months for example.

    I have pretty severe PPA/PPD that I'm getting help for soon. I know I obsess over my sons behavior and I freak every time he doesn't turn when I call his name. When he turns away when I'm talking to him. When he stops babbling for a few days. I know I have issues but I just feel like something is off. I've told my husband this and he said he can understand my fears but feels like our son is fine. He also points out that I've been "sure" about other things with him that haven't come true. He has a point there. My anxiety can cloud a lot.

    Anyways, can you shed some light on what is within normal for eye contact up close and anything else I've mentioned ? It would be greatly appreciated.

    1. Dear Steph-- I think you already know that you are bringing a lot of anxiety to the situation and you won't see it clearly until that is resolved.

      Babies normally make relatively brief eye contact rather than staring at people. That's the same as what adults do unless they are afraid of someone or wanting some positive response. Try to think of eye contact as like a gesture-- you would point at something briefly but not stand for many seconds with your finger pointing in one direction.

      As for not looking at you while in your lap, he is still farsighted compared to an adult and may be too close to get a clear image of your face. But also, he's with you-- he doesn't have to look for you, so he finds something interesting to look at. Those advertisements you see with baby gazing lovingly into Mom's eyes are just advertisements, you know. That's not a frequent event in real life.

      I understand your concerns, but really it all sounds fine to me. Just be sure you follow up on some help for your anxiety!

  5. SANDEEP PATEL-- I can't answer your query on the page you sent it to because the page is already too full. I agree with you that your baby's apparent problems with vision and hearing need to be looked into. Passing a hearing screen at birth does not necessarily mean that there will be no further hearing problems. Can you take the baby to a teaching hospital for examination? I think it would be wise to do that.

    Good luck to your family!