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Expert Q&A:
If my 1-month-old crosses her eyes, is this a serious or permanent problem?

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Thomas DeWitt
Answered by Thomas DeWitt M.D.
"Understanding each unique family situation, how it influences parenting decisions, and helping families make the right decision is the essence of the practice of pediatrics," says Thomas DeWitt. A pediatrician and academician for almost 30 years, Dr. DeWitt believes that "the greatest professional reward is still the privilege of sharing the challenges of parenting, medically and behaviorally, with families." 

Dr. DeWitt is the Carl Weihl Professor of Pediatrics, director of the Division of General and Community Pediatrics, and associate chair for education in the Department of Pediatrics at the Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine. He received his M.D. degree from the University of Rochester and did his residency, chief residency, and Robert Wood Johnson General Pediatrics Academic Development Fellowship at Yale-New Haven Hospital. He has more than 75 publications, is a senior editor of a pediatric textbook, and is a peer reviewer for many medical journals, including Pediatrics, the New England Journal of Medicine, and the American Journal of Public Health. Having served as president of the Ambulatory Pediatric Association and chaired both the Steering Committee of the American Academy of Pediatrics Pediatric Research in Office Settings (PROS) network and the Committee on Pediatric Education, he currently sits on the United States Preventive Services Task Force and the Accreditation Council for Academic Medical Education Residency Review Committee for Pediatrics. He is nationally and internationally known for his publications and presentations in the areas of faculty development and community-based education and research.

Dr. DeWitt is the father of three young adult children who have taught him much about parenting and perspectives on life. He lives in Cincinnati with his wife, a pastoral counselor, and a wonderful mixed breed dog.


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Question


I have good news for you. It is entirely normal for a 1-month-old infant to intermittently cross her eyes, and the vast majority of small infants will do this. The eye crossing happens for a couple of reasons. First, in the womb she obviously had little on which to focus her eyes and, when born, her brain has to learn how to control her eyes to look at things she can now see. As with any learning experience, her brain doesn't get it right initially, and as a result you will periodically see her cross her eyes. Second, she is also in the process of strengthening her eye muscles, and one set of muscles might be stronger at one point than another set.

Answer


I have good news for you. It is entirely normal for a 1-month-old infant to intermittently cross her eyes, and the vast majority of small infants will do this. The eye crossing happens for a couple of reasons. First, in the womb she obviously had little on which to focus her eyes and, when born, her brain has to learn how to control her eyes to look at things she can now see. As with any learning experience, her brain doesn't get it right initially, and as a result you will periodically see her cross her eyes. Second, she is also in the process of strengthening her eye muscles, and one set of muscles might be stronger at one point than another set.

As long as her eye crossing is occasional and she can move both eyes in all directions, you have very little to worry about. If either eye is constantly turned in or out, or cannot move fully in all directions, or if you are still uncomfortable with what you are observing, talk to your daughter's health care provider about a referral to a pediatric eye specialist. One final comment: Although the eye crossing tends to get better after a few months as the brain and muscles develop, you may still notice some of the eye crossing happening again when she gets tired—a very normal occurrence.

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