Baby Is Shaky After Waking Up – Why & What To Do

Seeing your baby shake after waking up can be alarming While occasional trembling or shaking in babies is often harmless, it can also raise concerns about underlying health issues. In this article, we will explore why babies might shake after waking up, when it is normal, and when you should consult a pediatrician.

Understanding Why Babies Shake After Waking Up

Movement Type	Key Characteristics	Typical Age Range
Physiologic Tremors	Fine, rapid quivers; occur during wake–sleep transitions; abortable when held	Birth to ~3 months
Benign Neonatal Sleep Myoclonus	Fast jerks during light sleep; stops immediately upon awakening	Birth to 6 months
Shuddering Attacks (Infant Shudder)	Brief shiver-like tremors of head/shoulders; triggered by excitement; conscious	3 months to 2 years
Jitteriness (Hypoglycemia)	Coarse tremors that don’t stop with soothing; often tied to hunger	Birth to early infancy
Startle (Moro) Reflex	Arms/legs fling out then hug in; triggered by sudden movement or noise	Birth to ~6 months

1. Immature Nervous System and Physiologic Tremors
   Newborns’ nerve pathways aren’t fully wired yet. As those connections mature, the brain’s signals to muscles can come through a bit glitchy, causing fine tremors or quivers in the arms, legs, chin, or eyelids when your baby transitions between sleep and wakefulness. These harmless jerks — often called physiologic tremors — are distinct from benign neonatal sleep myoclonus (which happens only during sleep and stops immediately on awakening). You’ll usually see these tremors in the first few weeks of life. They fade naturally as your baby’s nervous system refines itself, typically disappearing by 2–3 months of age.
2. Startle Reflex (Moro Reflex)
   Another common cause of shaking in babies after waking up is the Moro reflex, also known as the startle reflex. This reflex is a normal part of newborn development and is most noticeable during the first three to four months of life. The reflex can be triggered by sudden movements, loud noises, or even the baby’s own waking. Characteristics of the Moro Reflex:
   • Baby’s arms suddenly flail out and then return to their body.
   • Trembling or shaking in the arms and legs after waking up.
   • Crying or appearing startled.
   The Moro reflex is a protective mechanism that babies naturally grow out of as their nervous system develops.
3. Low Blood Sugar (Hypoglycemia)
   Sometimes, babies may experience shaking due to low blood sugar levels, especially if they haven’t fed for several hours. Hypoglycemia can cause trembling, shakiness, or jitteriness. This is more common in newborns, particularly if they are born prematurely or have other health conditions. Signs of Hypoglycemia in Babies:
   • Trembling or shaking that doesn’t go away after feeding.
   • Lethargy or sleepiness.
   • Pale or bluish skin tone.
   • Poor feeding or irritability.
   If you suspect your baby’s shaking is due to low blood sugar, offering a feeding can help stabilize their glucose levels. However, persistent shaking, especially if accompanied by other symptoms, should prompt a visit to your pediatrician.
4. Caffeine-Induced Jitteriness
   If you’re nursing and overdo the coffee (over ~300 mg caffeine/day), some of that caffeine passes into breastmilk and can jack up your baby’s jitters. You might spot fine trembling, even if they’ve just fed. Cutting back to 1–2 cups will usually soothe things.
5. Infant Shudder Attacks
   Also called infant shudder syndrome, these are brief clusters of shiver-like tremors — often of the head, shoulders, and arms — that pop up when your little one is excited or frustrated.
   • Duration: 3–6 seconds, may repeat up to 100× a day.
   • Key Clues: Consciousness preserved; stops if distracted; normal EEG.
   No treatment is needed; most babies outgrow it by age 2.

What to Do If Your Baby Shakes After Waking Up

1. Observe Their Behavior
   The first step when you notice your baby shaking is to carefully observe their behavior. Note how long the shaking lasts, when it occurs, and if it stops on its own. Occasional trembling, especially in newborns, can be normal and is often related to their immature nervous system or Moro reflex. When to Monitor:
   • If the shaking stops within a few seconds.
   • If it only occurs after waking up or during sleep.
   • If your baby is otherwise healthy, feeding well, and gaining weight.
   In these cases, it’s likely nothing to worry about, but keeping a record of these episodes can help your pediatrician if needed.
2. Ensure Proper Feeding
   If your baby hasn’t eaten for several hours, offering a feeding can help address potential low blood sugar. Regular feedings are essential for keeping their blood sugar levels stable, especially in the early months when they need to feed frequently. Steps to Take:
   • Offer a feeding if it’s been more than 2–3 hours since the last meal.
   • Make sure your baby is latching properly if breastfeeding.
   • If formula-feeding, ensure the right amount of milk is given based on their weight and age.
   Shaking due to low blood sugar should improve once your baby is fed. If the shaking persists, seek medical advice. Consistent Feeding Schedule Newborns do best on a clock early on—aim for every 2–3 hours, even if they snooze through a feeding window. That settles blood sugar and keeps jitteriness at bay. Hunger Cues, Not Cries Watch for early signs—rooting, lip-smacking—so you feed before shakes start. Crying is often too late and can already trigger tremors.
3. Comfort Your Baby
   The startle reflex can sometimes cause distress, so comforting your baby can help them relax. Swaddling can be an effective way to prevent the Moro reflex from being triggered as it keeps your baby’s limbs snug and secure. Tips for Comforting Your Baby:
   • Gently rock or hold your baby close.
   • Use a swaddle or sleep sack to help prevent sudden movements.
   • Speak in a soothing voice to calm them down.
   This can help reduce episodes of shaking caused by the Moro reflex and provide your baby with a sense of security. Soothing Strategies to Minimize Shaking
   • Swaddling Safely: A snug wrap tames startle reflexes and shudder attacks alike.
   • White Noise: A steady hum can calm jittery nerves at sleep–wake transitions.
   • Gentle Motion: Rocking hugs or a slow stroller stroll often resets tremors.
   • Warmth Check: Ensure arms/legs aren’t cold—babies can shiver if they’re chilled.

Parental Reassurance & Resources

It’s tough when every quiver feels alarming. Remember: most shaking in healthy babies is temporary and harmless.

• Keep a Log: Note date, time, duration, and context. Video helps your doctor see patterns.
• Trusted Sources:
  • American Academy of Pediatrics guidelines
  • SleepFoundation’s sleep-myoclonus overview
• Seek Support: Parent forums and your pediatric community can reassure you—and reduce stress, which helps everyone sleep better.

When to Seek Medical Advice

While occasional shaking or trembling in newborns is often harmless, there are instances where it’s important to consult a pediatrician. If the shaking is persistent or accompanied by other concerning symptoms, it may indicate an underlying issue that needs medical attention.

Warning Signs to Look For:

• Shaking that lasts for an extended period: If the shaking continues for more than a few seconds or minutes, seek advice.
• Other symptoms: Lethargy, poor feeding, vomiting, or difficulty breathing may signal an issue that requires prompt attention.
• Shaking that doesn’t improve: If feeding or comforting your baby does not stop the shaking, or if it occurs frequently, contact your pediatrician.

Diagnostic Steps and Red Flags

If shaking episodes become frequent or worrisome, here’s what typically happens in a check-up:

• Video Recording: Your pediatrician may ask you to record an episode (stabilize your phone!) so they can see the pattern.
• Blood Work: A quick glucose test rules out persistent hypoglycemia.
• Neurological Exam: Reflex checks (including asymmetric responses) help distinguish benign tremors from seizures.
• EEG: If the tremors persist during wakefulness or your baby seems unaware, an EEG can confirm or rule out epileptic activity.

Red Flags to Report:

• Shaking that doesn’t stop when you hold their arm
• Any loss of awareness or altered breathing
• Developmental delays or atypical reflex patterns

Possible Underlying Conditions

In rare cases, persistent shaking or tremors could indicate a neurological condition, such as seizures or muscle tone disorders. A pediatrician may conduct further tests, such as a neurological exam or blood tests, to rule out serious concerns.

Consult Your Doctor If:

• The shaking happens frequently and seems uncontrollable.
• Your baby seems unresponsive during or after shaking episodes.
• There are developmental concerns or delayed milestones.

Conclusion: Baby Is Shaky After Waking Up

In most cases, shaking after waking up in babies is a normal occurrence linked to an immature nervous system, the Moro reflex, or low blood sugar. However, it’s always important to observe your baby closely and provide regular feedings. If you notice any persistent or concerning symptoms, consult your pediatrician for further evaluation. With the right care and attention, most babies will outgrow these tremors as they develop.