Newborn Eye Contact: What's Normal?

Eye contact is one of the first milestones you'll notice in a newborn baby. While newborns are theoretically able to focus on their parents, their vision is still very immature compared to that of an adult. It is normal for newborns not to focus their eyes on objects or people all the time, as they need time to develop their ability to focus. However, if a newborn fails to make eye contact in the first six months, an immediate consultation with an expert is recommended.

Newborns can be fascinated by new faces and may not make eye contact with their primary caregiver

Within the first 7 hours of life, newborns can show an intense interest in their mother's face, even mimicking facial expressions. However, it is also normal for newborns not to focus their eyes on objects or people all the time. Their vision is still very immature compared to adults, and they need time to develop their ability to focus and track objects with their eyes. This development happens rapidly in the first few weeks of life, with babies usually starting to make eye contact by 6-8 weeks.

If a newborn is not making eye contact with their primary caregiver, it could be because they spend the most time with that person and are more interested in looking at new faces. This is a normal part of their development and should not be a cause for concern. In fact, it can be a positive sign that the baby is comfortable and secure with their primary caregiver, as they do not feel the need to constantly seek their attention or gaze.

However, it is important to be aware of other potential reasons for a lack of eye contact. In some cases, it could be a sign of autism, a neurovisual problem, or a visual impairment such as strabismus, amblyopia, congenital cataract, or retinopathy of prematurity. If there are concerns about a baby's eye contact or visual development, it is recommended to consult a healthcare provider or paediatrician, who can refer to an eye specialist if needed.

Babies may not make eye contact if they are tired or overstimulated

It is perfectly normal for newborns not to make eye contact with you. In fact, it is expected that newborns will not make eye contact all the time. Newborns need time to develop their ability to focus on objects and people, and if they are tired, they may not want to look at or focus on anything.

Babies' vision develops rapidly in the first weeks of life. They direct their gaze towards people around them to create interaction and, in the first months, their ability to focus on and track objects with their eyes improves. By six to eight weeks old, babies usually start looking you in the eye, and around six to ten weeks, they will begin to direct their eyes intentionally, looking directly at you and holding your gaze. By three to four months, they will start to deliberately reach for objects they recognise and smile deliberately at you when you make eye contact.

However, if a baby fails to make eye contact in the first six months, it is recommended to consult an expert immediately. Pediatricians can evaluate the eye contact problem by observing and asking parents about certain infant behaviour traits, such as whether the baby tends not to look at their parents, fails to recognise familiar faces, does not cry when their parents leave, does not show anxiety with strangers, tends to gaze out of the corner of their eye, or has a problem following objects visually.

If you are worried about your baby's eye contact, speak to your healthcare provider or a paediatrician. They can refer you to a children's eye specialist (paediatric ophthalmologist) if needed.

A lack of eye contact can be a sign of autism

It is normal for newborns not to focus their eyes on objects or people all the time. Their vision is still immature, and they need time to develop their ability to focus. However, a lack of eye contact can be a sign of autism.

Autism is a spectrum, and people with autism spectrum disorder (ASD) may have difficulty maintaining eye contact. This is not true of all autistic people, but research suggests that around 50% of autistic people experience alexithymia, a condition characterised by an inability to feel emotions, which can make eye contact difficult.

For autistic people, eye contact can be a very intense and overwhelming sensory experience. It can be physically uncomfortable, with symptoms including increased heart rate. It can also be invasive, distracting, and confusing. Autistic people may not understand the importance that neurotypical people place on eye contact, and they may find the experience of making eye contact uncomfortable.

The ability to make eye contact develops over time in babies and young children. Within the first seven hours, newborns can show an intense interest in their mother's face, even mimicking facial expressions. Around 6–10 weeks, babies will begin to direct their eyes intentionally, looking directly at caregivers and holding their gaze. Usually, by three months of age, babies will follow their caregiver's movements if they are not too far away. However, if a baby fails to make eye contact in the first six months, an immediate consultation with an expert is recommended.

While a lack of eye contact may be a feature of autism, it is not diagnostic on its own. It is essential to consider other factors and consult with healthcare professionals for a comprehensive evaluation.

Eye contact is important for brain development and emotional connection

It is normal for newborns not to look at you, as they need time to develop their ability to focus on objects and people. However, eye contact is important for brain development and emotional connection.

Eye contact is a powerful tool for building trust and forming emotional connections. When a parent or caregiver gazes into a baby's eyes, it fosters a deep sense of attachment and security, which is crucial for the baby's social and emotional development. This early social bonding lays the groundwork for healthy emotional and social development, as the baby's sense of security allows their brain to grow and develop on track.

Research has shown that eye contact literally syncs brain waves, with the release of oxytocin, the "love hormone", creating a sense of warmth and connection. This neural synchrony improves social learning and helps the baby understand and empathize with others on a deeper level.

As babies grow, they start to make connections between expressions and feelings. They learn how to respond and develop the ability to engage and relate to others, regulate their feelings, and communicate. Eye contact also helps infants and young children develop their communication skills, as they begin to understand facial expressions and non-verbal cues, which aids their ability to interpret emotions, intentions, and moods.

Eye contact is also integral to language development. Babies are highly attentive to their caregivers' facial expressions and mouth movements when spoken to, and by watching and listening simultaneously, they absorb language, pronunciation, and the nuances of verbal communication more effectively.

In summary, eye contact is a fundamental aspect of human communication that plays a vital role in early brain development and emotional connection. It forms the foundation of social interaction and is one of the first ways a baby connects with their caregivers, fostering a deep sense of attachment and security.

Vision impairment or other medical conditions can impact a baby's ability to make eye contact

Vision Impairment

Vision impairment at birth is called a congenital issue. It can also develop later as a result of disease, injury, or a medical condition.

Congenital Anomalies

Congenital anomalies refer to atypical formations of the eyes during pregnancy. These can include:

• Anophthalmos: The entire eyeball is absent from birth.
• Microphthalmos: The eyeball is smaller than normal from birth.
• Coloboma: The embryonic fissure does not close completely by the sixth week of intrauterine life, leading to a severe visual loss if the defect involves the macula and/or optic nerve.
• Congenital cataract: Opacity of the lens that can lead to vision loss.
• Infantile glaucoma: Can result in blindness without early intervention.
• Neuro-ophthalmic lesions: Lesions on the optic nerve can be caused by birth asphyxia, which also causes cerebral palsy.

Acquired Conditions

Acquired conditions are those that develop after birth. They can include:

• Retinopathy of prematurity (ROP): An eye disorder affecting extremely premature babies due to the atypical development of blood vessels in the retina. Low birth weight and gestational age are the most important risk factors for developing severe ROP.
• Ophthalmia neonatorum: Conjunctivitis that develops within the first 28 days of an infant's life, usually due to bacterial or viral infections.
• Amblyopia ("lazy eye"): Occurs when one or both eyes do not develop properly early in life, often as a result of strabismus, refractive errors, cataracts, or ptosis.
• Strabismus: Eye muscles are unable to work together, causing eyes to turn in or out constantly. It can be genetic or caused by prematurity, retinoblastoma, cerebral palsy, or spina bifida.

Other Medical Conditions

Other medical conditions that can impact a baby's ability to make eye contact include:

• Teething: The discomfort and pain can make babies fussy and less interested in social interaction, including eye contact.
• Overstimulation and sensory overload: Bright lights, loud noises, or too much activity can make it difficult for babies to focus and process information, leading to a preference for looking away.
• Neurovisual problems: In some cases, it is not the eyes that are the problem but the area of the brain that analyses the images. This is more common when the child is born prematurely.
• Autism: Looking away or avoiding eye contact can be a symptom of autism.

Frequently asked questions