Seizures in Babies & Toddlers
Content reviewed against published AAP, CDC, NIH guidelines
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A seizure occurs when there is abnormal electrical activity in the brain, causing involuntary movements, stiffness, jerking, staring, or altered consciousness. Seizures in babies can look different from those in adults — they may manifest as subtle eye movements, lip smacking, cycling leg movements, or brief stiffening episodes. Any suspected seizure in a baby requires medical evaluation, though many are single events with good outcomes.
Key takeaways
- A seizure occurs when there is abnormal electrical activity in the brain, causing involuntary movements, stiffness, jerking, staring, or altered consciousness.
- Most common cause: Febrile seizure (triggered by fever)
- Emergency: Seizure lasting more than 5 minutes — call 911/999 immediately
- Home care: During a seizure: lay child on their side (recovery position), do NOT put anything in their mouth
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Seizure lasting more than 5 minutes — call 911/999 immediately
- Seizure with breathing difficulty or blue color that does not self-resolve
- Seizure after head injury
- Seizure in baby under 6 months (always needs emergency evaluation)
- Multiple seizures without regaining consciousness between them
- First seizure with fever in baby under 12 months (rule out meningitis)
- Seizure with bulging fontanelle, stiff neck, or rash
Urgent — See doctor today:
- First seizure without fever at any age
- Febrile seizure that was prolonged (>5 minutes) or focal (one-sided)
- Clusters of head drops or body spasms (infantile spasms)
- Seizure with developmental regression
- Second seizure within same illness
Same-day appointment:
- Simple febrile seizure (brief, generalized, single episode) — needs evaluation same day for first occurrence
- Suspected seizure that parents are unsure about
- Recurrent stereotyped episodes that may be seizures
Monitor at home:
- Known febrile seizure disorder with typical brief episode managed per existing plan
- Confirmed breath-holding spells (diagnosis already made by doctor)
- Benign sleep myoclonus (ONLY occurs during sleep, stops when woken)
By Age
0-2 months
Normal: Benign neonatal sleep myoclonus (rhythmic jerking ONLY during sleep that stops when baby wakes) is common and NOT a seizure. Jitteriness (tremors that stop when limb is held) is common and benign. Startle reflexes can look alarming but are normal.
Worry if: Repetitive rhythmic jerking that does not stop when limb is held. Subtle seizure signs: eye deviation, lip smacking, tongue thrusting, cycling movements. Seizure with color change (blue or grey). Seizure with fever in newborn (meningitis/sepsis until ruled out). Multiple episodes. Seizure following difficult birth.
2-6 months
Normal: Benign myoclonus of infancy (brief whole-body jerks that baby recovers from immediately). Shuddering attacks (brief trembling episodes — benign). Startle/Moro responses that look dramatic.
Worry if: Clusters of head drops/body jackknifes (infantile spasms — urgent). Rhythmic jerking of limbs lasting >30 seconds. Eyes deviating to one side. Color change during episode. Developmental regression with seizure-like episodes. Seizure with fever, vomiting, or bulging fontanelle.
6-12 months
Normal: Self-gratification behaviors (rhythmic rocking or stiffening that stops with distraction). Breath-holding spells (triggered by crying, brief loss of consciousness). Sleep-related movements.
Worry if: Repetitive stereotyped episodes that cannot be interrupted. Developmental regression or loss of milestones. Clusters of brief spasms (infantile spasms/West syndrome). Post-ictal drowsiness after episode. Seizure with first fever (evaluate for meningitis in this age group).
1-3 years
Normal: Febrile seizures are common (2-5% of children aged 6 months to 5 years). Breath-holding spells peak at 12-18 months. Night terrors can mimic seizures (but occur from deep sleep and child is not responsive during event).
Worry if: First seizure without fever (needs evaluation). Seizure lasting more than 5 minutes (status epilepticus — call 911). Recurrent seizures. Seizure with developmental regression. Focal seizure (one side only). Multiple febrile seizures in same illness. Seizure with head injury.
Home Care
- During a seizure: lay child on their side (recovery position), do NOT put anything in their mouth
- Clear the area of hard/sharp objects to prevent injury
- Time the seizure — if it lasts more than 5 minutes, call emergency services
- Do NOT restrain the child or try to stop the movements
- Do NOT give food, water, or medication by mouth during or immediately after a seizure
- After seizure: keep child on their side, stay calm, they may be sleepy (post-ictal) — this is normal
- Video the episode if possible — this helps doctors enormously with diagnosis
- For febrile seizures: manage the fever with acetaminophen AFTER the seizure resolves (fever control does not prevent febrile seizures)
- Note: febrile seizures, while frightening, do not cause brain damage and most children outgrow them
Need help deciding what to do?
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Sources
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Related Symptoms
Bottom line
Most cases of seizures in babies are not emergencies. However, seek immediate care if seizure lasting more than 5 minutes — call 911/999 immediately.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.