In most cases, a baby will begin deliberately moving their head in the first months of life. They can usually turn it toward a sound by 2 months. By the end of the first year, and often much earlier, many babies begin shaking their head.

Head shaking can be a normal developmental milestone relating to reflexes and motor skills. However, some types of head shaking may signal a problem.

In this article, we examine the reasons why a baby may shake their head. We also look at related medical conditions for head shaking and explain when to contact a doctor.

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Gaining control of the head is a major developmental milestone.

At about 2 months old, most babies begin turning their head toward sounds. They continue gaining head control and can easily lift and move their head by 4 months. Some parents and caregivers also notice that head shaking begins around this time.

Developmental reasons why a baby might shake their head include:

Experimentation

Babies master new skills by practicing them. For an infant with little control over the world, increasing head control is a major change.

A baby who has recently learned to control their head may turn it from side to side and experiment with moving it into different positions.

Listening to sounds

A baby will commonly move their head toward familiar or interesting sounds, such as a loud crash or a parent’s or caregiver’s voice.

If two or more people are talking, or there are several competing noises in a room, a baby may move their head back and forth, trying to follow the sounds.

In a quieter room, the head movements may stop.

Communication

Babies can understand words well before they can talk. As a result, they may start understanding some of what parents or caregivers say to them at about 6 months. A baby may shake their head to communicate with them.

By a year, many babies shake their head to signal “no” or frustration.

Self-soothing

Some babies find it soothing to shake their head from side to side. They may do this when they are overstimulated, anxious, or trying to fall asleep.

Self-soothing is harmless and may help a baby feel less anxious in new situations.

When a baby shakes their head because something is wrong, they often have other symptoms simultaneously.

Parents and caregivers should monitor head shaking that accompanies other signs and symptoms, such as crying or not meeting developmental milestones.

Some things to watch for include:

Pain or ear infection

Some babies may shake their head to soothe themselves if they are in pain.

Sudden head shaking may be a sign of an ear infection, especially if the baby has a fever or grabs at their ear. Doctors may prescribe antibiotics to treat ear infections.

Epilepsy

Some people with epilepsy, including babies, have myoclonic jerks. These are very short seizures that cause sudden contractions in the muscles.

While myoclonic jerks can affect any part of the body, they may cause some babies to turn their head or neck. The jerks are very short, and parents or caregivers may not initially recognize them as seizures.

Myoclonic jerks happen suddenly and can be forceful. If a baby has these, it will not look as though they are voluntarily shaking their head.

Autism and other developmental issues

Some people with autism move their body to self-soothe or stimulate themselves. They may nod or shake their head, usually in rhythmic motions.

It is possible that an infant may be autistic if they:

  • do not meet developmental milestones
  • gain and then lose skills
  • do not make eye contact with or respond to parents or caregivers

Neurological disorders

Head shaking may signal a neurological problem, especially if a baby seems unable to control it or has other unusual movements or behaviors.

For example, a condition called rhombencephalosynapsis causes differences in the formation of the brain’s cerebellum. A 2013 study found that 50 of 59 children with this condition had persistent head shaking for years before a doctor formally diagnosed them.

Babies with neurological disorders may not meet developmental milestones and may have trouble with speech, movement, and other age-typical behaviors.

Shuddering attacks

Very rarely, babies and young children experience so-called shuddering attacks, which seem to occur spontaneously. A baby’s body may shake or shiver, and these movements might extend to their head.

Doctors do not know what causes these attacks, but they are usually harmless. However, a doctor may first rule out other causes, such as neurological conditions or head injuries.

It is never too early to see a doctor for worrisome or unusual behavior in a baby.

Early interventions can help for a severe developmental or neurological problem, and early treatment for ear infections and other common conditions may prevent these conditions from worsening.

A person should take a baby to the doctor’s office if they:

  • do not meet their developmental milestones — for example, if a baby does not move their head toward sounds by 4 months
  • have other symptoms along with the head shaking, such as fever
  • seem distressed
  • are unable to control their head or their movements

Parents or caregivers should also discuss any new behaviors at the baby’s next well-child visit.

As babies discover the world, they continually develop new skills. Sometimes, unusual behaviors appear along with these skills.

In most cases, head shaking is a normal, developmentally appropriate behavior that shows that a baby is exploring and interacting with their world.

If a baby has any accompanying symptoms or seems distressed, it is important to take them to see a doctor.