THE BABY’S EYES
WHEN WILL my baby see? This is one of the most frequent questions the pediatrician hears. Newborns react to light, following it with their eyes. and in the second month babies notice, or seem to notice, movement of objects. But these are probably not the answers parents really are seeking. What they want to know is, when will he see me and all the love I want to give him? This dawning of love, the perceptible change from helpless infant to human baby, has to wait for maturation of the visual system.
The baby must develop binocular vision, the process of fusing the separate images from two eyes into a single image, and acquire the ability to focus according to the distance between the object and his eyes. Only when he begins to see you, in the adult’s sense of seeing, will you be able to count on the look of recognition and the pleased smile of greeting. Your baby will then become a person and begin to develop a real personality. Apart from the clinical fact that his eyes follow a spot of light. we have no way of knowing what the newborn or very young infant actually sees, but once he has learned to focus, the change in his relationship with his parents is quite remarkable. This process takes time, perhaps as short as three months or as long as six or more.
Though she has carried her child within her for nine months, a mother may find herself unable to relate fully to the baby or even to make his acquaintance. She should nor feel guilty or frustrated. The infant must respond before the parent can feel satisfied that her mes-sages are getting across to him, and this response comes in full only when baby and mother can look into each other’s eyes knowing, some-how, that the other is seeing too. This period of early development may be even harder for fathers. Though he may help his wife by feeding, changing, and dressing the baby from time to time, the young father probably has to push himself a bit to produce a continual overflow of warm affection for a creature that does no more than eat, eliminate, sleep. and cry. All this will change at the first smile of recognition. In a way, it may be somewhat of a blessing that the baby does not “see” for the first several months.
This is the period of often agonized trial and error, of experimentation with sleeping schedules, formulas, and so forth. The baby is totally oblivious to our harried, even on occasion hostile. looks. His powers of perception, if we can call them that, are concentrated in his mouth. We have a period of grace in which to adapt to this new responsibility. The eyes of the newborn sometimes show certain mild. temporary symptoms which can be of concern to parents:
1. From so to 5o percent of newborns exhibit a tiny spot of bleeding on the white of the eye. This will disappear in two to three weeks and has no significance.
2. Medication required by law to prevent infection (primarily gonorrheal infection) may cause considerable swelling around the eyes, sometimes enough to hide them entirely, and also a temporary dis-charge. which disappears by the fifth day. The silver nitrate of the medication causes the discharge.
3. A temporary plugging of a tear duct at the corner of the eye may cause an intermittent discharge. Your donor will tell you how to deal with this condition, but usually no special attention is called for. Nevertheless. it is always a good idea to inform your doctor of any eye discharge. however minor.
4. While he is learning to focus, your baby may give the appearance of being cross•eyed. His lack of muscular coordination and control, together with the configuration of his features are responsible. Up to the age of five months this occasional crossing of the eyes has no sig. naviance.
In spite of all the crying he will do. your baby is not likely to produce tears before his fourth or fifth week of life; and since the majority of babies are born with “blue eyes.” it may be months before you can be sure whether he will have mother’s brown eyes or father’s blue eyes .
Some distortion of the shape of the baby’s head at birth is not at all unusual. In delivery the skull accommodates to the passage through the birth canal, and often the head emerges looking more like a football than a sphere. This distortion (or molding) is not cause for alarm. In from one to three weeks the head will regain its normal shape. Curiously, though mothers are said to talk a good bit among them-selves about distortions of the head. it is a subject they rarely bring up in their conversations with doctors.
They do show concern about the fontanel and about the localized collections of blood that may form at the time of birth between the skull and scalp. These blood clots, known as cephalohematomas, are common and quite harmless. The clots may linger for three to four months but always disappear. They go away in the course of an intermediate process of hardening (or calcification), which may produce a bony lump standing out in prominent silhouette against the natural contour of the skull. In three to four months the lump blends in with the normal skull. It should be emphasized that neither the distortion of head shape nor the collections of blood come about through anything either the mother or doctor has done.
Nor do they in any way affect the infant’s brain. You should not regard them as “damage.” They have no significance for the infant’s future. The fontanel (see page aro) may remain open for a year. The time varies considerably from baby to baby. This soft spot is a source of worry to many parents, who think the head is vulnerable to injury until the skull is completely closed. Some parents are almost afraid to shampoo the baby’s hair.
Those fears are groundless. The “soft’ spot is in fact an extremely tough fibrous covering. The fontanel will be an area of special interest to your doctor if your baby should become ill, particularly when there is high fever. In the presence of infection the doctor will want to know whether the fontanel seems “full” or “tense.” You have no need to worry about the doctor’s routine interest in the fontanel at periodic examinations, but by all means ask if your concern has not been completely quieted. The newborn’s earlobes may be slightly folded down at birth, a minor and inconsequential deviation that comes from the position of the fetus in the womb. You can expect that by one or two months of age they will have returned to normal.