By Linda Conlin, Pro to Pro Managing Editor
A fussy infant can be hard to figure out. Are they hungry, need a diaper change, hot or cold? After a process of elimination, there’s one more thing you may want to check. Does the skin around the eyebrows appear red or flushed? It could indicate that the baby is tired and needs to sleep.
While there’s some disagreement in the literature about the accuracy of flushed eyebrows as a sleep cue, there is a rational explanation. Being tired can be stressful for babies and they may be overstimulated or in a situation where they can’t just go to sleep. In all of us, stress activates the pituitary gland which signals the adrenal gland to produce cortisol. Cortisol is the ‘awake hormone’ part of the sleep/wake cycle. Blood vessels dilate due to cortisol release, and the skin around an infant’s eyebrows is less fatty, thinner, and more transparent, making the blood vessels more apparent, and so the eyebrows appear reddish. Babies also tend to rub their eyes when tired, which also contributes to redness around the eyes. Other cues for the need for sleep the baby’s eyes can provide are a glazed look and avoiding eye contact.
It’s important to remember, however, that redness around the eyes can have causes other than tiredness. Reddish eyes in infants can be caused by environmental irritants, allergies, and infections. Irritants usually cause localized redness that resolves once the irritant is removed. In the case of allergens, their eyes may produce histamine to fight the allergen. As a result, their eyelids and conjunctiva become red, swollen, and itchy. Redness in the eye area of a newborn also can be caused by a blocked tear duct, irritation, or infection. Any indication of infection, of course, requires immediate attention as well as other causes of redness that don’t resolve or worsen.
Once it’s determined that those reddish eyebrows indicate a tired baby, what can be done to help them fall asleep? Gently stroking the eyebrows encourages the baby to reflexively close their eyes and relaxes them, reducing cortisol levels. Daylight and screens also stimulate cortisol production. Blackout curtains for the sleeping area will block daylight, and the American Academy of Pediatrics (AAP) recommends that babies younger than 18 months get no screen time at all. The exception to this rule is video chatting with grandparents or other family members or friends, which is considered quality time interacting with others.
Taking care of an infant requires considerable detective work and awareness of sometimes subtle cues. Once again, the eyes can provide some clues. My kids are grown, but this is one thing I know now that I wish I knew then!