What is the cause of puffy upper eyelids in a 28 day old baby?

Some puffiness in the upper eyelids of babies born 28 days old may be related to improper sleeping positions, such as sleeping on the stomach for long periods of time, where fluid accumulates on the face, combined with relatively loose connective tissue in the eyelid area, and you may have puffiness.
If the puffiness is frequent and is not relieved by changing the sleeping position and putting the head up, you need to be alert to the possibility of vitamin D deficiency or kidney disease, at which point a hospital visit is recommended for a definitive diagnosis.