1, how to distinguish between shivering and convulsions General shivering is symmetrical, irregular, easy to stop (shivering stops when holding the infant’s hand in the hand), no cyanosis, lasts for a few seconds, and the infant generally performs well. In contrast, convulsions can be asymmetric (in the case of focal, generalized seizures are also symmetric), the movements of the limbs are more regular and do not stop easily (regular movements can be felt when the infant’s limbs are held by hand), the child may have cyanosis, loss of consciousness, and last for varying lengths of time. Most of the convulsions mean neurological disorders and need to be examined in a neurological specialist. In most cases, if the infant is generally well, neonatal shaking is a normal or non-specific manifestation, usually occurring when crying or being highly stimulated, and disappearing 1-2 months after birth. If the infant shakes even when quiet, or too often, it is necessary to exclude some diseases. 2, which diseases can cause shivering Besides cold, the most common causes are hypoglycemia and hypocalcemia. Hypoglycemia is common in children of diabetic mothers, as well as in preterm, younger-than-gestational-age or older-than-gestational-age infants. Symptomatic neonatal hypocalcemia is often associated with inadequate production of parathyroid hormone. Pre-meal glucose and electrolytes need to be checked at the hospital. Also, this problem may occur in the child if the mother drinks coffee. It usually disappears when the coffee drinking is stopped. In addition, frequent shaking (withdrawal syndrome) can occur in children of mothers who smoke and use drugs, which can be seen in Western countries. The next step is the presence or absence of neurological problems. If twitching is suspected, it needs to be taken to a neurologist for examination, as well as for cranial imaging and EEG.