Is this normal, doctor? Ten normal variants in infancy

Abstract

Recognizing what is normal constitutes a key skill for medical practitioners, especially paediatricians. It is a necessary requisite to providing reassurance and avoiding unnecessary referrals, investigations and treatment. Normal variants are atypical or uncommon findings in a given population which are of no clinical or pathological significance yet fall within the spectrum of what is considered the normal range. The list of conditions discussed in this article is by no means complete or comprehensive but merely a reflection of frequently encountered issues in primary care, paediatric outpatients and the paediatric emergency department; they include infantile dyschezia, ‘catch down’ growth, familial macrocephaly, positional plagiocephaly, asymmetrical thigh creases, sacral dimples, physiological anisocoria, PURPLE screaming episodes, gastro-oesophageal reflux and infant gratification and also provide guidance on what not to miss. This short article provides essential guidance for those new to paediatric outpatients or those less familiar with providing advice and guidance to worried parents.