The mother of a 4 week old infant is concerned that her infant's eyes are crossed for a few seconds occasionally. What should the NP advise?

In the case of a 4-week-old infant experiencing occasional crossed eyes, it is important to recognize that this is a common developmental phenomenon. Many infants have some degree of strabismus, or misalignment of the eyes, as their visual system is still maturing. This condition is often seen in infants up to about 2 months of age due to the immaturity of their ocular muscles and visual coordination skills.

During this early period, it is not unusual for the eyes to appear crossed intermittently as the brain and eyes work together to develop proper visual tracking and alignment. These occasional episodes typically resolve as the infant grows and gains better control over their eye movements.

Thus, advising the mother that seeing crossed eyes for brief periods is a normal finding for infants under 2 months can provide her with reassurance about her child's development. It is crucial to monitor the situation, as persistent strabismus beyond this age may warrant further evaluation, but for now, this transient occurrence is expected in a healthy 4-week-old baby.