Newborn babies, especially premature infants, aren't born beautiful and unscathed. Bruising and swelling are common features on newborns. Puffy and swollen eyes are also a common concern of premie parents.
Medication
Doctors often put ointment in newborn babies' eyes, especially premature infants, to prevent infection. This can irritate the eyes and cause puffiness, according to Providence.org.
Labor and Birth
If your premature baby was born vaginally, or spent any time in the vaginal canal during the pushing stage, pressure on the face can cause eye puffiness.
Time Frame
The puffiness due to the birth and medication only lasts a few days.
Size
Since premature babies are generally smaller than full-term babies, the puffiness around the eyes can appear more noticeable on their tiny heads.
Other Eye Issues
Premature babies may also appear cross eyed at first, until their eye muscles and coordination develop.