Many families first notice the first signs of achondroplasia at birth or even before birth, when an ultrasound shows shorter-than-expected upper arms and thighs and a larger head compared with the body. Soon after delivery, doctors often confirm what parents see: a newborn with short stature, a relatively large head with a prominent forehead, and hands that can look trident-shaped when the fingers spread. In some babies, how achondroplasia is first noticed also includes early features like low muscle tone, snoring or noisy breathing, or recurrent ear infections that prompt a genetics or orthopedic evaluation.