Why would a baby have epicanthal folds if he doesn't have down's syndrome?

Maybe: Epicanthal folds are normal in Asian races. Outside of asia, epicanthal folds can be part of Down syndrome or other syndromes. Epicanthal folds alone may not be reason for a medical genetics referral. If other anomalies are present (low set ears, joint/bone disorders, low iq, webbed nec), then referral is certainly warranted.

Often just normal: In early infancy the inner epicanthal folds can be a common variation in normal facial development.As the face grows, and the nasal root moves forward it often disappears.