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Newborn Reflexes O C T O B E R 2 0 1 9 NEWBORN REFLEXES MORO Reflex: also known as the embracing or startle reflex. Moro reflex is mediated by the brain stem and becomes apparent at approximately 25 to 26 weeks' gestational age. It is an involuntary motor response meant to protect the infant from sudden changes in body displacements.In normal infants, the response is symmetrical and disappears by 3 to 4 months. The Moro reflex consists predominantly of abduction and extension of the arms with hands open, and the thumb and index finger semiflexed to form a “C”. Leg movements may occur, but they are not as uniform as the arm movements. With return of the arms toward the body, the infant either relaxes or cries. Absence of the reflex may indicate: intracranial lesions asymmetrical response may indicate birth injury involving the brachial plexus, clavicle, or humerus abnormal persistence of embrace gesture may indicate hypertonicity persistence of entire Moro reflex after 4 months may indicate delay in neurologic maturation. ROOTING Reflex: Indicates normal maturity and intact trigeminal nerve. When cheek is stroked, infant turns toward stroking and opens the lips to suck (if not fed recently). This reflex helps the newborn baby find food; when the mother hold the child and allows her breast to brush the newborns cheek, the reflex makes the baby turn toward the breast. The rooting reflex disappears around the sixth week of life. SUCKING Reflex: Indicates normal maturity and intact hypoglossal nerve. Offer non-latex gloved finger or nipple to test; Newborns suck even when sleeping (non-nutritive sucking) and it can have a quieting effect on the baby; This reflex doesn't start until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability because of this; This reflex disappears at 12 months. GALANT Reflex: Also known as the Truncal incurvation reflex. When newborns lie in a prone position and are touched along the para- vertebral area by a probing finger, they flex their trunk and swing their pelvis toward the touch. PALMAR Reflex: Also known as the Grasp reflex. Stroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until the baby is about 5 to 6 months old. PLANTAR Reflex: Also known as Flexor plantar reflex. Stroking the lateral part of the sole of the foot with a fairly sharp object produces plantar flexion of the big toe; often there is also flexion and adduction of the other toes. This reflex disappears around 8 or 9 months in preparation for walking. CRAWLING Reflex: The crawling reflex appears around twenty-eight weeks in utero. This infant reflex disappears when the baby is around six weeks old, but reappears when the child is learning to crawl. You can elicit the response by applying pressure to the soles of a newborn’s feet when the infant is lying face-down. When you apply pressure to the baby’s feet, the infant will make crawling movements. The crawling reflex assists in delivery when the baby is moving through the birth canal. Later in life, it aids the child in milestones such as crawling, and eventually, walking. STEPPING Reflex: This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface. When held upright with one foot touching a flat surface, the newborn puts one foot in front of the other and walks; this reflex is more pronounced at birth and is lost in 4 to 8 weeks. DEEP TENDON REFLEX: Patellar and bicep reflexes; patellar reflex can be elicited by by tapping the patellar tendon with the tip of the finger...the lower leg moves perceptibly if the infant has an intact reflex. To elicit a biceps reflex, the thumb of the examiners left hand is placed on the tendon of the biceps muscle on the inner surface of the elbow. Tap the thumb as it rests on the elbow; tap the thumb as it rests on the tendon. You are more likely to feel the tendon contract than to observe movement. A biceps reflex is a test for spinal nerves C5-C6 and a patellar reflex is a test for spinal nerves L2-L4. PROTECTIVE Reflex: Also known as extrusion reflex. A newborn extrudes any substance placed on the anterior portion of the tongue. This protective reflex prevents the swallowing of inedible substances. It disappears at about 4 months of age. MAGNET Reflex: If pressure is applied to the soles of the feet of a newborn lying supine, the baby pushes back against the pressure. This tests spinal cord integrity. BABINSKI Reflex: Also known as Extensor plantar reflex; When the sole of the foot is firmly stroked, the big toe extends (bends back toward the top of the foot) and the other toes fan out; this is a normal reflex up to about 2 years of age. References: https://www.stanfordchildrens.org/en/topic/default?id=newborn-reflexes-90-P02630 Pillitteri, A., & Pillitteri, A. (2010). Maternal & child health nursing: care of the childbearing & childrearing family. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Davidson, M. R., London, M. L., & Ladewig, P. W. (2012). Olds maternal-newborn nursing & womens health across the lifespan. Boston: Pearson. .
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