Neonatal reflexes

Reflexes are unintentional movements or actions made either automatically, or as a response to specific stimuli. Neonatal reflexes evolved in human development to assist with infant survival, sending signals to parents to respond appropriately to their infants.

Infant reflexes help us ascertain that the infant’s brain activity and nervous system are healthy. They tend to occur at specific times during the psychomotor development of a normal infant. The most significant reflexes that appear in newborns are:

 Orienting Reflex/Rooting Reflex

This happens when we stroke, or touch the cheek, or the corner of the baby’s mouth. It may also happen automatically, when the newborn is hungry and is “looking for” food. In response, the infant turns his head towards the stimulus, opens his mouth, and is “oriented” towards the direction of the touch. The reflex aims to help an infant with breastfeeding.

Absence of this reflex may mean that there are neurological problems, such as paralysis of the facial nerve. The reflex normally stops at around 4 months.

Sucking Reflex

After the preparation by the rooting reflex for the beginning of feeding, the presence of a stimulus on the roof of the baby’s mouth urges the infant to start sucking.

Moro Reflex

It is often referred to as the startle reflex. It evolves from a sudden loud noise, or from sudden movements, for example when the infant is undressed, or the infant’s head is left to fall backwards. In response, the infant stretches, symmetrically extends his arms and legs, is restless or cries, and immediately after, quickly draws his arms and legs to his middle. This reflex can also take place when the baby cries.

The Moro reflex serves the baby, because his response expresses his surprise at possible severe, unexpected, or harmful stimuli, urging the parent to respond with a hug, by swaddling him, or grabbing his hands.

When the reflex is not symmetrical, it indicates paralysis of the brachial plexus, (a network of nerves that carries signals from the spine to the shoulder), or a fracture of the clavicle (collar bone), or the humerus (bone between the shoulder and the elbow). This reflex lasts at most from 5 to 6 months. Its persistent presence after 4 months may indicate a neurological problem.

Tonic neck reflex

When the baby’s head turns to one side, the arm on that side extends outwards, while the arm on the opposite side bends at the elbow. This is also called the fencing reflex.

This reflex lasts 6 to 7 months. It is strongest 2 to 3 months after birth, giving the infant of this age his usual asymmetric posture. After 4 months the infant’s posture becomes more symmetrical, the hands joining in the middle, and head movements to the right and left no longer leading to reflexive movements of the arms, and the infant now deliberately controlling the movements of his arms.

The persistence of this reflex after 5-6 months indicates a neurological problem.

Grasping reflex

The reflex happens when you stroke the palm of the baby’s hand. The baby closes his hand and grasps, without letting go of your finger. The grasping reflex lasts for 3-4 months after birth. After this, the normal infant is able to deliberately open his palm and let the object fall.

The persistent presence of the grasping reflex can indicate a neurological problem, such as cerebral palsy.

Babinski reflex

When you touch the sole of baby’s foot, his big toe moves upward, and his little toes fan out. This reflex lasts at least until the child is 2 years old.

Stepping reflex

Also called the walking, or dancing reflex. When one leg is stimulated, e.g., when standing up or touching a fixed surface, the other leg lifts up and bends, moving to a position in front of the other leg.

Asymmetry in this reflex may indicate a neurological problem, such as hemiplegia (paralysis of one side of the body).


Stelios Papaventsis MRCPCH DCH IBCLC 2013


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