NEONATAL REFLEXES
REFLEXES ELICITING THE REFLEX CHARACTERISTIC RESPONSE COMMENTS
Sucking and Touch infant’s lip, cheek or corner of Infant turns head toward stimulus, Response is difficult if not impossible to elicit
rooting mouth with nipple opens mouth, takes hold and sucks after infant has been fed, if response week
or absent, consider prematurity or
neurological defect. Response disappears
after 3 to 4 months but may persist up to 1
year.
Swallowing Feeding infant; swallowing usually Swallowing is usually coordinated If response is week or absent, this may
follows sucking and obtaining fluids with sucking and usually occurs indicate prematurity or neurological defect.
without gagging, coughing, or Sucking and swallowing are often
vomiting. uncoordinated in preterm infant.
Grasp
Palmar Place finger in palm of hand Infant’s fingers curl around Palmar response lessens by 3 to 4 months,
Plantar Place finger in base of toes examiner’s finger; toes curl plantar response lessens by 8 months.
downward.
Extrusion Touch or depress tip of tongue Newborn forces tongue outward. Response disappears about fourth month of
life.
Glabellar Tap over forehead, bridge of nose, Newborn blinks for first four or five Continued blinking with repeated taps is
(Myerson’s) or maxilla of newborn whose eyes taps consistent with extra pyramidal disorder.
are open
Tonic neck or With infant falling asleep or With infant facing left side, arm and Responses in legs are more consistent.
“fencing” sleeping, turn head quickly to one leg on that side extended; opposite Complete response disappear by 3 to 4
side. arm and leg flex (turn head to right, months, incomplete response may be seen
and extremities assume opposite until third or fourth year. After 6 weeks,
postures) persistent response is sign of possible
cerebral palsy.
NEONATAL REFLEXES
Moro’s Hold infant in semisitting position, Symmetrical abduction and extension Response is present at birth; complete
allow head and trunk to fall of arms are seen; fingers fan out to response may be seen until 8 week;
backward to an angle of at least 30 form a C with thumb and forefinger; response is absent by 6 month if neurologic
degrees. slight tremor may be noted; arms are maturation is not delayed; response may be
Place infant on flat surface, strike adducted in embracing motion and incomplete if infant is deeply asleep.
surface to startle infant. return to relaxed flexion and Asymmetric response may connote injury to
movement brachial plexus, clavicle or humerus.
Legs may follow similar pattern of Persistent response after 6 months indicates
response possible brain damage.
Preterm infant does not complete
“embrace”; instead arms fall
backward because of weakness.
Stepping or Hold infant vertically, allowing one Infant will simulate walking, Response is normally present for 3 to 4
“walking” foot to touch table surface alternating flexion and extension of week.
feet, term infants walk on soles of
their feet, and preterm infants walk
on their toes.
Crawling Place newborn on abdomen Newborn makes crawling movements Response should disappear about 6 week of
with arms and legs age.
Deep tendon Use finger instead of percussion Reflex jerk is present; even with
hammer to elicit patellar, or knee newborn relaxed, nonselective
jerk, reflex; newborn must be overall reaction may occur
relaxed.
Crossed Infant should be supine; extent one Opposite leg flexes, adducts, and Stimulation of sole of foot of fixated limb
extension leg, press knee downwards, then extends. should cause free leg to flex, adduct, and
stimulate bottom of foot, observe extend as if attempting to push away
opposite leg. stimulating agent. This reflex should be
present during newborn period.
NEONATAL REFLEXES
Startle Perform sharp hand clap; best Arms abduct with flexion of elbows, Response should disappear by 4 month of
elicited if newborn is 24 to 36 hr old hands stay clenched. age
or older. Response is elicited more readily in preterm
newborn.
Babinski’s sign On sole of foot, beginning at heel, All toes hyperextend, fanning of toes, Absence requires neurologic evaluation,
(plantar) stroke upward along lateral aspect with dorsiflexion of big toe- recorded should disappear after 1 yr of age.
of sole, then move finger across ball as positive sign.
of foot.
Pull-to-sit Pull infant up by wrists from supine Head will lag until infant is in upright Response depends on general muscle tone
(traction) position with head in midline position, then head will be held in and maturity and condition of infant.
same plane with chest and shoulder
momentarily before falling forward;
infant will attempt to right head.
Trunk incurvation Place infant prone on flat surface, Trunk is flexed and pelvis is swung Response disappears by fourth week
(galant) run finger down back about 4 to 5 toward stimulated side. Absence suggests general depression of
cm lateral to spine, first on one side nervous system.
and then down other.
Magnet Place infant in supine position, Both lower limbs should extended Absence suggests damage to spinal cord or
partially flex both lower extremities against examiner’s pressure. malformation
and apply pressure to soles of feet. Reflex may be weak or exaggerated after
breech birth.
Additional These are spontaneous behaviors May be slightly depressed
newborn temporarily because of maternal Parents need to be assured that behaviors
responses Yawn, analgesia, fetal hypoxia, or infection are normal . no treatment is needed for
stretch, burp, hiccups, sucking may help.
hiccup, sneeze
