Neonatal Reflexes: Dr. Balbirsingh

NEONATAL REFLEXES
Dr. Balbirsingh
J.L.N.Hospital Research centre,
Bhilai Steel Plant
INTRODUCTION
 Actions in response to specific stimuli that are
present in newborn infants.
 These are unconditioned reflexes and not learned

or developed through experience.
 Normally developing neonates or infants are

expected to respond to specific stimuli with a
specific, predictable behaviour or action.
MORO’S REFLEXE
ELICITED BY :
PLACING THE BABY IN SEMI UPRIGHT POSITION
↓
SUDDEN DROPING OF HEAD IN RELATION TO TRUNK
AND CATCHING THE FALLING HEAD
DISAPPEARS AT 3 TO 6 MTHS
RESPONSE
 OPENING OF HAND
 EXTENSION AND ABDUTION OF UPPER EXTRIMITIES
 ANTERIOR FLEXION OF UPPER EXTRIMITIES
 AUDIBLE CRY
ABNORMALITIES:
DEPRESSED OR ABSENT
 GENERALISED DEPRESSION OF CNS
ASYMMETRICAL RESPONSE
 FRACTURE CLAVICLE
 ERB PALSY
 HEMIPARESIS
EXAGERGERATED RESPONSE
 KERNECTERUS
STARTLE REFLEX
 It is variant of Moro’s Reflex.
 Ellicited by: sudden loud noise or by

tapping the sternum
 Response is like Moro’s reflex but

elbow remain flexed and hands closed
PALMER GRASP
 Elicited By: Placing finger or object in open
palm of each hand
 Response: Infant grasp the object and with
attempted removal grip reinforced
 Appears at 28 weeks of gestation and
disappears at 2-3 months of life
 Persistence beyond 6mths: Athetoid

CP
TONIC NECK REFLEX
ASYMMETRIC TONIC NECK REFLEX
 Elicited By: Passive rotation of head in supine
position
 Response: Extension of upper limb of same
side and flexion of upper limb of opposite side
 Appears at birth and disappear at 3
months
 Persistence > 3 months: Spastic CP
 Importance: Prevents body from

rolling
TONIC NECK REFLEX
SYMMETRIC TONIC NECK REFLEX
 Elicited By: Passive extension of head in

prone position
 Response: Extension of both UL & flexion of
both LL
 Appears in 3 mths and disappear in 6mths
 Persistence > 6mths : CP
Importance: When baby learn to turn to prone

position chocking over bed may asphyxiate him so
if baby lift his chin by extension of neck both upper
limbs extend automatically and chocking avoided.
GALANT REFLEX
 Elicited By: Holding the child in ventral
suspension or placed in prone position and
running finger down in paravertebral area on
one side
 Response: Swinging of pelvis towards
stimulated side
 Appears at birth disappear by 1 year
 Used for mapping sensory level of

trunk
PEREZ REFLEX
 Elicited By: Holding the child in prone

position and pressure applied upword
along spine.
 Response: Flexion of arms and legs

with extension of neck and cry
 Appear at birth and disappear at 6

weeks
TRACTION RESPONSE
 Grasp the baby at his wrist and finger

and pull to sit
 Response: Certain degree of head
control is demonstrated and head is
brought forward actively
ADDUCTION RESPONSE
 Elicited by: holding leg of baby in extension

and sole of foot is rubbed
 Response: the other leg first withdraw and

then extend with fanning of toes and bring
toward the side of stimulation (as to push the
noxious stimulus)
ROOTING REFLEX
(SEARCH REFLEX)
 Elicited By: Touching the corner of mouth
lightly with finger
 Response: Bottom lip is lowered on same
side and tongue moves towards the point of
stimulation as finger slides away head turns
to find it.
Appear 28 week & disappear 4-7 mths
Importance:
 Absence at birth and persistence beyond 7
months indicate developmental delay
 Helps the baby for finding the breast

SUCKING REFLEX
 Elicited By: Introducing finger into babies

mouth
 Response: Baby starts sucking vigorously
 Appear at 28 week disappear at 4-7 months
 Absence sucking at birth indicate sickness,

persistence beyond 7 mths developmental
delay
LANDAU REFLEX
 Elicited By: Holding the child in ventral

suspension
 Response: Extension of head, spine
and legs
 Appear at 3 months disappear at 9
months
 Absence beyond 3 mths indicate motor

weakness, mental sub normality & CP
PARACHUTE REFLEX
 Elicited By: Holding the child in ventral

suspension and suddenly brought down
the baby towards ground from height
 Response: Extension of both UL in
attempt to avoid injury
 Appears at 6-9 months persists life
long.
 Absent in CP and hemiplegia of

affected limb
PLACING REFLEX
 Elicited by: Bringing the anterior aspect of tibia

against edge of table
 Response: Lifts leg on the table
 Appear at birth and disapper

at 6 weeks.
WALKING REFLEX
 Elicited by: holding the baby

upright over the table so that sole
of foot presses against the table
 Response: Reciprocal flexion and

extension of leg simulating
walking
 Appears at birth and disappear at
6 week
PALMOMENTAL REFLEX
 Elicited by: Pressing the palm
 Response: Opening of mouth
 Appear at birth and disappear

at 3 year
CONCLUSION
Knowledge of neonatal reflexes is important for

 Understanding the human development as a
whole.
 Application for over all assessment of baby
 Recognition of possible neurodevelopemental
damage in prenatal and perinatal period.
 Establishment of the prognosis for future
 Predicting the Childs future potential
THANKS

Neonatal Reflexes: Dr. Balbirsingh

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NEONATAL REFLEXES

 These are unconditioned reflexes and not learned

 Normally developing neonates or infants are

PLACING THE BABY IN SEMI UPRIGHT POSITION

 EXTENSION AND ABDUTION OF UPPER EXTRIMITIES

 ANTERIOR FLEXION OF UPPER EXTRIMITIES

 It is variant of Moro’s Reflex.

 Ellicited by: sudden loud noise or by

 Response is like Moro’s reflex but

 Persistence beyond 6mths: Athetoid

 Persistence > 3 months: Spastic CP

 Importance: Prevents body from

 Elicited By: Passive extension of head in

Importance: When baby learn to turn to prone

 Used for mapping sensory level of

 Elicited By: Holding the child in prone

 Response: Flexion of arms and legs

 Appear at birth and disappear at 6

 Grasp the baby at his wrist and finger

 Elicited by: holding leg of baby in extension

 Response: the other leg first withdraw and

 Helps the baby for finding the breast

 Elicited By: Introducing finger into babies

 Appear at 28 week disappear at 4-7 months

 Absence sucking at birth indicate sickness,

 Elicited By: Holding the child in ventral

 Absence beyond 3 mths indicate motor

 Elicited By: Holding the child in ventral

 Absent in CP and hemiplegia of

 Elicited by: Bringing the anterior aspect of tibia

 Appear at birth and disapper

 Elicited by: holding the baby

 Response: Reciprocal flexion and

 Elicited by: Pressing the palm

 Response: Opening of mouth

 Appear at birth and disappear

Knowledge of neonatal reflexes is important for

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