Newborn Reflexes

Reflexes are involuntary movements or

actions. Some movements are spontaneous,
occurring as part of the baby’s usual activity.
Others are responses to certain actions.
Reflexes help identify normal brain and nerve
activity. Some reflexes occur only in specific
periods of development.

Primitive reflexes are reflex actions

originating in the central nervous system
that are exhibited by normal infants but not neurologically intact adults, in response to
particular stimuli. These reflexes disappear or are inhibited by the frontal lobes as a child
moves through normal child development.

REFLEX NORMAL RESPONSE ABNORMAL

RESPONSE
Rooting and Newborns turns head in direction of Weak or no response
sucking stimulus, opens mouth, and begins to suck occurs with
when cheek, lip, or corner of mouth is prematurity,
touched with finger or nipple. neurologic deficit or
injury, or central
nervous system
(CNS) depression
secondary to
maternal drug
ingestion (eg.
narcotics).
Extrusion Newborn pushes tongue outward when tip of Continuous
tongue is touched with finger or nipple. extrusion of tongue
or repetitive tongue
thrusting occurs
with CND
anomalies and
seizures.
Swallowing Newborn swallows in coordination with Gagging, coughing,
sucking when fluid is placed on back of or regurgitation of
tongue. fluid may occur,
possibly associated
with cyanosis
secondary to
prematurity,
neurologic deficit, or
 injury; typically
seen after
laryngoscopy.
Moro Bilateral symmetrical extension and Asymmetrical
abduction of all extremities, with thumb and response is seen
forefinger forming characteristic “C” are with peripheral
followed by adduction of extremities and nerve injury
return to relaxed flexion when newborn’s (brachial plexus) or
position changes suddenly or when newborn fracture of clavicle
is placed on back on flat surface. or long bone or arm
or leg. No response
occurs in cases of
severe CNS injury.

Stepping Newborn will step with one foot and then the Asymmetrical
other in walking motion when one foot is response is seen
touched to flat surface. with CNS or
peripheral nerve
injury or fracture of
long bone of leg.

Prone crawl Newborn will attempt to crawl forward with Asymmetrical

both arms and legs when placed on abdomen response is seen
or flat surface. with CNS or
peripheral nerve
injury or fracture of
long bone of leg.
Tonic neck or Extremities on side to which head is turned Persistent response
“fencing” will extend, and opposite extremities will after 4th month may
flex when newborn’s head is turned to one indicate neurologic
side while resting. Response may be absent injury. Persistent
or incomplete immediately after birth. absence seen in CNS
injury and
neurologic
disorders.

Startle Newborn abducts and flexes all extremities Absence of response

and may begin to cry when exposed to may indicate
sudden movement or loud noise. neurologic deficit or
injury. Complete and
consistent absence
of response to loud
noises may indicate
deafness. Response
may be absent or
diminished during
sleep.

Crossed Newborn’s opposite leg will flex and then Weak or absent
Extension extend rapidly as if trying to deflect stimulus response is seen
to other foot when placed in supine position; with peripheral
newborn will extend one leg in response to nerve injury or
stimulus on bottom of foot. fracture of long
bone.
Glabellar Newborn will blink with first 4 or 5 taps to Persistent blinking
“blink” bridge of nose when eyes are open. and failure to
habituate suggest
neurologic deficit.
Palmar grasp Newborn’s finger will curl around object and Response is
hold on momentarily when finger is placed in diminished in
palm of newborn’s hand. prematurity.
Asymmetry occurs
with peripheral
nerve damage
(brachial plexus) or
fracture of humerus.
No response occurs
 with severe
neurologic deficit.
Plantar Grasp Newborn’s toes will curl Diminished response
downward when a finger occurs with
is placed against the base prematurity. No
of the toes. response occurs with
severe neurologic
deficit.
Babinski sign Newborn’s toes will hyperextend and fan No response occurs
apart from dorsiflexion of big toe when one with CNS deficit.
side of foot is stroked upward from heel and
across ball of foot.