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Archaic Reflexes and Maturation Aspecs
Archaic Reflexes and Maturation Aspecs
MATURATION ASPECTS
OF NEWBORN INFANTS
MIHAI CRAIU MD PhD
ALFRED RUSESCU
CHILDRENS HOSPITAL
ARCHAIC REFLEXES 1
Reflexes are an involuntary reaction of
a muscle or a group of muscles to an
external stimulus.
Many parents are surprised when they
realize that their baby can do a lot of
movements during first days of his life
ARCHAIC REFLEXES 2
While some reflexes are kept for the
whole life (respiratory reflex), other
reflexes disappear, giving way to
voluntary, controlled motor habits and
skills.
Neonatology treats reflexes like a
peculiar temporary equipment for the
first period, as babys organism should
know how to
fulfill some vital functions right after
birth, as theres no time to learn.
ARCHAIC REFLEXES 3
Suckling reflex
Rooting reflex
Palmar and plantar grasp reflex
Moro reflex
Automatic walking reflex
SUCKLING REFLEX
During first nursing a
mother can notice that
suckling reflex is highly
developed in her baby.
A baby begins suckling
strongly, when he feels a
nipple or even a finger in
his mouth.
GRASPING REFLEX
If you touch a baby`s palm with a
finger or some object, he will
grasp it in his fist so strong, that
you will be able to raise him a
little.
This reflex will disappear when a
baby learns
taking objects, on about 4th
month of life.
Feet also have grasping reflex.
When you press a babys feet, his
toes begin bending and remain
in this position until stimulation
stops.
When a baby learns standing this
reflex will disappear.
MORO REFLEX
Gripping reflex (also called
Moro`s reflex) is a protective
reaction of organism. Noise or
change of position induces this
reflex.
He tosses his arms and legs up
very fast, like he wants gripping
something.
On 4th month of life this
reaction disappears.
CRONOLOGY OF REFLEXES
28 weeks all present at some extent
excepting automatic walking
32 weeks Moro reflex is complete
34 weeks grasping reflex is complete
37 weeks all present and complete,
excepting automatic walking
40 weeks automatic walking reflex
complete
MATURATION
Gestational age can be estimated
starting from firs day of the last
recorded menstrual cycle of the gravida
Probable birth day 270 +/- 10 days
Term gestation 38-42 weeks
Premature newborn < 38 weeks
Postmature newborn > 42 weeks
WEIGHT 1
Intrauterine growth is variable,
depending on maternal, placental and
fetal factors
Newborn weight should be concordant
with gestational age.
If weight is below the estimated value
the child will be diagnosed as SGA (small
for gestational age) or dismature.
WEIGHT 2
Small newborn weight, but concordant
with gestational age will be diagnosed as
prematurity.
At 30 weeks 1600 g birth weight
At 34 weeks 2600 g birth weight
At 38 weeks 3200 g birth weight
At 42 weeks 3800 g birth weight
WEIGHT 3
Small newborn weight, can be classified as
prematurity grade I - IV
Grade I prematurity 2000 - 2500 gBW
Grade II prematurity 1500 2000 gBW
Grade III prematurity 1000 1500 gBW
Grade IV prematurity < 1000 gBW
PREMATURITY
GESTATIONAL AGE
EVALUATION IN-UTERO
NEUROMATURATION
References
"New Ballard Score, expanded to include
extremely premature infants," by
Ballard, JL, et al, Journal of Pediatrics,
September 1991, page 417.
Mittendorfs Observations of
Gestational Term.
In the 1980s, Mittendorf noticed that birth
dates for women in his practice, primarily
second-generation Irish-Americans, averaged
seven days past their due dates.
He reviewed his records, then went on to
review records of 17,000 births, and
determined the average healthy, white,
private-care, primiparous woman averaged
288 days from LMP to birth:
8 days longer than Naegeles rule.
Mittendorfs Observations of
Gestational Term.
Mittendorf and others have determined several
factors that affect gestational term:
ethnicity,
parity,
nutrition,
substance use,
mothers age,
mothers size.
GESTATIONAL AGE
TERM vs PRETERM