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 are absent due
to the development of the frontal lobes as a child transitions normally into child development. These
primitive reflexes are also called infantile, infant or newborn reflexes.

REFLEX DESCRIPTION WHEN DOES IT DIMINISH OR

& HOW TO ELICIT IT DISAPPEAR

A blink reflex in a newborn serves the same Permanent

purpose as it does in an adult—to protect the eye
Blink Reflex from any object coming near it by rapid eyelid
closure. It may be elicited by shining a strong light
such as a flashlight or an otoscope light on an eye.
A sudden movement toward the eye sometimes
can elicit the blink reflex

Doll's Eye Reflex As with a doll's eyes, when a baby is lying on her This reflex lasts up to 2 months of
back, if you turn her head from side to side, her age.
eyes remain fixed.

If the cheek is brushed or stroked near the corner The reflex disappears at about
of the mouth, a newborn infant will turn the head the 6th week of life. At about this
Rooting Reflex in that direction. This reflex serves to help a time, newborn eyes focus
newborn find food: when a mother holds the child steadily, so a food source can be
and allows her breast to brush the newborn’s seen, and the reflex is no longer
cheek, the reflex makes the baby turn toward the needed.
breast.

When a newborn’s lips are touched, the baby

makes a sucking motion. The reflex helps a
newborn find food: when the newborn’s lips touch
the mother’s breast or a bottle, the baby sucks
and so takes in food.
Sucking Reflex  It can be maintained in such an infant by
offering the child a non-nutritive sucking
object such as a pacifier (after the fistula
has been corrected by surgery and until
oral feedings can be given).
The sucking reflex begins to
diminish at about 6 months of
age. It disappears immediately if
it is never stimulated such as in a
newborn with a
tracheoesophageal fistula who
cannot take in oral fluids.

The swallowing reflex in a newborn is the same as

in the adult. Food that reaches the posterior
Swallowing portion of the tongue is automatically swallowed. Permanent
Reflex Gag, cough, and sneeze reflexes also are present
in newborns to maintain a clear airway in the
event that normal swallowing does not keep the
pharynx free of obstructing mucus.

A newborn extrudes any substance that is placed It disappears at about 4 months

on the anterior portion of the tongue. This of age. Until then, the infant may
Extrusion Reflex protective reflex prevents the swallowing of seem to be spitting out or refusing
inedible substances. solid food placed in the mouth
 Palmar Grasp Newborns grasp an object placed in their palm by This reflex disappears at about 6
Reflex closing their fingers on it. Mature newborns grasp weeks to 3 months of age. A
so strongly that they can be raised from a supine baby begins to grasp
position and suspended momentarily from an meaningfully at about 3 months
examiner’s fingers. of age.

Plantar Grasp When an object touches the sole of a newborn’s
Reflex foot at the base of the toes, the toes grasp in the
same manner as do the fingers.
This reflex disappears at about 8
to 9 months of age in preparation
for walking. However, it may be
present during sleep for a longer
period.

Step (Walk)-in- Newborns who are held in a vertical position with This reflex disappears by 3 months
Place Reflex their feet touching a hard surface will take a few of age. By 4 months, babies can
quick, alternating steps. bear a good portion of their
weight unhindered by this reflex

The placing reflex is similar to the step-in place This reflex disappears by 3 months
reflex, except that it is elicited by touching the of age. By 4 months, babies can
Placing Reflex anterior surface of the lower part of a newborn’s bear a good portion of their
leg against a hard surface such as the edge of a weight unhindered by this reflex.
bassinet or table. The newborn makes a few quick
lifting motions, as if to step onto the table,
because of the reflex.

When newborns lie on their backs, their heads The reflex disappears between
usually turn to one side or the other. The arm and the 2nd & 3rd months of life.
the leg on the side toward which the head turns
extend, and the opposite arm and leg contract.
Tonic Neck The movement is most evident in the arms but may
Reflex. also be observed in the legs. If you turn a
newborn’s head to the opposite side, he or she will
often change the extension and contraction of
legs and arms accordingly. This is also called a
boxer or fencing reflex, because the position
simulates that of someone preparing to box or
fence. Unlike many other reflexes, the tonic neck
reflex does not appear to have a function. It does
stimulate eye coordination, because the
extended arm moves in front of the face. It may
signify handedness.

A Moro (startle) reflex can be initiated by startling It is strong for the first 8 weeks of
a newborn with a loud noise, sudden movement life and then fades by the end of
Moro Reflex or by jarring the bassinet. The most accurate the 4th or 5th month, at the same
method of eliciting the reflex is to hold newborns in time an infant can roll away from
(Startle or a supine position and allow their heads to drop danger
Embrace Reflex) backward about 1 inch. In response to this sudden
head movement, they abduct and extend their
arms and legs. Their fingers assume a typical “C”
position. Finally they swing their arms into an
embrace position and pull up their legs against
their abdomen (adduction). The reflex simulates
 the action of someone trying to ward off an
attacker, then covering up to protect himself.

When the sole of the foot is stroked in an inverted It remains positive (toes fan) until
“J” curve from the heel upward, a newborn fans at least 3 months of age, when it
Babinski (Plantar) the toes (positive Babinski sign). This is in contrast to is supplanted by the down-turning
Reflex the adult, who flexes the toes. This reaction occurs or adult flexion response.
because nervous system development is
immature.

Magnet Reflex If pressure is applied to the soles of the feet of a This is a test for spinal cord
newborn lying in a supine position, he or she integrity.
pushes back against the pressure.

Crossed If one leg of a newborn lying supine is extended This is a test for spinal cord
Extension Reflex and the sole of that foot is irritated by being integrity.
rubbed with a sharp object, such as a thumbnail,
the infant raises the other leg and extends it, as if
trying to push away the hand irritating the first leg.

Trunk Incurvation When newborns lie in a prone position and are Emerges at 20 weeks in utero and
Reflex touched along the paravertebral area by a is inhibited by 9 months
probing finger, they flex their trunk and swing their
(Galant’s Reflex) pelvis toward the touch

A newborn who is held in a prone position with a Appears approximately 3 months,

hand underneath, supporting the trunk, should disappears at 12-24 months.
Landau Reflex demonstrate some muscle tone. Babies may not
be able to lift their head or arch their back in this
position (as they will at 3 months of age), but
neither should they sag into an inverted “U”
position. The latter response indicates extremely
poor muscle tone, the cause of which should be
investigated.

A patellar reflex can be elicited in a newborn by Permanent

tapping the patellar tendon with the tip of the
finger. The lower leg moves perceptibly if the
infant has an intact reflex.
Deep Tendon
Reflexes To elicit a biceps reflex, place the thumb of your
left hand on the tendon of the biceps muscle on
the inner surface of the elbow. Tap the thumb as it
rests on the tendon. You are more likely to feel the
tendon contract than to observe movement. A
biceps reflex is a test for spinal nerves C5 and C6;
a patellar reflex is a test for spinal nerves L2–L4

References:

Birthsource.com,. (2015). Newborn Reflexes and Characteristics. Retrieved 17 November 2015, from
http://www.birthsource.com/scripts/article.asp?articleid=249

HealthyChildren.org,. (2015). Newborn Reflexes. Retrieved 17 November 2015, from

https://www.healthychildren.org/English/ages-stages/baby/Pages/Newborn-Reflexes.aspx

Pillitteri, A. (2010). Maternal & child health nursing: Care of the childbearing & childrearing family. Philadelphia: Wolters
Kluwer Health/Lippincott Williams & Wilkins.