NEONATAL REFLEXES

By- SNEHA DAS

1st year MPT (ortho)
NIHS, Kolkata
 Content
• Introduction
• Reflexes
• Significance
• References
 INTRODUCTION

 Primitive reflexes are involuntary motor responses

originating in the central nervous system present
after birth in early child development that facilitate
survival.
 Primitive reflexes are-
• Moro •Galanth
• Startle •Landue
• Grasp •Limb placement
• Tonic neck reflex •Babinski
• Blink •Parachute
• Dolls eye •Righting
• Rooting •Withdrawal
• Sucking
• Gag
• Stepping
 reflex
1. MORO
The Moro reflex is a normal primitive, infantile reflex. The
Moro reflex is an involuntary protective motor response
against abrupt disruption of body balance or extremely
sudden stimulation. Ernst Moro first described the Moro
reflex in 1918.

Age-
From birth to 2/3 months
Stimulus-
• Supine position. Suspend the baby horizontally, in a symmetrical supine
position such that the therapist's one hand behind the chest and the other
supports the head. The infant's head should be in the midline position.
• It is important to guarantee that both the infant's hands are open at the
moment of elicitation of the reflex so as not to produce an asymmetrical
response.

Response-
The normal Moro reflex starts with the abduction of the upper extremities and
extension of the arms. The fingers extend, and there is a slight extension of
the neck and spine. After this initial phase, the arms adduct and the hands
come to the front of the body before returning to the infant's side.
2. STARTLE REFLEX
The Moro reflex is often called a startle reflex that’s
because it usually occurs when a baby is startled
by a loud sound or movement.

Age-
Birth , Fade at around 2-4 months.

Stimulus-
Sudden loud or harsh noise.
Response-
Sudden extension or abduction of upper extremities
and crying .
3. GRASP REFLEX
The grasp reflex mainly the palmer grasp is
primitive, involuntary response to a mechanical
stimuli present in a newborn.
Age-
From birth to 6 months of age
Stimulus-
Maintain pressure to palm of hand or to ball of foot
under toes
Response-
Maintain flexion of fingers or toes
6. TONIC NECK REFLEX
It Is a brain stem reflex.
Age-
From birth to 4-6 months
Stimulus-
Rotation of the head to one side
Response-
Flexion of skull limb, extension of jaw limb
Reflex age stimulus response

Blink Four to six months Flash of light Close eye

Doll’s eye Subsides before Turning the head to Eyes move on a

11.5 weeks opposite fixing stationary
object
Reflex Age Stimulus Response

Rooting 4/6 months Corner of the Turn their head

mouth touching towards the
stimulus

Suck 12th months Stroking the center Pushing the lip

of upper lip around the inserted
object

Gag 6 months of age Food , finger toy Gagging

touching back of
mouth
4. STEPPING REFLEX
This reflex is also called walking or dancing reflex
as the baby appears to take steps or dance when
held upright with his or her feet touching a solid
surface.
Age-
Tends to disappears around 2-3 months
Stimulus-
Held upright over a flat or solid surface such as
couch or floor
Response-
Takes steps
12.Galanth reflex
Galanth reflex is anew born reflex named
after neurologist Johann Susmann galanth.
Age-
3/9 monthes
Stimulus-
Holding the new born in ventral suspension
and stroking along the one side of the
spine.
Response-
Flex towards the stimulated side.
9.LANDAU REFLEX
It is one of the most important neonatal reflex.
Age-
Should develop by 4-5 months.
Stimulus-
Place the head held horizontally in prone
Response-
it maintains the convex arc with head raised and
legs slightly flexed.
5. LIMB PLACEMENT REFLEX
This reflex should be integrated as the Childs
motor developments matures.
Age-
Present at birth and rapidly disappears by 6/9
months
Stimulus-
When the front leg of below the knee or the arm
below the elbow is brought into contact with the
edge of the table .
Response-
the child lifts the limb over the edge.
7. BABINSKI REFLEX
It was described by neurologist Joseph Babinski in
1896.
Age-
Birth to 2 years old
Stimulus-
Stimulation of the lateral planter aspect of the
foot
Response-
Extension of great toe and planter flexion of toes
8. PARACUTE REFLEX
It is a key milestone for the neuromotor
development of infants.
Age-
Appears at 8 months of age never disappears
Stimulus-
Positioning the infant prone in mid-air with head
first.
Response-
Extend the arms and spread the fingers to protect
head.
10. Righting Reflex
It involves complex muscular movement.
Age-
Around 6 months and persists lifelong.
Stimulus-
Positioning the head

Response-
Correcting whole body position in relation to head
11. WITHDRAWL REFLEX
It is a spinal reflex intended to protect the body
from damaging stimuli
Age-
From birth to 2 months
Stimulus-
Noxious stimulus to the sole of foot
Response-
Entire lower limb flexed uncomfortably
 Significance Of neonatal reflexes
• Primitive reflexes are necessary for newborn
survival, and abnormal reflexes can be a sign of
central nervous system dysfunction.
• early diagnosis of possible lifelong complications.
• An absent or abnormal sucking reflex is an indirect
indicator of neurological maturity in newborn
infants. When an abnormal sucking reflex is
associated with other signs of CNS involvement, it
suggests basal ganglia or brainstem dysfunction.
• Moro reflex is weak in preterm infants compared
to full-term infants due to their poor muscle tone
and resistance to passive movements. This
response correlates with a delay in motor
development in very low birth weight infants.
• Persistence of primitive reflexes past 4 to 6
months or absence before this time when they
should have been present is predictive of
cerebral palsy.
• The presence of 5 or more abnormal reflexes
correlated with the development of cerebral
palsy or mental delays.
 REFERENCES
• Connolly BH. Neonatal assessment: an overview. Phys
Ther. 1985 Oct;65(10):1505-13. doi:
10.1093/ptj/65.10.1505. PMID: 3901050.
• Carratalá F, Moya M. Variabilidad de los reflejos
neonatales en la exploración neurológica del recién
nacido a término sano [Neonatal reflexes variability in
the normal full term neonate during the neurological
exam]. Rev Neurol. 2002 Mar 1-15;34(5):481-5.
Spanish.
• Ghai, O. P. 1977, Essentials of pediatrics / O. P.
Ghai Sagar Publications New Delhi
• Susan B. O'Sullivan, Thomas J. Schmitz. Physical
Rehabilitation. Philadelphia :F.A. Davis, 2007.
THANK YOU