Innate reflexes- a gift of nature, necessary for the baby for survival outside the mother’s body, which help the newborn adapt to life in the world around him. Also in maternity hospital, immediately after the birth of the baby, the neonatologist checks innate reflexes and evaluates the development nervous system. If physiological reflexes are well developed and muscle tone normal, it means everything is fine with the child.
Basic unconditioned reflexes of newborns
1 Breathing reflex
The first, immediately after birth, is the respiratory reflex - the baby's lungs open and he takes his first independent breath.
2. Sucking reflex
The sucking reflex occurs in a newborn in response to irritation of the oral cavity, when touching the lips and tongue of the newborn. For example, when placing a pacifier, pacifier, or finger into the mouth, rhythmic sucking movements appear.
3. Swallowing reflex If something gets into the baby's mouth, he swallows. During the first days, the child learns to coordinate breathing movements with swallowing movements.
4. Gag reflex. The reflex causes the child to push any solid objects out of his mouth with his tongue. The gag reflex appears immediately after birth. The reflex prevents the child from choking. This reflex fades away closer to 6 months. It is the gag reflex that explains why it is so difficult for a baby under 6 months to swallow solid food.
5. Searching (seeking) Kussmaul reflex
The search reflex helps the baby find the nipple and is well expressed before feeding.
Normally it occurs in all newborns and should completely disappear by 3 months of age. Then a reaction to a visual stimulus appears, the child perks up at the sight of a bottle of milk, when the mother prepares the breast for feeding.
6. Proboscis reflex (oral Escherich reflex)
Caused by a quick, light touch with a finger, pacifier, or hammer upper lip child - in response, the newborn's facial muscles contract - the lips stretch out in the form of a proboscis.
Normally, the proboscis reflex is detected in all healthy newborns, and gradually fades away by the age of three months. Preservation proboscis reflex it is a sign in children over three months of age possible pathology brain and is observed in children with damage to the nervous system.
7. Babkin's palmo-oral reflex
The reflex is present normally in all newborns, and is more pronounced before feeding. After two months this reflex decreases, and by three months it disappears completely.
Sluggishness of the reflex is observed with damage to the central nervous system (CNS), especially with birth injury of the cervical spinal cord.
The rapid formation of the reflex and its extinction up to 3 months is a prognostically favorable sign in children who have suffered a birth injury.
8.Upper grasp reflex (Janiszewski)
In a normal baby, the grasping reflex is well evoked. Before feeding and during eating, the grasping reflex is much more pronounced.
The reflex is physiological until 3-4 months; later, on the basis of the grasping reflex, voluntary grasping of objects is gradually formed.
9. Robinson's hanging reflex
By 3-4 months, this unconditioned reflex transforms into a conditioned one - the child begins to grab toys purposefully. Good expression of the grasping reflex and the Robinson reflex contributes to the rapid development of the conditioned reflex and thereby the development of muscle strength in the hands and contributes to the more rapid development of fine manual skill.
10. Lower grasp reflex (plantar, Babinski reflex)
In healthy children, this reflex persists until 12-14 months of life.
The absence of the lower grasp reflex occurs when the spinal cord is damaged at the lumbar level.
11. Babinski reflex.
Most doctors now consider the Babinski reflex to be normal for the first year of life and that its presence is not a sign of pathology, and it will go away with age. They explain that this is due to insufficient development of the cerebral cortex and, accordingly, the central motor neuron system in early childhood and that this reflex is now very common.
12. Arshavsky’s heel reflex
When pressure is applied to the heel bone, the child causes a cry or crying grimace.
Their absence, decreased severity, or asymmetry may indicate damage to the nervous system.
13. Moro reaching reflex
The reflex is expressed immediately after birth. In all healthy newborns, the Moro reflex is always symmetrical (the same) in both hands and is expressed until the 4-5th month, then it begins to fade; after the 5th month, only individual components can be observed.
10. The revitalization complex as the main neoplasm of early infancy, its significance for the mental development of the child.
The “revival complex” described by N.M. Shchelovanov appears from 2.5 months and increases until the 4th month. It includes a group of reactions such as:
1) freezing, concentrating on an object, looking with tension;
2) smile;
3) motor revitalization;
4) localization.
After four months the complex disintegrates. The course of reactions depends on the behavior of the adult. Analysis age dynamics shows that up to two months the child reacts equally to both the toy and the adult, but he smiles more often at the adult. After three months, a motor response to the object seen is formed. In the first half of the year, the child does not distinguish between positive and negative influences. The child develops a need for attention, and expressive and facial means of communication appear. The more attentive an adult is to a child, the earlier he begins to distinguish himself from the world around him, which is the basis of his self-awareness and self-esteem. By the end of the first half of the year, the child shows a rich palette of emotions. The act of grasping at five months is already formed. Thanks to an adult, the child identifies a complete object and forms a sensory-motor act. Interest in actions and objects is evidence of a new stage of development. In the second half of life, the leading action becomes manipulative (throwing, pinching, biting). By the end of the year, the child masters the properties of objects. At 7–8 months, the child should throw, touch objects, and behave actively. Communication is situational and businesslike. Attitudes towards adults change, and a negative reaction to comments predominates. Emotions become brighter and vary depending on the situation.
The development of a baby’s motor skills follows a certain pattern: movements are improved from large, sweeping ones to smaller and more precise ones, and first this happens with the arms and upper half of the body, then with the legs and lower part of the body. The baby's sensory skills develop faster than the motor sphere, although they are both related. This age stage is preparatory to speech development and is called the preverbal period.
1. Development of passive speech - the child learns to understand, guesses the meaning; The anemotic hearing of a child is important, and articulation is important in an adult.
2. Practicing speech articulations. Changing the sound unit (timbre) leads to a change in meaning. Normally, a child at 6–7 months turns his head when naming an object if this object has a permanent place, and at 7–8 months he looks for the named object among others. By the first year, the child understands what subject is being discussed and performs basic actions. At 5–6 months, the child must go through the babbling stage and learn to clearly pronounce triads and dyads (three and two sounds), and be able to reproduce a communication situation.
If the Apgar score evaluates the condition of the newborn as a whole, then newborn reflexes allow you to assess the state of the baby’s nervous system without any complex examinations and start on time correct treatment see a neurologist while the child’s brain has not yet finished forming and it is not too late to correct the situation.
Part unconditioned reflexes, determined in the neonatal period, subsequently disappears, some of the reflexes appear a little later. If the reflex is evoked at an age at which it should already be absent, then it is considered pathological. Weak reflexes or their absence may also be a reason for further examination.
How to properly test newborn reflexes
The child’s unconditional reflex activity must be assessed in a warm room. The baby should be well-fed, dry and calm. In a children's clinic there are not always appropriate conditions, so it would be nice if the mother herself knew how to check the reflexes of newborns and, if necessary, drew the attention of the pediatrician to existing deviations.
The child's unconditioned reflexes are assessed in a state of vertical suspension by the armpits, in a position on the stomach and on the back. The applied irritations should not cause pain to the child. If the rules for checking reflexes are not followed, they can be extinguished by reactions to discomfort.
Newborn reflexes chart infants
|
Reflex |
Reflex onset time |
Age when the reflex disappears |
|
Support reflex |
By 2 months |
|
|
Automatic walking reflex |
By 2 months |
|
|
Labyrinthine tonic reflex |
At the end of 2 months |
|
|
Babkin's palmo-oral reflex |
By 3 months |
|
|
Perez reflex |
By 4 months |
|
|
Grasp reflex |
At 2 - 4 months |
|
|
Bauer's crawling reflex |
By 4 months |
|
|
Moro reflex |
By 4 months |
|
|
By 6 months |
||
|
By the end of the first year of life |
||
|
From the end of 1 month of life |
||
|
Upper Landau reflex |
From 4 months of age |
|
|
Nizhny Landau |
Formed by 5-6 months |
|
|
Chain neck and trunk reflexes |
By 6-7 months of life |
Newborn reflexes are divided into three groups:
- Persistent lifelong automatisms (corneal, orbiculopalpebral, conjunctival, pharyngeal, swallowing, tendon reflexes)
- Oral and spinal segmental automatisms, myeloencephalic postural reflexes. These are transient (passing) rudimentary reflexes that reflect the conditions for the development of a long-term analyzer. These include sucking, searching, proboscis, palmar-oral. And also grasping, support reflexes, Moro, automatic gait, Perez reflex, labyrinth reflex, cervical tonic reflexes.
- Mesencephalic automaticity: cervical and trunk reflexes (simple and chain), labyrinthine reflexes.
How to test your baby's basic reflexes
Search reflex: when stroking the corner of the mouth (without touching the lips), the child turns his head towards the stimulus, while his lip lowers and his tongue deviates. The reflex is especially pronounced before feeding.
Proboscis reflex: The child stretches out his lips with his proboscis when lightly hitting them with a finger. With this reflex, an automatic contraction of the orbicularis oris muscle occurs. In adults, reflexes of oral automatism appear when the cerebral cortex is damaged.
Fine sucking reflex disappears by the end of the first year of life. Before this age, you should try to wean your child off a pacifier or pacifier so that the child can develop a correct bite.
Grasp reflex: A child up to 2-4 months firmly grasps the fingers placed in his palm.
Support reflex: The child is taken from the back by the armpits, supporting the head index fingers. A raised child in this position bends his legs at the hip and knee joints, and as if “stands” on half-bent legs, leaning on the support with his full foot. If a child tries to “stand” on tiptoes and crosses his legs, then this is a deviation from the norm.
Automatic gait reflex: If the child is slightly tilted forward from the previous position, he will try to make stepping movements. Sometimes, at the level of the lower third of the legs, the child’s legs may cross.
Babkin's palmo-oral reflex: If you press thumb in the palm of the child at the tenors' bed, the child will open his mouth and bend his head. The reflex disappears by 3 months.
Moro reflex lasts up to 4 months of the child’s life. If you sharply lower a child by about 20 cm while in the doctor’s arms, and then quickly raise him, then in response to these actions the child will spread his arms and straighten his fingers, and then return them to their original position. To avoid dropping the baby, it is not recommended for new parents to test this reflex on their own.
If parents abruptly place the child on any surface, he will also spread his arms to the sides in fear, which is also a manifestation of the Moro reflex.
Bauer's crawling reflex: The baby will try to crawl if you put him on his stomach and place his palm under his soles. Spontaneous crawling disappears by 4 months.
Kernig reflex disappears after four months. At older ages it occurs when .
Galant reflex: If you run your fingers along the spine on both sides in the direction from the neck to the buttocks, a child lying on his side will arch his torso, and sometimes his leg may straighten. The Galant reflex should disappear by the 4th month of a child’s life.
Perez reflex causes pain, so it is better not to check it at all or to examine it last. It involves running a finger along the spinous vertebrae of a child lying on his stomach. Direction of movement: from the tailbone to the neck. With a positive Perez reflex, the torso bends, the upper and lower limbs bend, the head and pelvis rise, and sometimes urination and defecation occur. All this, naturally, is accompanied by a dissatisfied cry from the child. The Perez reflex should disappear by the fourth month.
Orbiculopalpebral reflex: By lightly tapping the upper arch of the orbit with your finger, you can cause the eyelid of the corresponding side to close. The reflex disappears by 6 months.
Asymmetric cervical-tonic reflex demonstrates a decrease in limb tone. If you turn the head of a child lying on his back so that the chin touches the shoulder, the tone of the limbs on the opposite side will increase, and decrease on the side to which face turned. (Limb tone may be increased, decreased or normal). With hypertonicity, the child’s muscles are overly tense and it is difficult to straighten the limbs. With hypotonicity, on the contrary, the muscles are excessively relaxed. The baby's tone is influenced by the position of the baby's body and head.
Trunk rectifying reaction manifested by straightening the head when the feet touch the support. By the end of the first month, the baby should already be able to hold his head.
Babinski reflex: In a child, the toes on the foot fan out if you irritate the outer edge of the foot with stroke movements in the direction from the heel to the toes. At the same time, dorsiflexion also occurs thumb. It is considered physiological until the age of two.
Upper Landau reflex: By four months, the baby should be able to lift his head and top part torso, resting on the plane with your hands.
Inferior Landau reflex: The child can extend and raise his legs in a prone position. Lower Landau is formed by five to six months. Around this age, the baby begins to crawl.
Chain righting reflex from torso to torso causes separate rotation of the torso and lower extremities when the child's shoulder or pelvic region is turned to the side. A chain righting reflex is formed by 6–7 months.
Only a doctor should interpret the meanings and evaluate the results of a study of newborns. The mother’s task is to ensure that the child is well examined and, if necessary, receives necessary treatment. Sometimes it's enough to do professional massage and special gymnastics to extinguish pathological reflexes; in severe cases, a neurologist will prescribe medications.
Innate reflexes- a gift of nature, necessary for the baby to survive outside the mother’s body, which help the newborn adapt to life in the world around him.
Even in the maternity hospital, immediately after the birth of the baby, a neonatologist checks innate reflexes and assesses the development of the nervous system. If physiological reflexes are well developed and muscle tone is normal, then everything is fine with the child.
A healthy child at birth should have a full set of physiological reflexes, which disappear by 3-4 months.
Pathology is their absence, as well as a delay in their reverse development.
It is unacceptable to stimulate the newborn's reflexes, especially the automatic walking reflex.
Basic unconditioned reflexes of newborns
1 Breathing reflex
The first, immediately after birth, is the respiratory reflex - the baby's lungs open and he takes his first independent breath.
2. Sucking reflex
The sucking reflex occurs in a newborn in response to irritation of the oral cavity, when touching the lips and tongue of the newborn. For example, when you put a pacifier, pacifier, or finger into your mouth, rhythmic sucking movements.
The sucking reflex is present in all healthy newborns and is a reflection of the child’s maturity. After feeding, this reflex fades to a large extent and after half an hour or an hour begins to revive again. The reflex persists during the first year of life. The sucking reflex decreases or even disappears if any of the cranial nerves involved in the act of sucking are damaged. Sucking calms the baby. If he did not nurse in infancy, then at an older age he may begin to suck the ends of his hair or fingers, or bite his nails, which will require the intervention of a psychotherapist or neurologist.
3. Swallowing reflex If something gets into the baby's mouth, he swallows. During the first days, the child learns to coordinate breathing movements with swallowing movements.
4. Gag reflex. The reflex causes the child to push any solid objects out of his mouth with his tongue. The gag reflex appears immediately after birth. The reflex prevents the child from choking. This reflex fades away closer to 6 months. It is the gag reflex that explains why it is so difficult for a baby under 6 months to swallow solid food.
5. Searching (seeking) Kussmaul reflex
The reflex should be evoked carefully without causing pain to the newborn.
Stroking the corner of the mouth with a finger (without touching the lips) causes the newborn to lower the corner of the mouth and lips, lick the mouth and turn the head in the direction from which the stroking is performed.
Pressing on the middle of the upper lip causes a reflex raising of the upper lip upward and extension of the head.
Touching the middle lower lip causes the lip to lower, the mouth to open, and the baby's head to make a flexion movement.
When painful stimulation occurs, only the head turns in the opposite direction.
The search reflex helps the baby find the nipple and is well expressed before feeding.
Normally it occurs in all newborns and should completely disappear by 3 months of age. Then a reaction to a visual stimulus appears, the child perks up at the sight of a bottle of milk, when the mother prepares the breast for feeding.
The search reflex is the basis for the formation of many facial (expressive) movements: shaking the head, smiling.
The search reflex is absent or reduced, asymmetrical in newborns with damage to the facial nerve. In the presence of cerebral pathology in newborns, the reflex may be delayed and does not disappear by 3 months of age
1 - palmar-oral;
2 - proboscis;
3 - search;
4 - sucking
6. Proboscis reflex (oral Escherich reflex)
Called fast easy touching the baby's upper lip with a finger, pacifier or hammer - in response, the newborn's facial muscles contract - the lips stretch out in the form of a proboscis.
Normally, the proboscis reflex is detected in all healthy newborns, and gradually fades away by the age of three months. Preservation of the proboscis reflex in children over three months of age is a sign of possible brain pathology and is observed in children with damage to the nervous system.
7. Babkin's palmo-oral reflex
When pressing with the thumb on the palm of the newborn, the baby turns his head and opens his mouth.
The reflex is present normally in all newborns, and is more pronounced before feeding. After two months, this reflex decreases, and by three months it disappears completely.
Sluggishness of the reflex is observed with damage to the central nervous system (CNS), especially with birth injury of the cervical spinal cord.
The rapid formation of the reflex and its extinction up to 3 months is a prognostically favorable sign in children who have suffered a birth injury.
The palmar-oral reflex may be absent with peripheral paresis of the arm on the affected side. When the central nervous system is damaged in a child older than 2 months, the reflex does not tend to fade, but, on the contrary, intensifies and occurs even when the palms of passive hands are lightly touched.
8.Upper grasp reflex (Janiszewski)
In response to a stroked touch on the palm of the newborn, the fingers bend and the object is grasped into a fist.
In a normal baby, the grasping reflex is well evoked. Before feeding and during eating, the grasping reflex is much more pronounced.
The reflex is physiological until 3-4 months; later, on the basis of the grasping reflex, voluntary grasping of objects is gradually formed.
In inhibited children, the reaction is also weakened; in excitable children, on the contrary, it is enhanced.
A decrease in the grasping reflex is observed in children born with asphyxia. The reflex is also weakened on the affected side of the cervical spinal cord. With paresis of the hands, the reflex is weakened or absent. The presence of a reflex after 4-5 months indicates damage to the nervous system.
9. Robinson's hanging reflex
In response to stroking the palmar side of the hand, the fingers bend and grasp the object. Sometimes, when this reflex is evoked, the child holds an object or finger so tightly that such a clinging child can be lifted upward by the fingers - this phase of the reflex is called the Robinson reflex. Thus, it turns out that a newborn, outwardly seeming to be a completely helpless creature, can develop such “muscular strength” in its hands that it holds it own body in limbo.
By 3-4 months, this unconditioned reflex transforms into a conditioned one - the child begins to grab toys purposefully. Good expression of the grasping reflex and the Robinson reflex contributes to the rapid development of the conditioned reflex and thereby the development of muscle strength in the hands and contributes to the more rapid development of fine manual skill.
10. Lower grasp reflex (plantar, Babinski reflex)
It is caused by pressing with the thumb on the sole at the base of the II-III toes. The child performs plantar flexion of the toes (presses the toes to the foot)
Pressing the ball of the foot with the thumb causes plantar flexion of the toes.
In healthy children, this reflex persists until 12-14 months of life.
The absence of the lower grasp reflex occurs when the spinal cord is damaged at the lumbar level.
11. Babinski reflex.
If you perform a line irritation of the sole along the outer edge of the foot in the direction from the heel to the toes, then dorsal extension of the big toe and a fan-shaped divergence of the II-V toes occurs.
Most doctors now consider the Babinski reflex to be normal for the first year of life and that its presence is not a sign of pathology, and it will go away with age. They explain that this is due to insufficient development of the cerebral cortex and, accordingly, the central motor neuron system in early childhood and that this reflex occurs very often now.
We want to warn parents.
Healthy newborns should NOT have the Babinski reflex.
The Babinski reflex is pathological from the first days of a child’s life and is a subtle sign of the pathology of the pyramidal tracts, and the frequency of its detection is not proof of its physiology, but proof of the frequency of neurological disorders in newborns. Moreover, if this reflex is spontaneous from birth (that is, it does not need to be caused, it appeared on its own)
12. Arshavsky’s heel reflex
When pressure is applied to the heel bone, the child causes a cry or crying grimace.
Their absence, decreased severity, or asymmetry may indicate damage to the nervous system.
13. Moro reaching reflex
Called various techniques: if you suddenly slap both hands on both sides on the surface on which the baby is lying, at a distance of 15 cm from his head (no need to hit with all your might!), then the newborn moves his arms to the sides and opens his fists - phase I of the Moro reflex. After a few seconds, the hands return to their original position (fetal position) - phase II of the Moro reflex.
A similar movement in the hands occurs with passive sudden extension (extension) of the newborn’s legs, lifting the baby’s unbent legs and pelvis above the bed, and pressing on the hips.
The reflex is expressed immediately after birth. In all healthy newborns, the Moro reflex is always symmetrical (the same) in both hands and is expressed until the 4-5th month, then it begins to fade; after the 5th month, only individual components can be observed.
With flaccid paresis of the arm, the reflex is reduced or completely absent on the affected side, which indicates that the spinal cord in the cervical region was injured during childbirth. In children with intracranial trauma, the reflex may be absent in the first days of life. With severe hypertension, there is an incomplete Moro reflex: the newborn only slightly withdraws his arms.
In each case, the threshold of the Moro reflex should be determined - low or high. In infants with damage to the central nervous system, the Moro reflex is delayed for a long time, has a low threshold, and often occurs spontaneously with anxiety or various manipulations. If the reflex appears when trying to change the child’s clothes or for no reason, then it should be shown to a neurologist.
14. Galant reflex
The child is placed face down, with his chest on his palm. Supporting the baby in weight (when the baby calms down and hangs his head, arms and legs completely), run a finger along the spine (at a distance of 1 cm from it) with right side- the baby will bend in an arc and press his right leg. The reflex is also checked on the left side.
The Galant reflex is well evoked from the 5th to 6th day of life. Normally, the reflex lasts up to 2-4 months and disappears after 6 months.
The reaction on both sides should be the same.
In children with damage to the nervous system, it may be weakened or completely absent during the 1st month of life. When the spinal cord is damaged, the reflex is absent for a long time. If the nervous system is damaged, this reaction can be observed in the second half of the year and later.
1.Galanta reflex
2.Perez reflex
3. Moro grasping reflex
15. Perez reflex
The child is placed face down, with his chest on his palm. Supporting the baby in weight (when the baby calms down and hangs his head, arms and legs completely), with light pressure, run your finger along the spinous processes of the baby’s spine from the tailbone to the neck.
This is unpleasant for the baby; in response, the child begins to hold his breath, followed by a cry. His spine bends, his pelvis and head rise, his arms and legs bend, a short-term general increase in muscle tone occurs, and sometimes loss of urine and defecation occur.
Normally, the Perez reflex is well expressed during the first month of a newborn’s life, gradually weakens and completely disappears by the end of the 3rd - 4th month of life.
Preservation of the reflex over 3 months should be considered a pathological sign. In newborns with birth damage to the cervical spinal cord, there is no raising of the head, that is, the Perez reflex appears to be “decapitated.” Suppression of the reflex during the neonatal period and a delay in its reverse development are observed in children with damage to the central nervous system.
16. Support reflex
If you take a newborn under the arms, he reflexively bends his legs at the hip and knee joints. At the same time, if he is placed against a support, he straightens his legs and firmly rests his entire foot on the surface of the table and “stands” like this for up to 10 seconds.
Normally, the support reflex is constant, well expressed and gradually disappears by 4-6 weeks of age.
When the nervous system is injured, the child may lean on his toes, sometimes even with his legs crossed, which indicates damage to the motor (pyramidal) pathway running from the cerebral cortex to the spinal cord.
In newborns with intracranial injury who were born with asphyxia, the support reaction is often depressed or absent in the first weeks of life. In hereditary neuromuscular diseases, the support reaction is absent due to severe muscle hypotonia.
1. protective reflex;
2. crawling reflex (Bauer);
3. support reflex and automatic gait;
4.grasping reflex;
5. Robinson reflex.
17. Automatic walking reflex, or step reflex
When leaning on your feet in easy time tilting the child's body forward, the newborn makes stepping movements.
This reflex is normally well evoked in all newborns and disappears by 2 months of life.
Alarming signs are the absence of an automatic walking reflex or walking on tiptoes with legs crossed.
In newborns with intracranial injury who were born with asphyxia, the automatic gait response is often suppressed or absent in the first weeks of life. In hereditary neuromuscular diseases, automatic gait is absent due to severe muscle hypotonia. In children with central nervous system damage, automatic gait is delayed for a long time.
18. Bauer crawling reflex
A hand is placed on the feet of the newborn, who is lying on his stomach. With our hand we lightly press on the baby’s soles - in response, the child reflexively pushes off with his feet and performs crawling movements.
The crawling reflex is normally evoked in all newborns. Crawling movements in newborns become pronounced on the 3-4th day of life and persist for up to 4 months, and then fade away. Attention should be paid to the asymmetry of the reflex.
The reflex is depressed or absent in children born with asphyxia, as well as with intracranial hemorrhages and spinal cord injuries. In diseases of the central nervous system, crawling movements persist for up to 6-12 months.
19. Defensive reflexes
A) Upper protective reflex. If a newborn is placed on his stomach, then a reflexive turn of the head to the side occurs and he tries to lift it, as if providing himself with the opportunity to breathe.
The protective reflex in healthy newborns is constantly expressed from the first day of life, and after one and a half months the child tries to hold his head up on his own. In children with central nervous system damage, the protective reflex may be absent. A decrease or disappearance of this reflex can occur either with particularly severe damage to the upper cervical segments of the spinal cord, or with pathology of the brain. And, if you do not passively turn the child's head to the side, he may suffocate. In children with cerebral palsy, with increased extensor tone, a prolonged raising of the head and even throwing it back is observed.
b) “Duck” reflex. When a stream of water or air hits the nose area, the newborn holds his breath.
c) Pupillary reflex. Bright light will cause pupil constriction
d) Blinking reflex If you blow into a baby’s face, he will squint his eyes.
20. Leg withdrawal reflex
With the newborn in the supine position, when his lower limbs are relaxed, a needle injection is applied to each sole one by one. There is simultaneous flexion of the hips, legs and feet.
The reflex should be evoked equally on both sides (symmetrical).
The reflex may be weakened in children born in breech, with hereditary and congenital neuromuscular diseases, myelodysplasia. A decrease in the reflex is often observed with leg paresis. The absence of a reflex indicates damage to the child’s lower spinal cord.
21. Cross reflex of extensors.
With the newborn in the supine position, we extend one leg and apply an injection in the area of the sole - in response, the other leg is extended and slightly adducted.
In the absence of a reflex, a pathology of the lumbar enlargement of the spinal cord can be assumed.
22. Neck-tonic reflexes or postural reflexes
Types of postural reflexes of a newborn baby
Asymmetric cervical tonic reflex (Magnus-Klein)
It appears when the child’s head is passively turned to the side. The arms and legs are extended on the side towards which the child's face is facing, and the opposite ones are flexed. The hand to which the baby's face is turned straightens. At this moment, the tone of the extensors of the shoulder, forearm, and hand increases - the “fencer” pose, and the tone of the flexors increases in the muscles of the arm to which the back of the head is facing.
Symmetrical tonic neck reflexes
When a newborn baby passively flexes his head, the muscle tone of the flexors in the arms and extensors in the legs increases. At the same time, when the baby straightens his head, the opposite effect appears - his arms straighten and his legs bend.
Asymmetrical and symmetrical cervical reflexes of the newborn are constantly expressed in newborns.
U premature babies they are weakly expressed.
Labyrinthine tonic reflex
In the position of the child lying on his stomach, the tone in the flexor muscles increases: the head is bent to the chest or thrown back, the back is arched, the arms are bent and also brought to the chest, the hands are clenched into fists, the legs are bent in all joints and brought to the stomach. After some time, this position is replaced by swimming movements, which turn into a spontaneous crawling reflex.
Landau reflex
Give your child a “swimmer’s position” - lift the baby into the air so that his face looks down, and he will immediately raise his head, and then straighten (or even arch) his back, as well as straighten his legs and arms - swallow, from 6 months to one and a half years 
1. asymmetric cervical topical Magnus-Klein reflex;
2. symmetrical cervical tonic reflexes;
3.tonic labyrinthine reflexes;
4. Landau reflex.
These reflexes normally disappear in the first 2-3 months. So, as the unconditioned and cervical-tonic reflexes fade, the child begins to hold his head, sit, stand, walk and carry out other voluntary movements. Delay in the reverse development of tonic reflexes (over 4 months) indicates damage to the central nervous system of the newborn. Persistent tonic reflexes prevent the further development of the child’s movements and the formation of fine motor skills.
IN last years talk about availability swimming reflex in a newborn, which is that the baby will flounder and will not drown if he is lowered into water. This reflex can only be tested in the presence of an instructor in the infant pool.
Problems with reflexes are the first symptoms of pathology of the central nervous system. If you are alarmed by any deviations from the norm, then do not hesitate to consult a doctor. A re-examination must necessarily take place after the appointed time - it may vary depending on the expected nature of the pathology - from several days to a month, which will help to exclude existing suspicions or, if necessary, carry out timely treatment. Remember that the child changes every day, and the manifestation of reflexes depends on a number of conditions (fullness, fatigue and many others). It is very important to check innate reflexes over time. Timely treatment is the key to a child’s future health.
How is the neonatal period determined, what is its duration? It is scientifically proven that this period lasts 28 days, during which time the child’s primary adaptation to the environment occurs. The adaptation is helped by the reflexes of a newborn; these are mechanisms inherent in nature that allow the baby to perform its first (yet unconscious) actions.
Types of reflexes - classification
There are 2 types of reflexes - conditioned and unconditioned; in infancy, only unconditioned ones work, laid down from birth. Conditional ones appear later, based on experience.
In total, there are 15 unconditioned reflexes of newborns, each of them has its own purpose. Some arise and immediately disappear, others fade slowly, and others remain forever.
There are several groups of basic reflexes of newborns:
- Aimed at ensuring general vital functions (breathing, swallowing, sucking, spinal motor automatisms).
- Ensuring safety for the child’s body when exposed to external stimuli.
- “Temporary” ones that work to maintain a single process. For example, there is a reflexive holding of breath so that the child can move through the birth canal.
Table of basic reflexes of newborns by month
Oral reflexes
From the very first minutes of life, a small organism needs nutrition. Nobody teaches a baby to suck milk from the breast and swallow; everything is based on reflex activity.
Sucking reflex The baby has had it since birth. Thanks to it, the baby is able to clasp the nipple or pacifier with his lips and make rhythmic sucking movements. The reflex is strongly expressed up to a year, which is consistent with the appearance of the main teeth, with the help of which sucking is replaced by chewing.
Up to 3 years it persists mildly. The intensity of sucking signals the degree of hunger of the baby; if the child is full, then the sucking becomes weaker and is more pronounced before eating. Constant weakness sucking reflex is caused by many reasons, the establishment of which occurs with the help of a doctor.
Swallowing reflex promotes the swallowing of food received. It is caused by the work of the medulla oblongata and persists for life.
Proboscis reflex It lasts for a shorter period of time – by two to three months it disappears. Touching the baby's lips with a finger or object causes the mouth to curl into a tube resembling a small trunk.
Babkin reflex, it is also called palm-oral. If you lightly press on both palms of the child, the baby opens his mouth. By three months the reaction fades away, after which it disappears completely.
Search reflex (Kussmaul) . An attempt to touch the cheek at the corner of the mouth (very lightly) leads to a search for a stimulus, that is, a search for food. After three months the reflex passes, the baby determines the food source visually. When checking it, you should not touch the baby’s lips directly, otherwise you will get a proboscis reflex.
Spinal automatisms
Spinal reflexes Newborns are characterized by the baby’s muscular system and its condition.
Defense reflex is detected by turning the head when placing crumbs on the stomach. In this way, the child opens air access to his respiratory tract. When the central nervous system is damaged, this reflex is usually absent.
Grasp (monkey) reflex – the ability to firmly grasp and hold the fingers of an adult placed in the palms of a baby. Lifting by the fingers is another similar Robinson reflex. Weakening occurs by four months.
- this is when, when stroking the soles, the fingers open in a fan-shaped manner, and the feet bend with back side.
Newborn reflexes - Plantar reflex (Babinski)
This reflex is preserved up to two years; the symmetry of the reaction and energy are indicators for assessing the child.
Moro reflex (hug) - a reaction consisting of two phases, occurring in response to noise or knocking.
At first, the baby spreads his arms in different sides and unclenches his fingers, while his legs straighten. Then the arms and legs return to their original position, reminiscent of a hug. This reflex is observed up to five months. An incomplete Moro reflex or its asymmetry appears with lesions of the nervous system.
Kernig reflex observed when it is not possible to unclench the hip joint after flexion. Upon reaching four months disappears completely.
Automatic walking reflex checked with support from the armpits and a slight bend forward. The baby takes steps without accompanying them with hand movements. Normally, the baby should rest on the entire foot and walk without clinging.
If the legs cross slightly, then this is considered acceptable in the first 1.5 months. The ability to walk independently is an already acquired skill, conditioned complex work cerebral cortex, develops by 1 year. If the “automatic gait” remains for a long time, then this may be a manifestation of damage to the central nervous system.
Support reflex visible when the baby is held and placed on hard surface. First, he pushes his feet away, then stands flat, pressing his tiny soles tightly against the support. Throughout the entire month and a half, the support and walking reflexes are well expressed.
Crawling reflex (Bauer) – it is called spontaneous crawling, this happens when the baby is placed on his stomach or back. The movements intensify if you place your palm on the child’s soles, the baby can even move forward. The reflex appears on days 3-4, and fades away on third fourth month. A warning sign a violation of symmetry or persistence of crawling movements for up to six months to a year is considered.
Galant reflex called the response of the spinal zone to an external stimulus. If you move your finger along the back, the child will arch his back and straighten his leg on the side of the influence.
Posotonic reflexes (automatisms)
This group of reflexes is based on the redistribution of muscle tone as motor development child. While the baby still cannot hold his head up, cannot sit, walk or stand, his muscles must be regulated. The medulla oblongata and subsequently the midbrain are responsible for regulation.
Magnus-Klein reflex (asymmetrical tonic cervical) - the baby takes the “fencing pose” if his head is turned to the side while the little one is on his back. That is, the limbs towards which the face is facing are extended, and the opposite ones are bent.
| Name | How to stimulate | Response to stimulus | Appearance (age) | Disappearance (age) | Reasons for deviations |
|---|---|---|---|---|---|
| Search | Stroking the cheek | Turning the head towards the stimulus, opening the mouth | From birth | 3-4 months (in sleep up to 12 months) | Lethargy, depression of the nervous system. cerebral palsy |
| Sucking | Touching lips or mouth | Sucking movements | From birth | 4 month (in sleep up to 7 months) | A well-fed person reacts poorly. Prematurity, CNS depression - absence |
| Cervical tonic (“fencer”) | While the baby is on his back, turn his head to the side | Straightening the arms and legs from the side of the turned head; on the opposite side the arm and leg are bent | Birth – 2 months | 4-6 month | Inability to get out of this state or persistence for more than 6 months – motor neuron disorders |
| Prehensile | Place your finger in the child's palm | Firmly grasping the fingers with both palms | From birth | 3-6 month | CNS lesions |
| Stepping reflex | Support under the arms, slight forward bend. Feet should touch the surface | Similarity of steps, alternating movements of the legs | From birth | 2-4 month | Absence: cerebral palsy, leg paralysis, child depression |
| Reflex Moro (hug) | Sudden sound or popping sound when baby is lying on his back | Symmetrical opening of the arms and straightening of the legs, after a few seconds clasping oneself with the arms | From birth | Up to 4 months | Paralysis or fracture of the clavicle leads to asymmetry, absence or long-term effect - disorders of brain structures |
| Plantar reflex | Pressure at the toes | Symmetrical finger tuck | From birth | 4-8 month | Cerebral palsy, brain damage |
| Babinski reflex | Move along the sole to the toes from the heel | Opening your fingers in a fan shape | From birth | By about a year | Cerebral palsy, central nervous system lesions |
Checking the severity of reflexes is carried out with the help of a neurologist and pediatrician; they are able to determine how correctly the functions of the baby’s nervous system are functioning.
What influences the untimely appearance of reflexes in newborns?
The reasons are completely different, ranging from trauma during childbirth to individual reactions to medical supplies. Spinal or oral reflexes of a newborn are weak in cases of prematurity or mild asphyxia.
It is not always necessary to sound the alarm, if sucking and searching behavior is weakly expressed, perhaps the baby is simply full, then he does not show strong reflex activity. But before feeding, on the contrary, sucking and searching intensify.
If the newborn’s reflexes are not observed at all, then this is a reason for immediate qualified medical care. The most important life support functions may suffer if the baby’s health is not maintained in a timely manner. There may be several reasons: severe vices intrauterine development, severe asphyxia, injuries received during childbirth.
Of course, parents should have information about innate reflexes, but only an experienced neonatologist or pediatrician can professionally assess the child’s health. Deviations from the norm can be significant or not very significant; for minor violations, the doctor will prescribe treatment or special procedures. If the deviations are severe, then the doctor will help to understand the reasons and will be able to take emergency measures to ensure that the baby is not in danger.
Any strange manifestation of a child’s behavior requires increased attention, because his successful adaptation to the world depends on it. The reflexes of a newborn are the care of nature itself so that the baby can feel as comfortable as possible.
After the birth of a newborn child, all its organs and systems begin to adapt to completely new living conditions. Very young children are deprived of basic human skills, which they will have to master in the future as they grow up. An important role and significance in the adaptation process is played by the reflexes of newborns, with the help of which the baby survives and can later live fully without them.
When a baby appears, he is first examined by a pediatrician and a neurologist. Very important part examination is to check innate reflexes. At normal operation central nervous system, all physiological reflexes should be normal in the child. Their testing is carried out by specialists in a warm, well-lit room. In this case, the baby, awake, dry and well-fed, is placed on a flat, semi-rigid surface, which is also important for correct diagnosis.
The innate reflexes of newborns are nothing more than a specific response to certain external stimuli. Each of the reflexes appears and disappears at a certain time. Some tend to appear immediately at birth and fade away as the baby grows, while others tend to appear during the process of growing up.
All reflexes in a healthy newborn child should be symmetrical. We are talking about the same response of the left and right sides to stimuli. An abnormal reaction is considered when the reflex is present on one side, but absent on the other.
This may indicate problems with the nervous system.
Reflexes can be roughly classified into two main groups:
- unconditioned reflexes of newborns, which are inherent in nature itself, take place immediately after birth and subside over time, giving way to conditioned ones;
- conditioned reflexes of newborns, which the child acquires from his own life experience in the process of brain maturation and physical, as well as psycho-emotional development.
Among the innate or unconditioned reflexes, there are about 15 types. They are the ones who help the child survive the difficult process of adaptation associated with adapting to completely new living conditions. Some of them play a pushing role for the acquisition of other reflexes, and some even remain with the child for life.
Among the innate reflexes, several groups can be distinguished:
- through which it is ensured normal functioning all systems of the baby - respiratory, swallowing, sucking, as well as spinal;
- with which the weak children's body can protect itself from external irritants, for example, cold or heat, bright light, etc.;
- temporary, play a one-time role in the baby’s life, for example, during labor activity When passing through the birth canal, the baby is able to reflexively hold his breath.
Oral reflexes of newborns
This concept should be understood as the baby’s ability to suck mother's breast or a pacifier for artificial feeding and also swallow the resulting food.
Among the main oral reflexes it should be noted:
Sucking- begins to manifest itself literally from the first hours of the baby’s life. It manifests itself in the form of the child’s readiness to grab with his lips any irritants that touch the lips or enter the oral cavity. Active and rhythmic sucking movements provide the child with nutrition and appear until about 1 year of age, after which they begin to gradually subside. ()
Swallowing- with the help of which the child can swallow incoming food.
Proboscis- at the slightest touch to the child’s lips, he sticks them out, curled into a tube that resembles a proboscis. The orbicularis oris muscle is responsible for this, which involuntarily contracts when touched (often disappears by 2-3 months).
Search or Kussmaul reflex- in which the child lowers his lower lip and turns his head towards the stimulus, actively searching for his mother’s breast. The reflex occurs with every gentle touch to the corners of the baby’s mouth and, most often, is also present only in the first months of the child’s life.
Palmo-oral or Babkin reflex- is expressed in the opening of the child’s mouth with a simultaneous movement of the head in the direction of the stimulus with light, simultaneous pressure on his palms. It is clearly expressed only in the first months and by the third month of the child’s life it begins to gradually fade away.
Spinal- representing a set of specific reactions that indicate the state of the baby’s muscular system. Specialists check these reflexes throughout the newborn period.
Protective- activated in the first hours of a child’s life. If the baby is placed on his tummy, his head turns to the side and he tries to lift it (). Thus, by nature, the child has a protective function against breathing disorders.
Grasping and motor reactions
Robinson and Janiszewski reflexes or grasping- are expressed in the grasping movement of both arms of the baby and quite strong holding of the mother’s fingers in the arms. Sometimes the gripping force is so strong that in this way it is even possible to slightly lift the child. This reflex begins to weaken around 3-4 months of a newborn’s life. If it accompanies the baby at a later age, this may indicate the presence of neurological problems.
Babinski reflex or plantar reflex, when lightly stroking the outer part of the child’s sole is accompanied by the opening of the toes in the form of a fan. At the same time, the back of the foot is slightly bent. This skill is judged by its energy and symmetry.
Moro reflex- occurs in two phases, which are a specific reaction of the baby to a loud knock or other sharp sound. At the same time, in the first phase, the child spreads his arms to the sides, unclenching his fingers and straightening his legs. In the second phase, the baby returns to its previous position. Sometimes it is called the hug reflex, since in its second phase the child makes a movement that resembles hugging himself. Remains clearly expressed until approximately 5 months of age.
Kernig reflex- manifests itself in the form of a specific response to attempts to unclench the legs in the knee joints and move them to the sides in hip joint. At normal healthy child this movement fails. It appears before the baby reaches 4 months.
Automatic gait reflex or stepping— the baby makes movements with his legs, simulating independent walking. This happens when you lift it a little, slightly tilting your body forward. At the same time, he should step on the entire foot, which is a good signal. If the feet begin to cling to each other or the child, then this may be a signal to contact a neurologist.
Galant reflex, which determines the degree of response of the child’s spine to external stimuli. The baby should arch his back when you run your finger along the spine (hereinafter,).
This is far from full list all reactions. There are some other congenital reactions that will definitely be checked by a specialist in the maternity hospital.
When should parents be concerned?
In cases where congenital reflexes appear with a weak degree of intensity or are slightly delayed, it is necessary to seek advice from a specialist. Such deviations may indicate certain health problems, for example:
- the baby getting injured during labor;
- the presence of certain diseases;
- birth of a child prematurely;
- birth with asphyxia;
- specific individual reaction to taking certain medicines etc.
A particularly dangerous situation will be when reflexes are completely absent due to serious birth injuries, severe intrauterine defects, deep asphyxia. This fact is the basis for emergency resuscitation measures. However, if the child is helped in a timely manner, problems can be easily avoided, since the baby’s body reserves are enormous.