13135335 newborn reflexes(2)

8/8/2019 13135335 Newborn Reflexes(2)

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Newborn Reflexes

Reflexes are involuntary movements or

actions. Some movements are spontaneous,occurring as part of the babys usual activity.

Others are responses to certain actions.Reflexes help identify normal brain and nerveactivity. 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 ABNORMALRESPONSE

Rooting and

sucking

Newborns turns head in

direction of stimulus,

opens mouth, and begins

to suck when cheek, lip,or corner of mouth is

touched with fingeror

nipple.

Weak or no response

occurs with

prematurity,

neurologic deficit orinjury, or central

nervous system

(CNS) depressionsecondary to

maternal drugingestion (eg.narcotics).

Extrusion Newborn pushes tongue

outward when tip of tongue

is touched with finger ornipple.

Continuous

extrusion of tongue

or repetitive tonguethrusting occurs

with CND

anomalies and

seizures.

Swallowing Newborn swallows in coordination with

sucking when fluid is placed on back oftongue.

Gagging, coughing,

or regurgitation offluid may occur,

possibly associatedwith cyanosis

secondary to

prematurity,neurologic deficit, or


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injury; typically

seen after

laryngoscopy.

Moro Bilateral symmetrical extension andabduction of all extremities, with thumb and

forefinger forming characteristic C are

followed by adduction of extremities and

return to relaxed flexion when newbornsposition changes suddenly or when newborn

is placed on back on flat surface.

Asymmetricalresponse is seen

with peripheral

nerve injury

(brachial plexus) orfracture of clavicle

or long bone or arm

or leg. No responseoccurs in cases of

severe CNS injury.

Stepping Newborn will step with one foot and then the

other in walking motion when one foot is

touched to flat surface.

Asymmetrical

response is seen

with CNS orperipheral nerve

injury or fracture of

long bone of leg.

Prone crawl Newborn will attempt to crawl forward with

both arms and legs when placed on abdomenor flat surface.

Asymmetrical

response is seenwith CNS or

peripheral nerve

injury or fracture oflong bone of leg.
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Tonic neck or

fencing

Extremities on side to which head is turned

will extend, and opposite extremities will

flex when newborns head is turned to one

side while resting. Response may be absentor incomplete immediately after birth.

Persistent response

after 4th month may

indicate neurologic

injury. Persistentabsence seen in CNS

injury andneurologicdisorders.

Startle Newborn abducts and flexes all extremities

and may begin to cry when exposed tosudden movement or loud noise.

Absence of response

may indicateneurologic deficit or

injury. Completeand consistentabsence of response

to loud noises may

indicate deafness.

Response may beabsent or diminished

during sleep.

Crossed

Extension

Newborns opposite leg will flex and then

extend rapidly as if trying to deflect stimulusto other foot when placed in supine position;

newborn will extend one leg in response to

stimulus on bottom of foot.

Weak or absent

response is seenwith peripheral

nerve injury or

fracture of longbone.

Glabellar

blink

Newborn will blink with first 4 or 5 taps to

bridge of nose when eyes are open.

Persistent blinking

and failure to

habituate suggest

neurologic deficit.

Palmar grasp Newborns finger willcurl around object and

hold on momentarilywhen finger is placedin palm of newborns

hand.

Response isdiminished in

prematurity.Asymmetry occurswith peripheral

nerve damage

(brachial plexus) orfracture of humerus.

No response occurs
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with severe

neurologic deficit.

Plantar Grasp Newborns toes will curl

downward when a fingeris placed against the base

of the toes.

Diminished response

occurs withprematurity. No

response occurs with

severe neurologic

deficit.

Babinski sign Newborns toes willhyperextend and fan apart

from dorsiflexion of big

toe when one side of footis stroked upward from

heel and across ball of

foot.

No response occurswith CNS deficit.

13135335 newborn reflexes(2)

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