Newborn reflexes

Baby reflexes are involuntary movements or actions. Some movements are spontaneous and occur as part of the baby’s normal activity. Others are responses to certain actions. Healthcare providers check reflexes to determine if the brain and nervous system are working well. Some reflexes occur only in specific periods of development.

The following are some of the normal reflexes you will see your baby perform during her first weeks. Not all infants acquire and lose these reflexes at exactly the same time, but this table will give you a general idea of what to expect.

Table 1. Newborn reflexes

Rooting reflex in babies

Rooting reflex starts when the corner of the baby’s mouth or baby’s cheek is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking. This helps the baby find the breast or bottle to start feeding. The rooting reflex is present at birth and assists in breastfeeding, disappearing at around four months of age as it gradually comes under voluntary control. A newborn infant will turn their head toward anything that strokes their cheek or mouth, searching for the object by moving their head in steadily decreasing arcs until the object is found. After becoming used to responding in this way (if breastfed, approximately three weeks after birth), the infant will move directly to the object without searching. Rooting reflex lasts about 4 months.

Suck reflex

Rooting helps the baby get ready to suck. When the roof of the baby’s mouth is touched, the baby will start to suck. Sucking reflex, which triggers an infant to forcibly suck on any object put in the mouth or an area around mouth is touched, doesn’t start until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability because of this. Because babies also have a hand-to-mouth reflex that goes with rooting and sucking reflex, they may suck on their fingers or hands.

Moro reflex baby

Moro reflex is often called a startle reflex. That’s because it usually occurs whenever the baby has been startled by a loud noise, bright light, strong smell, sudden movement, or other stimulus. In response to the sound, the baby throws back his or her head, extends out his or her arms and legs, cries, then pulls the arms and legs back in. A baby’s own cry can startle him or her and trigger this reflex. Moro reflex or Startle reflex lasts until the baby is about 2 months old.

Tonic neck reflex

Tonic neck reflex also called asymmetrical tonic neck reflex (ATNR) occurs when the head of a child who is relaxed and lying face up is moved to the side. The arm on the side where the head is facing reaches away from the body with the hand partly open. The opposite arm (the arm on the side away from the face) bends up at the elbow and the fist is clenched tightly. Turning the baby’s face in the other direction reverses the position. The tonic neck position is often described as the fencer’s position because it looks like a fencer’s stance. This is often called the fencing position.

Tonic neck reflex lasts until the baby is about 5 to 7 months old.

Grasp reflex

Grasp reflex also called Palmar grasp reflex occurs if you place a finger on the infant’s open palm or stroking the palm of a baby’s hand causes the baby to close his or her fingers in a grasp. Trying to remove the finger causes the grip to tighten. Newborn infants have strong grasps and can almost be lifted up if both hands are grasping your fingers.

The grasp reflex lasts until the baby is about 5 to 6 months old. A similar reflex in the toes lasts until 9 to 12 months.

Stepping reflex

Step reflex also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface. The walking or stepping reflex is present at birth; though infants this young can not support their own weight, when the soles of their feet touch a flat surface they will attempt to ‘walk’ by placing one foot in front of the other. Stepping reflex disappears as an automatic response in about 2 months and reappears as a voluntary behavior at around eight months to a year old.

Babinski reflex

The Babinski reflex appears when the side of the foot is stroked, causing the toes to fan out and the hallux to extend. The Babinski reflex is caused by a lack of myelination in the corticospinal tract in young children. Babinski reflex is often confused with the plantar reflex, the Babinski reflex is also present at birth and fades around the first year.

The Babinski reflex is a sign of neurological abnormality in adults.

Placing reflex

Placing reflex is when the baby extends his leg when sole of his foot is touched

Galant reflex

The galant reflex also known as Galant’s infantile reflex, is present at birth and fades between the ages of four to six months. When the skin along the side of an infant’s back is stroked, the infant will swing towards the side that was stroked. If the reflex persists past six months of age, it is a sign of pathology.

Plantar grasp or Plantar reflex

The plantar reflex or plantar grasp is present at birth and fades around the infant’s first birthday. The plantar reflex causes the infant’s toes to curl up tightly when something rubs the ball of their foot.

Truncal incurvation or galant reflex

This reflex occurs when the side of the infant’s spine is stroked or tapped while the infant lies on the stomach. The infant will twitch their hips toward the touch in a dancing movement.

Parachute reflex

Parachute reflex occurs in slightly older infants when the child is held upright and the baby’s body is rotated quickly to face forward (as in falling). The baby will extend his arms forward as if to break a fall, even though this reflex appears long before the baby walks.

Symmetrical tonic neck reflex

Symmetrical tonic neck reflex (STNR) is a primitive reflex that is characterized by upper extremity extension and lower extremity flexion with neck extension, and by upper extremity flexion and lower extremity extension with neck flexion ¹⁾. Symmetrical tonic neck reflex (STNR) consists of two phases: flexion (inward movement) and extension (outward movement). When the child is positioned on their hands and knees, flexion or lowering of the head causes the arms to bend and the legs to extend. When the head is extended or raised, the arms extend and the legs bend. Although often seen in children with cerebral palsy (CP), it is an uncommon finding in term neonates and infants. Symmetrical tonic neck reflex is developed after the asymmetrical tonic neck reflex (ATNR) and allows the infant to defy gravity on their hands and knees, and is a precursor to creeping ²⁾. This reflex helps the infant learn to rise up onto the hands and knees. The symmetrical tonic neck reflex emerges between 6 and 9 months of life, and should be integrated by 9 to 12 months of life. This is a short-lived reflex that primarily helps the baby to learn to get up off the floor and onto their hands and knees. However, if this reflex is retained, the baby will not be able to move forward by crawling or creeping but will do a “bear walk”, scoot on their bottoms, or skip crawling, and just stand up and walk.

Glabellar reflex

Glabellar reflex also known as the “glabellar tap sign”, nasopalpebral reflex or blinking reflex, is a primitive reflex elicited by repetitive light tapping on the forehead over the glabella produces a reflex blinking of both eyes ³⁾. Subjects blink in response to the first several taps. If the blinking persists, this is known as Myerson’s sign and is abnormal and a sign of frontal release; it is often seen in people who have Parkinson’s disease ⁴⁾. However, the glabella tap reflex may also be positive as a release phenomenon as a result of diffuse (probably frontal lobe) damage ⁵⁾ and in one report was positive in 36% of patients with no intracranial pathology ⁶⁾. As the glabella tap reflex is neither sensitive forthe presence of intracerebral pathology, nor specific for parkinsonism, its role in modern clinical practice is question-able.

Tonic labyrinthine reflex

Tonic labyrinthine reflex is a primitive reflex found in newborn humans. With this reflex, tilting the head back while lying on the back causes the back to stiffen and even arch backwards, the legs to straighten, stiffen, and push together, the toes to point, the arms to bend at the elbows and wrists, and the hands to become fisted or the fingers to curl. The presence of this reflex beyond the newborn stage is also referred to as abnormal extension pattern or extensor tone. The presence of the tonic labyrinthine reflex as well as other primitive reflexes such as the asymmetrical tonic neck reflex (ATNR) beyond the first six months of life may indicate that the child has developmental delays and/or neurological abnormalities ⁷⁾. For example, in people with cerebral palsy, the reflexes may persist and even be more pronounced. As abnormal reflexes, both the tonic labyrinthine reflex and the asymmetrical tonic neck reflex can cause problems for the growing child. The tonic labyrinthine reflex and asymmetrical tonic neck reflex (ATNR) both hinder functional activities such as rolling, bringing the hands together, or even bringing the hands to the mouth. Over time, both the tonic labyrinthine reflex and asymmetrical tonic neck reflex (ATNR) can cause serious damage to the growing child’s joints and bones, causing the head of the femur to partially slip out of the acetabulum (subluxation) or completely move out of the acetabulum (dislocation).

Landau reflex

The Landau reflex assists with posture development and technically isn’t a primitive reflex as it isn’t present at birth. It is when a baby lifts his head up causing the entire trunk to flex and typically emerges at around 3 months of age. It is fully integrated by one year. If the landau reflex persists beyond this point, children may experience short term memory problems, poor motor development and low muscle tone.