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Primitive Reflexes

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

If the cheek is brushed or stroked near the The reflex disappears at about
corner of the mouth, a newborn infant will turn the 6th week of life. At about this
Rooting Reflex the head in that direction. This reflex serves to time, newborn eyes focus
help a newborn find food: when a mother holds steadily, so a food source can be
the child and allows her breast to brush the seen, and the reflex is no longer
newborn’s cheek, the reflex makes the baby turn needed.
toward the 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 The sucking reflex begins to
touch the mother’s breast or a bottle, the baby diminish at about 6 months of
sucks and so takes in food. age. It disappears immediately if
it is never stimulated such as in
Sucking  It can be maintained in such an infant by a newborn with a
Reflex offering the child a non-nutritive sucking tracheoesophageal fistula who
object such as a pacifier (after the fistula cannot take in oral fluids.
has been corrected by surgery and until
oral feedings can be given).

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 Permanent
Reflex swallowed. 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 It disappears at about 4 months


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

Plantar Grasp When an object touches the sole of a newborn’s This reflex disappears at about 8
Reflex foot at the base of the toes, the toes grasp in to 9 months of age in
the same manner as do the fingers. 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 This reflex disappears by 3
Place Reflex with their feet touching a hard surface will take months of age. By 4 months,
a few quick, alternating steps. babies can 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
reflex, except that it is elicited by touching the months of age. By 4 months,
Placing Reflex anterior surface of the lower part of a newborn’s babies can bear a good portion
leg against a hard surface such as the edge of a of their weight unhindered by
bassinet or table. The newborn makes a few this reflex.
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 the 2nd & 3rd months of life.
and the leg on the side toward which the head
turns extend, and the opposite arm and leg
Tonic Neck contract. The movement is most evident in the
Reflex. arms but may 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 It is strong for the first 8 weeks
startling a newborn with a loud noise, sudden of life and then fades by the end
Moro Reflex movement or by jarring the bassinet. The of the 4th or 5th month, at the
most accurate method of eliciting the reflex is to same time an infant can roll
(Startle or hold newborns in a supine position and allow away from danger
Embrace their heads to drop backward about 1 inch. In
Reflex) 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 It remains positive (toes fan)
inverted “J” curve from the heel upward, a until at least 3 months of age,
Babinski newborn fans the toes (positive Babinski sign). when it is supplanted by the
(Plantar) This is in contrast to the adult, who flexes the down-turning or adult flexion
Reflex toes. This reaction occurs because nervous response.
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 and the sole of that foot is irritated by being integrity.
Reflex 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 When newborns lie in a prone position and are Emerges at 20 weeks in utero
Incurvation touched along the paravertebral area by a and is inhibited by 9 months
Reflex probing finger, they flex their trunk and swing
their pelvis toward the touch
(Galant’s
Reflex)

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


hand underneath, supporting the trunk, should months, disappears at 12-24
Landau Reflex demonstrate some muscle tone. Babies may not months.
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 Permanent


by 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.

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