NEONATAL REFLEXES

Dr. Balbirsingh J.L.N.Hospital Research centre,

Bhilai Steel Plant

INTRODUCTION

Actions in response to specific stimuli that are present in newborn infants.

These are unconditioned reflexes and not

learned or developed through experience.

Normally developing neonates or infants are expected to respond to specific stimuli with a specific, predictable behaviour or action.

MORO’S REFLEXE

ELICITED BY :

PLACING THE BABY IN SEMI UPRIGHT POSITION

↓SUDDEN DROPING OF HEAD IN RELATION TO

TRUNK AND CATCHING THE FALLING HEAD

DISAPPEARS AT 3 TO 6 MTHS

RESPONSE

OPENING OF HAND

EXTENSION AND ABDUTION OF UPPER EXTRIMITIES

ANTERIOR FLEXION OF UPPER EXTRIMITIES

AUDIBLE CRY

ABNORMALITIES:

DEPRESSED OR ABSENT GENERALISED DEPRESSION OF CNS

ASYMMETRICAL RESPONSE FRACTURE CLAVICLE ERB PALSY HEMIPARESIS

EXAGERGERATED RESPONSE KERNECTERUS

STARTLE REFLEX

It is variant of Moro’s Reflex.

Ellicited by: sudden loud noise or by tapping the sternum

Response is like Moro’s reflex but elbow remain flexed and hands closed

PALMER GRASP Elicited By: Placing finger or object in

open palm of each hand Response: Infant grasp the object and

with attempted removal grip reinforced

Appears at 28 weeks of gestation and disappears at 2-3 months of life

Persistence beyond 6mths: Athetoid CP

TONIC NECK REFLEX

ASYMMETRIC TONIC NECK REFLEX Elicited By: Passive rotation of head in

supine position Response: Extension of upper limb of

same side and flexion of upper limb of opposite side

Appears at birth and disappear at 3 months

Persistence > 3 months: Spastic CP

Importance: Prevents body from rolling

TONIC NECK REFLEX SYMMETRIC TONIC NECK REFLEX

Elicited By: Passive extension of head in prone position

Response: Extension of both UL & flexion of both LL

Appears in 3 mths and disappear in 6mths Persistence > 6mths : CP

Importance: When baby learn to turn to prone

position chocking over bed may asphyxiate him so if baby lift his chin by extension of neck both upper limbs extend automatically and chocking avoided.

GALANT REFLEX Elicited By: Holding the child in ventral

suspension or placed in prone position and running finger down in paravertebral area on one side

Response: Swinging of pelvis towards stimulated side

Appears at birth disappear by 1 year

Used for mapping sensory level of trunk

PEREZ REFLEX

Elicited By: Holding the child in prone position and pressure applied upword along spine.

Response: Flexion of arms and legs with extension of neck and cry

Appear at birth and disappear at 6 weeks

TRACTION RESPONSE Grasp the baby at his wrist and

finger and pull to sit Response: Certain degree of head

control is demonstrated and head is brought forward actively

ADDUCTION RESPONSE

Elicited by: holding leg of baby in extension and sole of foot is rubbed

Response: the other leg first withdraw and then extend with fanning of toes and bring toward the side of stimulation (as to push the noxious stimulus)

ROOTING REFLEX (SEARCH REFLEX)

Elicited By: Touching the corner of mouth lightly with finger

Response: Bottom lip is lowered on same side and tongue moves towards the point of stimulation as finger slides away head turns to find it.

Appear 28 week & disappear 4-7 mths

Importance: Absence at birth and persistence

beyond 7 months indicate developmental delay

Helps the baby for finding the breast

SUCKING REFLEX

Elicited By: Introducing finger into babies mouth

Response: Baby starts sucking vigorously

Appear at 28 week disappear at 4-7 months

Absence sucking at birth indicate sickness, persistence beyond 7 mths developmental delay

LANDAU REFLEX

Elicited By: Holding the child in ventral suspension

Response: Extension of head, spine and legs

Appear at 3 months disappear at 9 months

Absence beyond 3 mths indicate motor weakness, mental sub normality & CP

PARACHUTE REFLEX

Elicited By: Holding the child in ventral suspension and suddenly brought down the baby towards ground from height

Response: Extension of both UL in attempt to avoid injury

Appears at 6-9 months persists life long.

Absent in CP and hemiplegia of affected limb

PLACING REFLEX

Elicited by: Bringing the anterior aspect of tibia against edge of table

Response: Lifts leg on the table

Appear at birth and disapper at 6 weeks.

WALKING REFLEX

Elicited by: holding the baby upright over the table so that sole of foot presses against the table

Response: Reciprocal flexion and extension of leg simulating walking

Appears at birth and disappear at 6 week

PALMOMENTAL REFLEX

Elicited by: Pressing the palm

Response: Opening of mouth

Appear at birth and disappear at 3 year

CONCLUSION

Knowledge of neonatal reflexes is important for Understanding the human development as

a whole. Application for over all assessment of

baby Recognition of possible

neurodevelopemental damage in prenatal and perinatal period.

Establishment of the prognosis for future Predicting the Childs future potential

THANKS