New Born Reflex

  • Introduction
  • Moro’s Reflex
  • Rooting Reflex
  • Grasp Reflex
  • Sucking Reflex
  • Stepping Reflex
  • Tonic neck reflex.

Every baby’s reflex is extremely important. Though they might be subtle, they play a very important role. Those tiny twitches, grasps, movements help us to assess the baby’s development and also helps the baby to acquaint himself gradually to the world around him and be more independent. In fact it is these reflexes that will evolve in to more advance skills like rolling over, sitting and standing, holding objects and walking.  

 So I am going to tell you the basic essential reflexes which you will notice in your child.

MORO S REFLEX:

This is a reflex you will notice when the baby is startled or surprised. The baby will stretch their arms outwards, throw their head backwards.  Some babies may also extend their legs. After this they will curl their arms and legs towards their body.

What are triggering factors?

  • Loud noise
  • Intense light
  • Sudden jerky movements
  • A feeling of falling down. This is seen when the parents either lay them down or suddenly pick them up.

How to test this reflex?

I still remember during my MBBS days when I was posted in the Pediatric department, we would go for rounds with our senior doctors. I used to be so startled and in awe when the doctors would asses these reflexes in new born babies and the way each baby would respond. Those days, moments are still so fresh even now.

We usually asses the Moro’s reflex by doing the head drop test. The doctor tries to simulate the sensation of falling by gently lowering the baby’s head relative to the body and then observe for the reflex.

When does it start?

Moro reflex starts right from birth. They exhibit a full Moro‘s reflex which involves their arms, legs and head. Gradually once the neck can support the weight of the head which is usually by 4 months of age, the reflex becomes less intense. And by the time the baby is 6 months it tends to disappear. Do not panic when you see such reflexes. These are natural neurological developments and it is a way the baby tries to protect him.

How to pacify a baby with Moro’s reflex?

Moro’s reflex is a normal reaction in healthy babies but however some babies have an exaggerated or an overactive response and can disturb them or even interfere with their sleep. As a parent , certain things that you can do to calm you baby is:

  • Hold your baby close to you till they calm down.
  • Gently bring the baby’s stretched arms and legs close to the body.
  •  Support the baby’s head and neck while you move or hold them
  • swaddle the baby gently,

Abnormal reaction:

However some babies might have an abnormal reaction of either involving only one side or having no reflex at all. This can be seen in conditions like:

  • Infections
  • Injury at the time of birth
  • Muscle weakness
  • Spastic cerebral palsy
  • Peripheral nerve damage.

ROOTING REFLEX

This is another unique reflex you will see in your baby. This reflex is important as it helps the baby find the mother’ breast. In fact you can trigger this reflex by gently touching the corner of the baby’s mouth and the baby will naturally turn their head to follow and root in that direction.

The rooting reflex starts to develop around 28 to 30 weeks of gestation .It is very strong in the first few weeks after birth  and by 3 weeks of age  they are naturally able to turn their head and position themselves to start sucking. By the time they are 4 months  this reflex becomes more like a voluntary action. However in babies who are born prematurely before 28 weeks, the rooting reflex is very poor so in such cases it is better to guide their mouth to your nipple until they are able to find the nipple on their own.

Babies have different ways to express their desire to feed. Finger sucking is also one of them. I m sure being a parent you are always concerned if your baby is getting enough or is sucking properly. Well remember this- in the first few days of life ,new borns don’t need large quantities of breast milk or formula feed as their stomach is really small.  The secret to know if your baby is feeding well is  to check your baby’s diapers. Generally after day 3, babies who are breastfed will have 3 wet diapers per day and by day 5 they will have about 5 or more wet diaper pr day.

Take home message

The reflexes are a guide to help them survive in this new environment. The rooting reflex helps them to find a breast or bottle nipple. Most babies quickly adapt themselves but however some babies find it difficult to start breastfeeding. They have difficulty in latching, rooting or sucking; in that case speak to your pediatrician or lactation consultant.

GRASP REFLEX

This my most favourite reflex. Just love the way they hold on to your little finger. It’s a priceless moment and my heart just melts.  This reflex starts when the baby is inside the womb and continues till the baby is 6 months of age.

This grasp reflex is of two types:

 Plantar and palmar grasp reflex. While the palmar reflex is seen in the palms, the plantar reflex is seen in the soles of the feet. The plantar reflex is also called as the Babinski reflex. You can test if your baby has a good Babinski reflex by firmly running your finger along the outer part of the sole. You will see the big toe flex upward and backward towards the top of their foot and the other toes will fan out.

Why is palmar reflex important?

It’s these reflex that lays the foundation and gradually helps the baby to develop the voluntary movements. Babies who are less than 4 months old find it difficult to grasp or hold things. But gradually between 4 to 6 months of age they learn to reach out for bright coloured objects, they try to hold on to them. In fact it is this reflex that act as a back bone for building these neural pathways.

Do you know the palmar reflex starts when the baby is16 weeks of gestation? Ultrasound studies have shown images of babies grasping the umbilical cord. That is so interesting right!!  The reflex usually starts to disappear by 6 months of age. By 6 months the baby’s brain develops and is able to think as to what they need to do rather than having a reflex reaction. Hence by 6 months, involuntary reflex gets replaced by voluntary movements.

Let me tell you enjoy this reflex as it will disappear even before you know.  The way they hold on to your finger will literally skip your heart beat.

SUCKING REFLEX

Babies are born with a lot of reflexes that helps them to cope up with the new environment. The reflexes are involuntary movements that can either happen spontaneously or a response to different actions. Sucking reflex is one such reflex.

When does sucking reflex start?

Sucking reflex starts developing at 32 weeks of pregnancy and it is fully developed by 36 weeks of pregnancy. In fact on ultrasound imaging, if you’re lucky you might see the baby suck their thumb or fingers.

 Those babies who are born prematurely may not have a good sucking reflex. Infact some of them may not even have the endurance to have a complete feeding session. But don’t worry they might take a couple of weeks extra but they gradually learn to coordinate both sucking and swallowing.

Stages:

First stage: Fixing: in this stage they try to fix their mouth on the nipple either from the breast or from the bottle. While breast feeding the baby places their lip on the areola of the breast and squeezes the nipple between their tongue and roof of the mouth. A similar action happens when they suck from a bottle.

 Stage 2 : Expression: in this stage the baby moves the tongue to the nipple to suck the milk from the breast. Suction creates a negative pressure and  helps to keep the breast in the baby’s mouth  .

 As a mother how can you help them?

Most babies are not a pro at sucking. Some of them learn it quickly while others take time . You can help them by:

Kangaroo care: this is very important. Keep your baby close to you and have plenty of skin to skin contact. This helps the baby to stay warm and it helps to increase your milk supply.

Feeds: in the early or initial stages it is advised to feed your baby every 2 to 3 hours. Premature babies may require to be fed more frequently than other babies. After a certain period if you feel your baby is sucking enough and getting good amount of milk then the frequency can be reduced. 

Positing: try to hold your baby in the breast feeding position even if they are being fed by tube. You can also soak cotton balls with your breast milk and place near your baby’s mouth so that they get acquainted to the smell of your breast milk and gradually start feeding.

Different positions: let me tell you this is like a hit and trial experiment. You need to experiment with different positions while nursing and your baby might feel comfortable with one of them. It could be a twin position or some of them feel comfortable when they are tucked under the arm with their body supported by the pillow.

Let down reflex: try to increase your let down reflex. This allows the milk to start flowing. You can also do this by massaging your breast, hand expressing or placing a warm heat pack to your breast. This will make expressing milk much easier for your baby. 

Remain positive. This is the key. It can be very disheartening or depressing. But don’t worry. You are not alone in this. A lot of mothers experience it and they will get through this. Be calm and patient, try to know your baby better and with time they will start consuming more milk.

STEPPING REFLEX:

This is yet another interesting reflex. These reflexes help the paediatrician to assess the child’s growth and development and if the child is hitting the various milestones at the correct time. Have you noticed when you hold your baby upright above a flat surface, the baby will stretch their legs towards the surface. You might also notice that your baby tries to put one foot down and  then lifts up that foot  and tries to put the other one down just like how they are trying to walk.

When does it begin?

Like I said most of the new born reflexes are seen immediately after birth. Even the stepping reflex is seen after birth. Unlike certain other reflexes  like the cough, sneeze, blink  and yawn reflex that last throughout adulthood, this reflex gradually disappears by 2 to 3 months of age.

Take home message:

These new born reflexes are like milestone indicators. They pave way for their further growth, movement, developmental activities. Enjoy every little moment with your baby because even before you realise they will be walking and running around. But again let me reinforce this, if you notice that your baby is not going in the right track, never hesitate, immediately consult your paediatrician.

TONIC NECK REFLEX

Haven’t you noticed at times when your baby is lying on their back they resemble a cute little archer with their head turned to the same side as their outstretched arm and their other arm bent at the elbow.

The tonic neck reflex begins as early as 18 weeks after conception. Yes you are right this reflex develops when the baby is in the mother’s womb and it lasts for almost 5 to 7 months after the baby is born.

Tonic neck reflex is very important:

It is this reflex that helps the baby come out through the birth canal.  After birth, the reflex helps your baby to discover their hands also enhance hand eye coordination.  This reflex is also called the fencing reflex with the baby lying down and their head turned to the right or left with the corresponding arm extended and the other arm bent next to their head.

How do you test it?

Make the baby lie down on their back and turn their head and face to the left. When you do that you will see that the left arm will stretch out and the right arm will flex next to the head. And a similar action happens when you turn the face and head to the right.  You might not notice this reflex all times as it depends if the baby is in a relaxed state and is not distracted by something else in the room.

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