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Neonatal Reflexes

  1. A number of primitive neonatal reflexes can be elicited in healthy term neonate. These disappear as the child grows.
  2. Absence of reflex response indicates general depression of central of peripheral motor functions. Abnormal persistence of neonate reflexes is pathognomonic of central motor lesions
  3. Sucking and Rooting reflexes
    1. The sucking reflex is tested by introducing a finger or teat into the mouth, when vigorous sucking will occur.
    2. The rooting or search reflex when the baby's check contacts the mother's breast he/she seeks the nipple and find the nipple without being directed to it.
    3. These reflex is strong and well synchronized with swallowing at 34 weeks and disappear by 6 - 9 month when voluntary control of feeding achieved.
  4. Moro reflex
    1. Hold the baby at an angle of about 450 from the couch and then suddenly let the head fall back a short way
    2. The reflex consists of abduction and extension of the arms. The hands open, but the fingers often remain curved this followed by adduction and flexion. The reflex is also accompanied by crying, extension of the trunk and head without movement of the legs.
    3. The Moro reflex may be incomplete in babies with gestation of less than 35 weeks '
  5. Asymmetrical Moro Suggest
    1. Brachial palsy
    2. Fracture of clavide or humerus
    3. Hemiplegia It is inhibited on one side if the hand is holding an object The reflex disappear after the age of 12 weeks.
  6. Grasp reflex
    1. When the baby's palm is stroked with the examiner's index finger, the baby's fingers close on it and grasp it. Stroke the dorsum of hand make baby to open the hand.
    2. This reflex present at time of birth in full term baby and usually disappear by the age of 12 weeks persistence beyond this age should arouse suspicion of brain damage
    3. Glabellar tap when the examiner gently taps the glabella (junction between the nose and forehead), both eyelids of the neonate blink. The reflex is present after 32 weeks of gestation
  7. Asymmetric Tonic Neck Reflex (ATNR) :
    1. The supine, infant’s head is turned suddenly to one side. The arm and leg on the same side extend, while the opposite limbs go into flexion.
    2. This reflex disappear by 5 months of age.
    3. Persistence of the reflex beyond the age of 6 to 9 months or a constant tonic neck posture are abnormal and usually indicate spastic cerebral palsy.
  8. Walking / stepping
    1. Hold the infant in standing position and place foot on a flat surface. The leg extends to take the infant’s weight, the opposite leg flexes then extend and as it takes weight the original leg reflexes.
    2. Time of appearance – 4 days
    3. Time of disappearance – 2 Months
  9. Placing
    1. With the baby held upright between the hands of the examiner the dorsal part of the foot is brought lightly in contact with the edge of the table. Normally the baby flexes knee and hip and places foot on the table.
    2. Time of appearance – 4 day
    3. Time of disappearance - 5 – 9 Months

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