Neonatal reflexes

• Method of testing:
• stroke lateal sole of foot from heel to across base of toes

• Expected response:
• toes flare with dorsiflexion of the big toe

• abnormal response/possable cause:
• no response (bilateral CNS deficit)
• (unilateral local nerve damage)

Time reflexes dissappear: 12 mo's

lightly stroke the back lateral to the vertebral column

• Expected response:
• entire trunk flexes tward side stimulated

• abnormal response/possible cause:
• No response CNS deficit

Time reflex disappears: 1 mo

press finger against base of fingers or toes

• Expected response:
• fingers curl slightly; toes curl forward

• Abnormal response/possible cause:
• weak or absent; neurologic deficit or muscle damage

• Time reflex disappears:
• Palmer grasp lessens 3-4 mo, disappears by 5-6 mo.
• Plantar grasp disappears by 8-9 mo's

lets infant's head drop back approximately 30 degrees

• Expected response:
• sharp extension and abduction of arms with thumbs and forefingers in "C" position, followed by flexion and abduction to "embrace" position. Legs follow similar pattern

• Abnormal response/possible cause:
• absent: CNS dysfunction. Asymmetry:brachial plexus injury, paralysis, or fractured clavicle or bone of extremity. Exaggerated: manternal drug use

Time reflex disappears: 6 mo

touch or stroke side of cheek near mouth

Expected response: infant turns to side touched (difficult to elicit if infant sleeping or just fed)

• Abnormal response/possible cause:
• weak or absent; prematutity, neurologic deficit, depression from maternal drug use

Time reflex disappears: 3-4 mo's

make a loud noise

• Expected response:
• similar to moro, but hands remain clenched

• Abnormal response/possible cause:
• weak or absent neurologic damage, deafness

Time reflex disappears: 4mo

hold infant so feet touch solid surface

• Expected response:
• infant lifts alternate feet as if walking

• Abnormal response/possible cause:
• asymmerty fracture of extremity, neurologic deficit

Time reflex disappears: 4-7 mo's

Place nipple or finger in mouth, rub against palate

• Expected response:
• infant begins to suck may be weak if recently fed

• Abnormal response/possible cause:
• weak or absent: prematurity, neuro-logic deficit, maternal drug use
• Time reflex disappears: well coordinated with swallow by 34-36 wk of gestation, disappears by 1 yr.

Place fluid on the back of the tongue

• Expected response:
• infant swallows fluid should be coordinated with sucking

• Abnormal response/possible cause:
• coughing, gagging, choking, cyanosis: tracheoesophageal fistuls, esophageal atresia, neurologic deficit

Time reflex disappears: present throughout life

gently turn head to one side while infant is supine position

• Expected response:
• exension of extremities on side to which head turned, with flexion on opposite side

• Abnormal response/possible cause:
• prolonged period in position, neurologic deficit

Time reflex disappears: may be weak at birth and increase to 1 mo, then disappears by 4 mo's