Reflexes are involuntary movements or actions. Some movements are spontaneous and occur as part of the baby's normal activity. Others are responses to certain actions. Healthcare providers check reflexes to determine if the brain and nervous system are working well. Some reflexes occur only in specific periods of development. The following are some of the normal reflexes seen in newborn babies: Rooting reflexThis reflex starts when the corner of the baby's mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking. This helps the baby find the breast or bottle to start feeding. This reflex lasts about 4 months. Suck reflexRooting helps the baby get ready to suck. When the roof of the baby's mouth is touched, the baby will start to suck. This reflex doesn't start until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability because of this. Because babies also have a hand-to-mouth reflex that goes with rooting and sucking, they may suck on their fingers or hands. Moro reflexThe Moro reflex is often called a startle reflex. That’s because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out his or her arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him or her and trigger this reflex. This reflex lasts until the baby is about 2 months old. Tonic neck reflexWhen a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the fencing position. This reflex lasts until the baby is about 5 to 7 months old. Grasp reflexStroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until the baby is about 5 to 6 months old. A similar reflex in the toes lasts until 9 to 12 months. Stepping reflexThis reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface. This reflex lasts about 2 months.
Craniosynostosis (premature closure of the suture) can cause a misshaped head. Bone growth occurs perpendicular to the suture. If one suture is closed, compensatory growth will occur in the remaining open sutures. Synostosis of the sagittal suture (the most common type of synostosis) results in scaphocephaly (a thin elongated head). Synostosis of the coronal sutures results in brachycephaly (a wide flat head). Synostosis of the metopic suture results in trigonocephaly (a triangular shaped head). The most common cause of a misshapen head is flattening of the occipit on one side and is not from lambdoid synostosis but is positional in nature (caused from the baby lying supine with the head turned to one side as a preferred position). It is important not only to palpate the sutures but also the fontanelles. The posterior fontanelle cannot be palpated after six weeks. The anterior fontanelle is often small by six months. Closure of the anterior fontanelle occurs between 10 and 20 months. The anterior fontanelle should be palpated while the child is sitting and quiet and it should be flat or slightly concave. A full, slightly bulging fontanelle can be seen with a child that is supine or crying.  Page 2
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Both infants in this exam have developed a pincer grasp. The first infant uses the pincer grasp to feed himself a cheerio. The second infant demonstrates a pincer grasp by grabbing the tip of a measuring tape and pulling the tape out. The pincer grasp should be equal in either hand. Handedness does not develop until after 12 months of age. Early handedness and asymmetric fine motor skills are seen with a hemiparesis. Page 5
The presence and strength of a reflex is an important sign of nervous system development and function. Many infant reflexes disappear as the child grows older, although some remain through adulthood. A reflex that is still present after the age when it would normally disappear can be a sign of brain or nervous system damage. Infant reflexes are responses that are normal in infants, but abnormal in other age groups. These include:
Other infant reflexes include: TONIC NECK REFLEX This reflex occurs when the head of a child who is relaxed and lying face up is moved to the side. The arm on the side where the head is facing reaches away from the body with the hand partly open. The arm on the side away from the face is flexed and the fist is clenched tightly. Turning the baby's face in the other direction reverses the position. The tonic neck position is often described as the fencer's position because it looks like a fencer's stance. TRUNCAL INCURVATION OR GALANT REFLEX This reflex occurs when the side of the infant's spine is stroked or tapped while the infant lies on the stomach. The infant will twitch their hips toward the touch in a dancing movement. GRASP REFLEX This reflex occurs if you place a finger on the infant's open palm. The hand will close around the finger. Trying to remove the finger causes the grip to tighten. Newborn infants have strong grasps and can almost be lifted up if both hands are grasping your fingers. ROOTING REFLEX This reflex occurs when the baby's cheek is stroked. The infant will turn toward the side that was stroked and begin to make sucking motions. PARACHUTE REFLEX This reflex occurs in slightly older infants when the child is held upright and the baby's body is rotated quickly to face forward (as in falling). The baby will extend his arms forward as if to break a fall, even though this reflex appears long before the baby walks. Examples of reflexes that last into adulthood are:
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Which reflex would the nurse expect to see while examining an eight month old who is developing normally?
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