Monitoring Primitive Reflexes During Infancy: The Best First Step is Prevention

Monitoring Infant Primitive Reflexes

It is important for parents of a newborn to monitor primitive reflexes to ensure they are present and also that they integrate on schedule. While a pediatrician can incorporate this testing during well baby visits, parents can also learn to do the test themselves. Primitive reflexes that do not start going away at around four months of age are the first major sign of a neurological problem developing down the way. The earlier the problem is detected, the faster it can be remediated.

Doing the primitive reflex test on infants is  easy for any parent to perform. While there are more than thirty different primitive reflexes, the following are the ones that should be present at birth and are consistently associated with a brain imbalance.

Rooting and Sucking Reflex

A pacifier can be used to test if your baby latches reflexively. Use your finger or small paintbrush to gently stroke your baby’s cheek about a half inch from the corners of the lips. Make the stroking motion toward the mouth. Baby should open his mouth toward the stimulus and turn his head to latch on to the objet. If the reflex is weak, do it multiple times per day until you notice it is strong. There should be resistance when pulling out the pacifier. At four to six months, the rooting and sucking reflex should start to go away. To help ensure that it does, do this same exercise several times a day until it’s gone.

Moro Reflex

To test the moro reflex, hold the child in a fetal position and clap your hands loudly or make a loud banging sound. She should react with a startle. The arms and legs will usually fly open, the head and back will lean backward, and the baby will take a deep breath before going back to the fetal position. An asymmetric Moro, where only one arm flies out the hand stays open, may indicate a brain imbalance.

Galant Reflex

This reflex can be activated by stroking the skin along one side of the spine in a downward motion. This will cause the baby to flex the muscles on the same side, bending forward into a C shape. For an older baby, place him on the floor on all fours and stroke one side of the spine about an inch below the shoulder blade.

Plantar Reflex

To elicit the plantar reflex, hold your baby’s foot by the ankle and use your fingernail or a small brush to gently stroke the outside bottom of the foot, from the bottom of the heel along the outside of the foot toward the toes, but don’t touch the ball of the foot. Hold the foot around the ankle firmly and stroke the bottom of the foot with the other. Do one foot at a time. Use the same amount of pressure as you would to tickle the foot. Baby’s big toe should go up and all toes should fan out. This reflex should be present until age one.

Asymmetric Tonic Neck Reflex (ATNR)

Make sure your baby is laying calmly on the floor. Gently move the head to one side and hold it for 10 seconds to initiate movement of the legs and arms. It should take a few seconds for this reflex to start and it will get more pronounced as you hold it. Your baby should respond by straightening and extending the arm and leg on the side of the head turn and then flexing the arm and leg on the opposite side – just like a fencing position. Repeat on the other side. Make sure you are moving the head gently and naturally as you do not want to cause a neck injury.

Lateral Propping

Stand behind your child and put your hands on the side of each shoulder. Have her sit up. Gently push her to one side with a quick motion to lose balance. Keep your other hand in position to prevent the fall. The push should make her react by throwing out her arms to protect herself.

Remediating Retained Primitive Reflexes

Parents may notice some of these reflexes may be more persistent on one side of the body. This may signify that one side of the brain is developing normally but not the other. This could also mean a nerve injury or possibly even a brain injury. The baby should be checked out by a doctor as soon as possible.

If these reflexes persist beyond what is typical, primitive reflex integration exercises can be started. The way to get rid of these reflexes is to use them. Remediation is easy, and lingering primitive reflexes can be gone in a matter of weeks and at most should not take more than three to six months to integrate.

If a baby is delayed in acquiring a motor milestone like rolling over or crawling, it is most likely because her primitive reflexes are still active. By monitoring primitive reflexes closely during infancy and remediating them early, you can help ensure the healthy development of brain connections that advance a newborn from one milestone to the next.