Primitive reflexes

Primitive reflexes are reflex actions originating in the central nervous system that are exhibited
by normal infants but not neurologically intact adults, in response to particular stimuli. These
reflexes disappear or are inhibited by the frontal lobes as a child moves through normal child
development.[1] These primitive reflexes are also called infantile, infant or newborn reflexes.

Older children and adults with atypical neurology (for instance, people with cerebral palsy) may
retain these reflexes and primitive reflexes may re-appear in adults because of certain
neurological conditions including, but not limited to, dementia, traumatic lesions, and strokes.[2][3]
An individual with cerebral palsy and typical intelligence can learn to suppress these reflexes,
but the reflex might resurface under certain conditions such as during an extreme startle reaction.
Reflexes may also be limited to those areas affected by the atypical neurology, such as
individuals whose cerebral palsy affects only their legs retaining the Babinski reflex but having
normal speech; in individuals with hemiplegia, the reflex might be seen in the foot on the
affected side only.

Primitive reflexes are primarily tested with suspected brain injury to test the functioning of the
frontal lobe. If they are not being suppressed properly they are called frontal release signs.
Atypical primitive reflexes are also being researched as potential early warning signs of autistic
spectrum disorders.

Adaptive value of reflexes

Reflexes vary in utility. Some have a survival value. A perfect example would be the rooting
reflex, which helps a breastfed infant find the mother's nipple. Babies display it only when
hungry and touched by another person, not when they touch themselves. There are a few reflexes
that probably helped babies survive during human evolutionary past like the Moro reflex. Other
reflexes such as sucking and grabbing help establish gratifying interaction between parents and
infants. They can encourage a parent to respond lovingly and feed more competently. They can
also help parents comfort their infant because they allow the baby to control distress and the
amount of stimulation they receive.[5]

Moro reflex
The Moro reflex in a four-day-old infant: 1) the reflex is initiated by pulling the infant up from
the floor and then releasing him ; 2) he spreads his arms 3) he pulls his arms in ; 4) he cries (10
seconds)

Moro reflex

This is sometimes referred to as the startle reaction, startle response, startle reflex or embrace
reflex. It is more commonly known as the Moro response or Moro reflex after its discoverer,
pediatrician Ernst Moro.

The Moro reflex is present at birth, peaks in the first month of life and begins to disappear
around 2 months of age. It is likely to occur if the infant's head suddenly shifts position, the
temperature changes abruptly, or they are startled by a sudden noise. The legs and head extend
while the arms jerk up and out with the palms up and thumbs flexed. Shortly afterward the arms
are brought together and the hands clench into fists, and the infant cries loudly.[6] The reflex
normally disappears by three to four months of age,[7] though it may last up to six months.[8]
Bilateral absence of the reflex may mean damage to the infant's central nervous system while a
unilateral absence could mean an injury due to birth trauma such as a fractured clavicle or injury
to the brachial plexus. Erb's palsy or some other form of paralysis is also sometimes present in
such cases.[7] A way to experiment to see if the reflex is present is to hold the infant horizontally
on their back and let the head drop slightly or produce a sudden loud sound against the surface.
In human evolutionary past, the Moro reflex may have helped the infant cling to his mother
while she carried him around all day. If the infant lost its balance, the reflex caused the infant to
embrace its mother and regain its hold on the mother’s body.[5]

Walking/stepping reflex

Walking reflex

The walking or stepping reflex is present at birth; though infants this young can not support
their own weight, when the soles of their feet touch a flat surface they will attempt to 'walk' by
placing one foot in front of the other. This reflex disappears at 6 weeks as an automatic response
and reappears as a voluntary behavior at around eight months to a year old.

Rooting reflex
The rooting reflex is present at birth and assists in breastfeeding, disappearing at around four
months of age as it gradually comes under voluntary control. A newborn infant will turn his head
toward anything that strokes his cheek or mouth, searching for the object by moving his head in
steadily decreasing arcs until the object is found. After becoming used to responding in this way
(if breastfed, approximately three weeks after birth), the infant will move directly to the object
without searching.

Rooting reflex

Sucking reflex

The sucking reflex is common to all mammals and is present at birth. It is linked with the rooting
reflex and breastfeeding, and causes the child to instinctively suck at anything that touches the
roof of their mouth and suddenly starts to suck simulating the way they naturally eat. There are
two stages to the action:

1. Expression: activated when the nipple is placed between a child's lips and touches their
palate. They will instinctively press it between their tongue and palate to draw out the
milk.
2. Milking: The tongue moves from areola to nipple, coaxing milk from the mother to be
swallowed by the child.

Tonic neck reflex

Tonic neck reflex

Main article: Asymmetrical tonic neck reflex

The tonic neck reflex, or known as asymmetric tonic neck reflex or 'fencing posture' is present at
one month of age and disappears at around four months. When the child's head is turned to the
side, the arm on that side will straighten and the opposite arm will bend (sometimes the motion
will be very subtle or slight). If the infant is unable to move out of this position or the reflex
continues to be triggered past six months of age, the child may have a disorder of the upper
motor neurons. According to researchers, the tonic neck reflex is a precursor to the hand/eye
coordination of the infant. It also prepares the infant for voluntary reaching.[5]

Palmar grasp reflex

Grasp reflex

The palmar grasp reflex appears at birth and persists until five or six months of age. When an
object is placed in the infant's hand and strokes their palm, the fingers will close and they will
grasp it. The grip is strong but unpredictable; though it may be able to support the child's weight,
they may also release their grip suddenly and without warning. The reverse motion can be
induced by stroking the back or side of the hand.

Plantar reflex
Main article: Plantar reflex

A plantar reflex is a normal reflex that involves plantar flexion of the foot (toes move away from
the shin, and curl down. An abnormal plantar reflex (aka Babinski Sign) occurs when upper
motor neuron control over the flexion reflex circuit is interrupted. This results in a dorsiflexion
of the foot (foot angles towards the shin, big toe curls up). This also occurs in babies under ~1
year, because of low myelination of the corticospinal tracts. As these tracts develop to adult
form, the flexion-reflex circuit is inhibited by the descending corticospinal inputs, and the
normal plantar reflex develops.[9]. Also known as the Babinski reflex, this is a sign of
neurological abnormality, e.g. upper motor neurone lesion, in adults.[10]

Galant reflex

Galant Reflex
Main article: Galant reflex
The Galant reflex, also known as Galant’s infantile reflex, is present at birth and fades between
the ages of four to six months. When the skin along the side of an infant's back is stroked, the
infant will swing towards the side that was stroked. If the reflex persists past six months of age, it
is a sign of pathology. The reflex is named after the Russian neurologist Johann Susman Galant.
[11]

Swimming Reflex
An infant placed face down in a pool of water will begin to paddle and kick in a swimming
motion. The reflex disappears between 4–6 months. Its survival function is to help the child stay
alive if it is drowning so a caregiver has more time to save it. Although the infant will begin to
paddle and kick, placing them in water is very risky. They swallow a large amount of water at
the same time. It is advisable to postpone swimming lessons in infants until they are at least three
months old.[5]

Babkin reflex

An infant demonstrating the Babkin reflex: he opens his mouth when pressure is applied to both
palms (8 seconds).

The Babkin reflex[12] occurs in newborn babies, and describes varying responses to the
application of pressure to both palms. Infants may display head flexion, head rotation or opening
of the mouth, or a combination of these responses. Smaller, premature infants are more
susceptible to the reflex, with an observed occurrence in a child of 26 weeks gestation.[13] Named
for Russian neurophysiologist, Boris Babkin.

Other primitive reflexes tested in adults

As mentioned these are generally referred to as frontal release signs although this may be a
misnomer. They include the palmomental reflex, snout reflex, glabellar reflex or "tap", in
addition to some of those mentioned above.

MORO
The Moro reflex is a normal reflex for an infant when he or she is startled or feels like they are falling. The
infant will have a "startled" look and the arms will fling out sideways with the palms up and the thumbs
flexed. Absence of the Moro reflex in newborn infants is abnormal and may indicate an injury or disease.

INFANTILE REFLEXES

Infantile reflexes are tested and observed by medical professionals to evaluate neurological function and
development. Absent or abnormal reflexes in an infant, persistence of a reflex past the age where the
reflex is normally lost, or redevelopment of an infantile reflex in an older child or adult may suggest
significant central nervous system, nerve trunk, or peripheral nerve problems.