Assessment: Normal Newborn Reflexes*
| Reflex | Description | Implications of Deviations from Normal Patterns |
|---|---|---|
| Moro (startle) | Symmetrical abduction and extension of arms with fingers extended in response to sudden movement or loud noise | Asymmetrical reflex may indicate brachial (Erb’s) palsy or fractured clavicle |
| Tonic neck (fencing) | When head turned to one side, arm and leg on that side extend, and opposite arm and leg flex | Asymmetry may indicate cerebral lesion, if persistent |
| Rooting and sucking | With stimulus to cheek, turns toward stimulus, opens mouth, sucks | Absence of response may indicate prematurity, neurological problem, or depressed infant (or not hungry) |
| Palmar grasp | If palm stimulated, fingers curl; holds adult finger briefly | Asymmetry may indicate neurological involvement |
| Plantar grasp | Pressure on sole will elicit curling of toes | Absence/asymmetry associated with defects of lower spinal column |
| Stepping/dancing | If held in upright position with feet in contact with hard surface, alternately raises feet | Asymmetry may indicate neurological problem |
| Babinski | Stroking the sole in a upward fashion elicits hyperextension of toes | Same as for plantar grasp |
| Crawling | When placed in prone position, attempts to crawl | Absence may indicate prematurity or depressed infant |
* Reflexes are good indicators of the neurological system in infants who are well, but not in neonates who are sick.
Infants with infections may not show normal reflexes yet have an intact neurological system.