Lack of automatic walking reflex. Checking and meaning of reflexes of a newborn

After giving birth, the newborn begins to undergo a process of adaptation to new conditions for him. To cope with a difficult task, the baby is helped by special skills that are divided into two types - conditional, unconditional. The first are given to the baby from birth, the second are acquired. The degree of development of reflexes in a newborn indicates the nature of its development and may indicate the presence of problems.

Babies have unconditioned reflexes from birth. They appear as a child's response to a specific stimulus. They are characterized by the appearance and disappearance in a certain period of development. Conditional or acquired reactions appear in a newborn as a result of experience in which changes occur in brain cells, observed physiological changes and psycho-emotional development takes place.

Types of reflexes in a baby

Up to 28 days, newborns have exclusively unconditioned types of reflexes that ensure the process of their adaptation to the world. In infants, about 15 varieties of unconditioned reactions are distinguished. According to some of them, at the time of birth, doctors assess the condition of the baby. The kid during this period does not know how to control his own body and movements, since the brain is not yet able to perform such functions.

The appearance of such reflexes and their gradual extinction has a certain regularity and a monthly schedule.

oral

Oral reflexes enable babies to provide themselves with food, they are responsible for the right process sucking. The group consists of several types, each of them has its own purpose.

Allocate:

• sucking;
• swallowing;
• proboscis;
• exploratory;
• Babkin.

Some of the abilities can already be observed in the fetus and visualized during ultrasound. For example, when examining a mother, one can see how the child puts his finger to his mouth and performs sucking movements. A similar ability is present in infants from birth, when, when a foreign object enters the oral cavity, he clasps it with his lips and tongue, and begins intensive sucking.

Some oral reactions disappear in babies by 3-4 months. Others are able to persist for 3 years, such as suckling.

spinal

Spinal reactions are involuntary movements of an infant made by the body, arms or legs in response to an external stimulus. This category includes:

• prehensile;
• protective;
• plantar;
• Babinsky and a number of others.

Such skills provide the baby with safety and protection.

Pozotonic

Postural types of reactions of infants are associated with the skills to hold the head, sitting posture and stand correctly. Thanks to these abilities, the baby has the ability to correctly distribute the various degrees of load on the muscle fibers, which occurs and depends on the nature of the body position.

How are they manifested and what are the characteristics

Most congenital reactions are observed in children under 1 year of age, after which they disappear. Most of them occur in the first months of life, disappearing by 4 months. The time of their extinction is different, which is due to the period that the baby needs to fully adapt to new conditions. Among them are those that contribute to the emergence of new skills or are observed throughout life.

proboscis

When you touch the baby's lips, they curl up and form a "proboscis" shape. Such a sucking reflex is associated with an automatic contraction of the circular muscle located in the oral cavity.

Search

The Kussmaul reflex is characteristic only of newborn children. When touching and lightly stroking the lips with a finger, the child actively tries to find maternal breast, which is expressed in the lowering of the lower sponge and the parallel movement of the tongue of the crumbs in the direction of finding the stimulus.

sucking

The most important of the reflexes of babies appears in the womb. It is expressed in the implementation by the infant of rhythmic sucking movements immediately after an object enters his mouth, which often acts as a nipple. By the severity of this ability, pediatricians assess the degree of maturity in premature babies.

Babkin palmar-oral reflex

Moderate finger pressure on the baby's palms causes the baby to open its mouth and move the head forward. Such a reflex is due to the desire of the newborn to seek food for himself.

Prehensile

The grasping reaction is expressed in the baby's ability to hold the object tightly. When a finger of an adult or other object enters the palm of the hand, the baby unconsciously squeezes the fingers of the palm. The grip can be so strong that the baby can be lifted.

Moro reflex

The reaction of the baby to the impact of the stimulus proceeds in two stages. First, the baby makes a spread of his arms to the sides, after which he opens his palms, performing a movement that imitates a hug. You can cause a similar reaction in a newborn in various ways:

• simultaneously slap on the plane of the surface on which the baby is located, approximately 15 cm from the baby;
• suddenly straighten the legs of a lying child;
• lift the lower part of the body by the outstretched legs.

A similar reaction is manifested in infants in the first months of life and disappears as they grow older.

Landau

The Landau reaction can be upper or lower, it appears in infants by 4 months. The first appears in the child when he lies on the surface. He rests on his hands, trying to raise his head and body. The lower Landau effect can be observed when the child is in the "swimmer" position. When lifting it and facing the floor, one can observe the arching of the back, raising the head and extension of the limbs.

kerning

In a child lying on his back, bending of the leg in the hip joint or knee is carried out. With a normal Kerning reaction, it will not be possible to immediately straighten the baby's limb.

Babinsky

The reaction is manifested by slight movement and contact of the finger with the outer edge of the sole of the feet in the direction from the foot to the heel.

The baby will react with a fan opening of the toes, flexion of all joints with back side feet.

Support reflex

When the infant is in a vertical position and the surface of the foot comes into contact with the support, the lower extremities are straightened and the standing posture is imitated with the support of an adult. The reaction is typical for infants of the first year, when they reach the age of 8-12 months, children begin to stand on a flat surface on their own.

Automatic walking reflex

The response is also known as the stepping response, which highlights the infant's main response. If you provide the baby with the contact of the feet with the surface and slightly tilt his body forward, then you can observe an imitation of walking. This stepping over of the legs is called the effect of stepping.

Some children at the same time make a kind of crossing at the level of the lower leg. This situation is normal and is associated with increased tone of the thigh muscles in babies aged 1.5 months.

Bauer

The crawling reflex appears in babies immediately after birth. The child in the position lying on his stomach, when he feels the touch of the palms on the soles of his feet, begins to push off, using the hands of an adult as a support. In some cases, the child is able to move forward a little, so even the smallest children should not be left unattended.

Galanta

With a dashed finger along the spine, the baby bends in the form of an arc, and the head turns in the direction of the irritating effect. It is also considered normal to abduct the legs to the side.

Perez

The reaction is manifested when pressed with a slight movement over the spinous process of the spine. At the same time, the child unbends the body, flexes the limbs and begins to cry. In connection with the negative coloring of the emotions of the baby, checking the functioning of the nervous system using this method is resorted to only as a last resort.

Robinson

This name can be found when it comes to the grasping reflex. When an object hits the area of ​​​​the baby's palm, the baby immediately clings to it. Even in the first month of life, a child can grasp the diaper so strongly that it can be quite difficult to open the fists. As they grow older, this reaction becomes less pronounced, and as a result, conscious retentions come to replace it.

Emetic

Newborn babies do not have the ability to swallow properly. When the baby chokes, the gag reflex automatically occurs, while the baby unconsciously sticks out his tongue, which causes a defensive reaction.

Protective

The ability to protect oneself healthy child appears from the first hours of life. The baby laid on his stomach immediately makes a reflex turn of his head, which helps him avoid blocking the supply of oxygen.

Swallowing

When an object enters the baby's mouth, he makes a swallowing movement. This reflex helps the child learn to coordinate their movements. The baby every day acquires the skill of breathing and swallowing. While he is learning to adapt to new conditions, you can observe that he rhythmically inhales and exhales slowly, trying to swallow food between these when feeding.

Spontaneous

The spontaneous reflex is called the Moro or startle reaction. It is observed with an unexpected impact on the surface on both sides of the baby lying on the surface. In response to it, the limbs of the child open and immediately close, producing a “hug” movement.

Table of onset and extinction of reflexes

Assessment of the child's health status, the work of his nervous system is carried out on the basis of the presence and severity of various conditional and unconditional reactions. The absence of some of them may indicate violations prenatal development or birth trauma. Most of them appear immediately after birth. Some are observed after a few days of life. For example, the Bauer reaction appears on the 3-4th day, Galant on the 5-6th day. Until what age the reflexes should disappear can be seen in the table.

Features of the development of reflexes in premature babies

By the nature of congenital automatisms, the presence of reflexes and their vivacity after birth, the state of the nervous system of children is assessed. In premature babies, a significant part of the innate abilities are absent, since the process of brain maturation has not been completed to the end. The earliest manifested oral reactions are present in them, but not all receptors are affected. Toddlers have a unique potential, therefore they are able to recover and catch up with their peers in development in a short time.

How to independently check the presence of reflexes in a child

To independently check the presence of a reflex in a child, it is enough to repeat the actions that cause a similar reaction. Don't get upset if you don't desired result. Perhaps the baby is tired, or the time for the test was chosen poorly. For example, the lack of a sucking reflex may be due to the fact that the baby is simply not hungry.

It is necessary to check the baby's reactions to stimuli in a warm room, while he must be dry and not feel hungry. Touching the baby should be gentle, in otherwise reflexes can be extinguished in response to discomfort.

Causes and signs of weak development of reflexes

It is desirable to study information about what reflexes a newborn should have; in some cases, they may not appear sufficiently.

The reasons for this situation may be the following circumstances:

• received birth injuries;
• dysfunction of the nervous system;
• premature birth of a child;
• spinal pathology;
• previous asphyxia.

A sign of weakening is the lack of expression or one-sided manifestation of symmetrical reflexes. In some cases, the baby is not ready to respond to the stimulus, for example, if the child does not have a desire to eat, the sucking reflex will not be pronounced.

Symptoms

When anomalies in the development of a child are detected, several parameters of the manifestation of the reflex are analyzed. The following points are to be assessed:

• expressiveness;
• symmetry;
• uniformity of manifestation on each side for symmetrical reactions;
• the speed of receiving a response;
• manifestation duration.

In this case, the final verdict must be made by the doctor.

Complete absence

The complete absence of a reflex, especially spinal, is a bad sign. The absence of an "automatic step" is observed with paresis, a decrease in muscle tone and cerebral palsy.

Underdevelopment

When examining a baby, the doctor analyzes the symmetry of some reflexes. For example, if a grasping reaction is observed in a baby with only one hand, then this may signal a possible cerebral palsy, cerebral hemorrhage, or paresis. If, when checking the Moro reflex, the child holds the dilution of the hands with only one limb, then this may indicate problems with the clavicle or paresis.

Treatment

Classification and methodology for studying reflexes in newborns involves an analysis of the overall clinical picture.

In the complete absence

The complete absence of reflexes is often the result of birth trauma or intrauterine anomalies. In this case, the content of therapy is determined on an individual basis and depends on the reasons for the lack of reactions and the nature of the pathologies. In most cases, treatment requires inpatient observation and long-term therapy.

With partial malformation

With partial unformed reflexes, the observation of specialized specialists is assigned. Often this situation is observed in children with a syndrome of depression of the nervous system. They have low muscle tone and motor activity. In severe cases, there are problems in the area of ​​sucking movements, so these babies are fed through a tube. Such newborns should not be left in a supine position on the stomach, which is associated with a lack of expression of the protective reflex. Treatment of infants with partial unformed reflexes involves drug therapy, massages and physiotherapy.

Forecasts

The child's body has large reserves that help it recover even in the most difficult situations. With insufficient development of reflexes, a good result is shown by an integrated approach, involving the appointment of pharmacological preparations, massages and special physiotherapy. At the same time, regularity and constant monitoring of narrow specialist with the implementation of the recommendations.

In the study of unconditional reflex activity, the child must be in a state of wakefulness, not be wet and hungry, so that reflex reactions are not suppressed by a reaction to discomfort. When examining unconditioned reflexes, it is necessary to ensure that the irritations applied do not cause pain to the child. Unconditioned reflexes and movements are examined in three positions: on the back, on the stomach and in a state of vertical suspension. When evaluating the results of the examination, it is necessary to take into account not only the presence, but also the severity of a particular reflex (bright, moderate, weak, absent), the uniformity and time of its appearance from the moment of irritation (quickly, late), completeness, the strength of the response and the speed of extinction .

In a healthy full-term and even premature infant with a body weight of at least 2100 g, unconditioned reflexes can be expressed to varying degrees, which is determined by the type of nervous activity of the child, the time of day when reflexes are determined, and the physiological state. If, despite repeated attempts, it is not possible to evoke a reflex, it can be stated that it is suppressed. At the same time, unconditioned reflexes, especially reflexes of oral automatism (search, sucking, proboscis), as well as the Babkin reflex and the Moreau reflex, can occur at the slightest irritation, which sometimes creates the impression of a spontaneous reflex. In such cases, the reflex zone is usually expanded, the latent period is shortened, and with repeated irritations there is no tendency for it to fade. Then they talk about a pathological increase in the reflex.

Oppression unconditioned reflexes or their excessive severity indicate damage to the nervous system. In the early period of the newborn, inhibition of unconditioned reflexes is most often due to:

• intrauterine hypoxia;
• asphyxia in childbirth;
• intracranial birth trauma;
• anomalies in the development of the brain;
• hereditary metabolic diseases;
• toxic-infectious diseases.

The absence or sharp inhibition of unconditioned reflexes may also be directly related to a violation muscle tone- its sharp increase (some malformations of the brain, asphyxia during childbirth) or with its pronounced decrease (spinal amyotrophy, congenital myopathy, etc.). In this case, there may be an uneven decrease in unconditioned reflexes. So, with spinal amyotrophy, against the background of a general decrease in the activity of unconditioned reflexes, reflexes of oral automatism remain relatively intact. Activation of reflexes of oral automatism is characteristic of pseudo-bulbar disorders.

Pronounced asymmetry of reflexes (normally evoked on the one hand and absent or depressed on the other) is associated, as a rule, with peripheral damage to the nerves, roots, and cells of the anterior horns of the spinal cord. Less often, the asymmetry of the reflexes is due to central hemiparesis. With obstetric paresis of the hand, the Babkin reflex and the Robinson reflex may be absent. The paretic hand does not take part in the Moro reflex. With paresis of the facial nerve, the search reflex on the affected side is not fully expressed - the corner of the mouth does not take part in the reflex response. Asymmetry of the Talent reflex is observed with unilateral lesions of the spinal cord, with hemihypoplasias. With a transverse injury to the spinal cord below the level of injury, there will be no response characteristic of this reflex, as well as a cross extensor reflex and a jerk reflex.

Among the many physiological reflexes, the following have the greatest diagnostic value.

Sucking reflex. If you put a nipple in your baby's mouth, he starts to make active sucking movements. Disappears at the end of the first year.

The sucking reflex is absent: paresis of the facial nerves, profound mental retardation, serious condition.

Kussmaul reflex(search reflex) - with dashed skin irritation in the area of ​​​​the corner of the mouth (do not touch the lips), the corner of the mouth drops, the tongue deviates and the head turns towards the stimulus (search for the mother's breast). The reflex is especially well expressed before feeding. Fades away in 6-7 weeks, disappears by the end of the first year.

Reflex asymmetryKussmaul: unilateral paresis of the facial nerve.

ReflexKussmaul is missing: bilateral paresis of the facial nerve, damage to the central nervous system.

Proboscis reflex. It is caused by a light tapping of a finger on the cheek at the corner of the mouth. There is a contraction of the circular muscle of the mouth, causing the lips to stretch with the proboscis.

Babkin's reflex(reflex palmar-roto-head, hand-mouth). Caused by finger pressure on the palmar surface in the tenor area (elevation thumb) newborn. In response, the newborn makes a grasping movement, opens his mouth and bends his head, turning it towards the stimulus. Babkin's reflex disappears by 3-4 months. With hydrocephalus, cerebral palsy with insufficiency mental development and the formation of speech can be called at the age of over 5 months.

Babkin reflex asymmetry: obstetric paresis of the hand.

The Babkin reflex is absent or reduced: damage to the brachial plexus, asphyxia, cerebral hemorrhage, brainstem lesions (spontaneous nystagmus, lack of pupillary response to light, a symptom of a floating gaze, impaired swallowing), paresis of the flexors of the fingers.

Reflex asymmetric neck-tonic. It is called in a newborn lying on his back, turning his head to the side. At the same time, the tone of the extensors of the upper and lower extremities increases on the side facing the face, and decreases on the other side ("swordsman's posture").

Reflex is delayed: intrauterine and birth disorders.

Robinson reflex(grasping reflex, tonic grasping reflex) - a continuation of the Babkin reflex. The child must grab the doctor's fingers so that it can be lifted. You can also cause a reflex from the lower extremities, if you press your finger on the sole at the base of the II-III fingers - this causes plantar flexion of the fingers.

Robinson's reflex weakens by 3-4 months of life and by the year it completely disappears.

Asymmetry of the Robinson reflex: obstetric paresis of the hand.

Robinson's reflex is absent: severe birth trauma, cerebral palsy, damage to peripheral nerves (paresis of both hands).

Babinsky reflex. Stroke irritation of the sole in a child of the first months of life causes extension and fan-shaped divergence of the fingers. The physiological Babinski reflex is accompanied by flexion of the hip, lower leg and dorsiflexion of the foot.

Moro reflex invoked in various ways:

1. the child, who is in the hands of a doctor, is sharply lowered down to a distance of 20-30 cm, and then lifted up to the initial level;
2. quickly straighten the lower limbs;
3. sharply hit the table on which the child lies, at a distance of 15-20 cm from the head on both sides.

In response to these actions, the child leans back, his shoulders unbend and his arms spread apart (the first phase of the reflex). In the second phase of the reflex (the hug reflex), the hands return to their original position. It normally lasts up to 4 months. Weakens by 2-3 months.

Moro reflex asymmetry: obstetric paresis of the arm, fracture of the clavicle.

Moro reflex weakened: hemorrhages in the brain.

Moro reflex absent: paresis of both hands, cerebral damage, cerebral edema.

The straightening reflex and the support reflex. The child, raised by the armpits, bends the legs in all joints. Placed on a support, he unbends his legs, straightens his torso, neck and stands on half-bent legs on a full foot.

Reflex missing: hypertonicity, cerebral palsy (ICP).

Automatic walking reflex. It is a continuation of the straightening and support reflexes. If the child standing on the table is slightly tilted forward, then he makes step movements that are not accompanied by the movement of the hands. Sometimes when walking, the legs cross at the level of the lower third of the legs or feet.

There is no automatic walking reflex:(crossing the legs and standing on the fingers - the "pose of a ballerina"): hypertonicity, spastic paresis, cerebral palsy.

Bauer reflex(crawling reflex). It is called when the child is placed on his stomach and the support for his soles is created with the palm of his hand. The child, starting from the support, begins to crawl.

Reflex Galant(paravertebral reflex) - with dashed skin irritation near and along the spine, an arcuate flexion of the body and a turn of the head in the direction of the stimulus occur. Sometimes the leg is extended and retracted.

Asymmetry of the Galant reflex: unilateral lesion of the spinal cord, hemihypoplasia.

Galant reflex is absent: paresis of the back muscles, severe birth trauma.

Perez reflex caused by light pressure with a finger on the spinous vertebrae from the coccyx to the neck. It is manifested by a loud cry, raising the head, arching the body (lumbar lordosis), raising the pelvis, flexing the lower and upper extremities, and general muscular hypertension. Sometimes there is urination and defecation. This reflex should be investigated last, as the child reacts negatively to it (crying).

Weakens and disappears the Perez reflex by 2-3 months of life.

Peres reflex absent: severe damage to the central nervous system.

When evaluating the results of a study of unconditioned reflexes in newborns, it must be borne in mind that they are of diagnostic value only in combination with other symptoms. A change in any one reflex in the absence of other neurological disorders has no independent diagnostic value.

A moderate increase in the main congenital reflexes can be observed with a mild form of perinatal encephalopathy (syndrome of increased neuro-reflex excitability).

A significant decrease in basic congenital reflexes can be a manifestation of:

• hypertensive-hydrocephalic syndrome;
• syndrome of depression of the central nervous system.

The results of the study of the state of the nervous system in a child in the first month of life give only a qualitative description. Quantitative characteristics of the identified violations neuropsychic development with the help of scoring, it makes it possible for the local doctor to predict early the likelihood of deviations in the activity of the central nervous system and in the further development of the child. In addition, a quantitative assessment helps to differentiate the causes of developmental deviations, as it allows you to more clearly establish which functions suffer in the first place and to the greatest extent (L.T. Zhurba, E.M. Mastyukova).

According to the proposed method, a quantitative assessment is carried out on the basis of indicators that are evaluated according to a four-point system (optimal development of a function - 3 points, its absence - 0 points), taking into account the dynamics of normal age development. The optimal score on the scale of age development corresponds to 30 points.

A score of 27-29 points can be considered as a variant of the age norm, but it must be borne in mind that if a child loses 3 points in terms of any one function or due to the presence of risk factors, it should be classified as a risk category for developmental disorders or the possibility of detecting local disorders (vision, hearing, etc.). Such a child needs mandatory dynamic observation by a neurologist.

When assessing 23-26 points, the child is referred to the risk group.

A score of 13-22 clearly indicates developmental delay.

A child with a score below 13 has severe general developmental delay as a result of an organic lesion of the central nervous system.

For greater reliability of the assessment obtained during the first patronage, it is necessary to repeat the study during repeated patronage.

A quantitative assessment of the age development of the newborn in all parameters in combination with clinical data will allow, if necessary, to consult the child early with a neuropathologist, and therefore approach the formulation of a nosological diagnosis and prescribe not only adequate rehabilitation therapy, but also determine the timing of dynamic observation by a neuropathologist . In cases where it is necessary, the child is hospitalized.

Quantification of the development of the newborn (1st week)

(L.T. Zhurba, E.M. Mastyukova)

The motor functions of the child are laid long before his birth, already in the womb. The intrauterine movement of the arms and legs leads to the fact that at the time of birth the child begins to move. The muscular and structural development achieved in the womb, coupled with neural control, enables the infant to move as soon as it is born. In the first hours after birth, the child observes: walking, grasping, swimming reflexes, crawling reflex, etc. The makings of prenatal intrauterine movement smoothly pass into postnatal (after the birth of the child).

The newborn does not have movements aimed at maintaining a certain posture. It is dominated by the tone of the flexor muscles. At rest, his fingers are usually clenched into fists, and his legs are pulled up to his stomach. Separate movements of the limbs are jerky and sharp.

When the foot comes into contact with a hard surface, the child begins to perform slow primitive movements resembling walking.
Unconditioned physiological reflexes of the newborn are reduced within a few months, which is necessary for proper development. For example, the development of motor skills of the hand is impossible without the extinction of the grasping reflex. The prognostic value of deviations found in the evaluation of unconditioned reflexes is very small.

When resting on the feet lung time tilting the body forward, the child makes step movements. The step reflex is normally well evoked in all newborns and disappears by 2 months of age. Evaluation of the automatic walking reflex is very important for the doctor, as it helps to identify the location of the lesion of the nervous system and its degree.

Alarming signs are the absence of an automatic walking reflex or walking on tiptoe with legs crossed.

The newborn does not have the readiness to stand, but he is capable of a support reaction. If you hold the child vertically in weight, then he bends his legs in all joints. The child placed on a support straightens the body and stands on half-bent legs on a full foot. The positive support reaction of the lower extremities is a preparation for stepping movements. If the newborn is slightly tilted forward, then he makes step movements (automatic gait of newborns - approx. site). Sometimes, when walking, newborns cross their legs at the level of the lower third of the lower leg and feet. This is caused by a stronger contraction of the adductors, which is physiological for this age and outwardly resembles the gait in cerebral palsy.

The support reaction and automatic gait are physiological up to 1-1.5 months, then they are oppressed and physiological asthesia-abasia develops. Only by the end of the 1st year of life does the ability to stand and walk independently appear, which is considered as a conditioned reflex and requires the normal function of the cerebral cortex for its implementation.

In newborns with intracranial injury, born in asphyxia, in the first weeks of life, the support reaction and automatic gait are often depressed or absent. In hereditary neuromuscular diseases, the support reaction and automatic gait are absent due to severe muscle hypotension.
In children with CNS damage, automatic gait is delayed for a long time.

The formation of walking begins with attempts to step over (at about 5 months). By 8 months, babies are already well-crossed, making a large number of steps if supported under the armpits. Then they begin to walk, holding on to the railing with both hands, a movable chair or supported by adults. From 9 to 11 months, walking becomes possible even when holding the child by only one hand. By the age of one, and sometimes even later, they learn to walk completely independently, first taking a few steps and, finally, overcoming long distances.

Sitting, standing, standing up, walking are complex motor acts, built according to the type of chain reflexes. The mastery of them and the voluntary fulfillment of them by the child testify to great success in the development of his motor skills.

How is the neonatal period determined, what is its duration? It is scientifically substantiated that this period lasts 28 days, at this time the primary adaptation of the child to the environment takes place. The reflexes of the newborn help the adaptation, these are the inherent mechanisms that allow the baby to perform their first (yet unconscious) actions.

Types of reflexes - classification

There are 2 types of reflexes - conditional and unconditional, in infancy only unconditional ones work, laid down from birth. Conditional ones appear later, on the basis of experience.

In total, 15 unconditioned reflexes of newborns are distinguished, each of them has its own purpose. Some appear and disappear immediately, others fade slowly, and still others remain forever.

There are several groups of basic reflexes of newborns:

• Aimed at ensuring general life activity (breathing, swallowing, sucking, spinal motor automatisms).
• Providing security for child's body when exposed to external stimuli.
• "Temporary", which work to maintain a single process. For example, there is a reflex breath holding, so that the child can move through the birth canal.

Table of basic reflexes of newborns by months

oral reflexes

From the very first minutes of life, a small organism needs food. No one teaches to suck milk from the breast and swallow the baby, everything is based on reflex activity.

Sucking reflex The baby has it since birth. Thanks to him, the baby is able to grasp the nipple of the breast or the pacifier with his lips and makes rhythmic sucking movements. The reflex is strongly pronounced up to a year, it is natural for the appearance of the main teeth, with the help of which sucking is replaced by chewing.

Up to 3 years, it remains mild. The intensity of sucking signals the degree of hunger of the baby, if the child is full, then the sucking becomes weaker, it is expressed stronger towards the meal. The constant weakness of the sucking reflex is due to many reasons, the establishment of which occurs with the help of a doctor.

Swallowing reflex promotes swallowing of the received food. It is caused by the work of the medulla oblongata and persists for life.

proboscis reflex it persists for a shorter time - by two to three months it disappears. Touching a finger or an object to the baby's lips causes the mouth to curl into a tube, resembling a small trunk.

Babkin's reflex, it is also called palmar-oral. If you lightly press both palms of the child, then the baby slightly opens his mouth. By three months, the reaction fades away, after which it disappears completely.

Search reflex (Kussmaul) . An attempt to touch the cheek at the corner of the mouth (very lightly) leads to a search for a stimulus, that is, a search for food. After three months, the reflex disappears, the baby determines the source of food visually. When checking it, you should not touch the lips of the crumbs directly, otherwise you will get a proboscis reflex.

Spinal automatisms

spinal reflexes newborns characterize the infant's muscular apparatus and its condition.

defensive reflex is found in turning the head when laying the crumbs on the stomach. In this way, the child opens air access to the respiratory tract. With damage to the central nervous system, this reflex is usually absent.

Grasping (monkey) reflex - the ability to firmly grasp and hold the fingers of an adult placed in the palms of an infant. Raising the fingers is another similar Robinson reflex. Weakening occurs by four months.

- this is when, when stroking the soles, the fingers open in a fan-shaped way, and the feet bend from the back.

Reflexes of the newborn - plantar reflex (Babinsky)

This reflex is preserved up to two years, the symmetry of the reaction and energy is an indicator for evaluating the child.

Moro reflex (hugs) - a reaction consisting of two phases that occurs in response to noise or knocking.

At first, the baby spreads his arms in different sides and unclenches his fingers, while straightening his legs. Then the arms and legs return to their original position, resembling a hug. This reflex is observed up to five months. An incomplete Moro reflex or its asymmetry is manifested in lesions of the nervous system.

Kernig's reflex observed when it is not possible to unclench the hip joint after flexion. After reaching four months, it completely disappears.

Automatic walking reflex tested with armpit support and a slight forward lean. The baby takes steps without accompanying them with hand movements. Normally, the baby should lean on the entire foot and walk without clinging.

If the legs are slightly crossed, then this is considered acceptable in the first 1.5 months. The ability to walk independently is an already acquired skill, due to the complex work of the cerebral cortex, which develops by the age of 1 year. If the "automatic gait" remains for a long time, then this may be a manifestation of a CNS lesion.

Support reflex visible when the baby, holding, is placed on a hard surface. First he pushes his feet away, then he flattens out, pressing his tiny soles firmly against the ground. During the entire month and a half, the support and walking reflexes are well expressed.

Crawling reflex (Bauer) - it is called spontaneous crawling, this happens when the baby is placed on the stomach or back. The movements are intensified if you put your palm on the soles of the child, the baby can even move forward. There is a reflex for 3-4 days, and extinction for third fourth month. warning sign it is considered a violation of symmetry or the preservation of creeping movements up to six months - a year.

Reflex Galant called the response of the spinal area to an external stimulus. If you move your finger along the back, then the child will arch the back and straighten the leg from the side of impact.

Postural reflexes (automatisms)

The group of these reflexes is based on the redistribution of muscle tone as the child's motor development progresses. While the baby is not yet able to hold his head, cannot sit, walk and stand, his muscles must be regulated. The medulla oblongata and, subsequently, the midbrain are responsible for regulation.

Magnus-Klein reflex (asymmetric tonic neck) - the baby takes the "swordsman's pose" if his head is turned on its side while the little one is on his back. That is, the limbs where the face turns are unbent, and the opposite ones are bent.

Checking the severity of reflexes is carried out with the help of a neurologist and a pediatrician, they are able to determine how well the functions of the infant's nervous system work.

What affects the untimely appearance of reflexes in newborns?

The reasons are completely different, ranging from trauma during childbirth, ending with an individual reaction to medications. Spinal or oral reflexes of the newborn are mild in case of prematurity or mild asphyxia.

It is not always necessary to sound the alarm if sucking and searching behavior is weakly expressed, perhaps the baby is just full, then he does not show strong reflex activity. But before feeding, on the contrary, sucking and searching are intensified.

If the reflexes of the newborn are not observed at all, then this is an occasion for immediate qualified medical care. The most important life support functions can suffer if the baby is not properly maintained in time. There can be several reasons: severe malformations of intrauterine development, severe asphyxia, injuries sustained during childbirth.

Of course, parents should have information about innate reflexes, but only an experienced neonatologist or pediatrician can professionally assess the state of health of a child. Deviations from the norm are significant and not very, with minor violations, the doctor will prescribe treatment or special procedures. If the deviations are strong, then the doctor will help to understand the reasons, and will be able to take emergency measures so that the baby is not in danger.

Any strange manifestation of the child's behavior requires increased attention, because his successful adaptation to the world depends on it. The reflexes of a newborn are the care of nature itself so that the baby can feel as comfortable as possible.

If the Apgar scale assesses the condition of the newborn as a whole, then newborn reflexes allow you to assess the state of the baby's nervous system without any complex examinations and start the right treatment with a neurologist in time, while the child's brain has not yet finished forming and it is not too late to correct the situation.

Part of the unconditioned reflexes, determined in the neonatal period, subsequently disappears, some of the reflexes appear a little later. If the reflex is called at the age at which it should already be absent, then it is considered pathological. Weak reflexes or their absence may also be a reason for further examination.

How to test reflexes in newborns

It is necessary to evaluate the unconditioned reflex activity of the child in a warm room. The baby should be full, dry and calm. There are not always appropriate conditions in the children's clinic, so it would be nice if the mother herself knew how to check the reflexes of newborns and, if necessary, drew the attention of the pediatrician to the existing deviations.

The unconditioned reflexes of the child are evaluated in the state of vertical suspension by the armpits, in the position on the stomach and on the back. Inflicted irritations should not hurt the child. If the rules for checking reflexes are not followed, they can be extinguished by reactions to discomfort.

Table of reflexes of newborns and infants

Reflexes of newborns are divided into three groups:

1. Persistent lifelong automatisms (corneal, orbiculopalpebral, conjunctival, pharyngeal, swallowing, tendon reflexes)
2. Oral and spinal segmental automatisms, myeloencephalic postural reflexes. These are transient (passing) rudimentary reflexes that reflect the conditions for the development of a long-term analyzer. These include sucking, search, proboscis, palmar-oral. As well as grasping, support reflexes, Moro, automatic gait, Perez reflex, labyrinth reflex, cervical tonic reflexes.
3. Mesencephalic adjusting automatisms: cervical and trunk reflexes (simple and chain), labyrinth reflexes.

How to test basic reflexes in a child

Search reflex: when stroking in the area of ​​​​the corner of the mouth (without touching the lips), the child turns his head towards the stimulus, while his lip drops and his tongue deviates. The reflex is especially pronounced before feeding.

Proboscis reflex: The child stretches his lips with his proboscis when lightly tapping them with his finger. With this reflex, an automatic contraction of the circular muscle of the mouth occurs. In adults, reflexes of oral automatism appear when the cerebral cortex is damaged.

Fine sucking reflex disappears by the end of the first year of life. Until this age, you should try to wean the child from the pacifier or pacifier so that the child has the correct bite.

grasp reflex: A child up to 2-4 months firmly grasps the fingers placed in his palm.

Support reflex: The child is taken from the back by the armpits, supporting the head with the index fingers. An elevated child in this position bends the legs at the hip and knee joints, and, as it were, “stands” on half-bent legs, leaning on the support with a full foot. If the child tries to "stand" on tiptoe, crosses his legs, then a deviation from the norm.

Automatic gait reflex: If the child is slightly tilted forward from the previous position, then he will try to make stepping movements. Sometimes, at the same time, at the level of the lower third of the shins, the child's legs may cross.

Babkin palmar-oral reflex: If you press your thumb on the palm of the child at the bed of tenors, the child will open his mouth and bend his head. The reflex disappears by 3 months.

Moro reflex lasts up to 4 months of a child's life. If you sharply lower the child by about 20 cm, which is in the hands of a doctor, and then quickly raise it, then in response to these actions the child will spread his arms and straighten his fingers, and then return them to their original position. In order not to drop the child, it is not recommended for newly-made parents to check this reflex on their own.
If the parents abruptly put the child on any surface, he will also spread his arms in fear, which is also a manifestation of the Moro reflex.

Bauer's crawling reflex: the child will try to crawl if he is placed on his stomach and put his hand under the soles. Spontaneous crawling disappears by 4 months.

Kernig's reflex disappears after four months. At an older age, it occurs in .

Reflex Galant: If you run your fingers along the spine on both sides in the direction from the neck to the buttocks, the body of a child lying on its side will arch, sometimes the leg may straighten. The Galant reflex should disappear by 4 months of age.

Perez reflex causes pain, so it is better not to check at all or to examine it last. It consists in running a finger along the spinous vertebrae of a child lying on his stomach. Direction of movement: from the coccyx to the neck. With a positive Perez reflex, the body bends, the upper and lower limbs bend, the head and pelvis rise, sometimes urination and defecation occur. All this, of course, is accompanied by the displeased cry of the child. The Perez reflex should be gone by the fourth month.

Orbiculopalpebral reflex: Lightly tapping with a finger along the upper arc of the orbit can cause the closing of the eyelid of the corresponding side. The reflex disappears by 6 months.

Asymmetric cervico-tonic reflex demonstrates a decrease in the tone of the limbs. If you turn the head of a child lying on his back so that the chin touches the shoulder, the tone of the limbs on the opposite side will increase, and decrease on the side to which the face is turned. (The tone of the extremities may be increased, decreased or normal). With hypertonicity, the child's muscles are overly tense, it is difficult to straighten the limbs. With hypotension, on the contrary, the muscles are excessively relaxed. The tone of the child is influenced by the position of the body and head of the child.

Trunk rectifier response manifested by straightening the head when the feet come into contact with the support. By the end of the first month, the baby should already hold his head.

Babinski's reflex: In a child, the fingers on the foot diverge like a fan, if the outer edge of the foot is irritated with dashed movements in the direction from the heel to the toes. At the same time, dorsiflexion of the thumb also occurs. It is considered physiological until the age of two.

Upper Landau reflex: by four months, the child in the position on the stomach should be able to raise his head and upper body, leaning on the plane with his hands.

Lower Landau reflection: The child can unbend and raise the legs in the prone position. The Lower Landau is formed by five to six months. Around this age, the baby begins to crawl.

Chain mounting reflex from trunk to trunk causes a separate rotation of the trunk and lower extremities when turning the shoulder or pelvic section of the child to the side. A chain adjusting reflex is formed by 6-7 months.

Only a doctor should interpret the values, evaluate the results of a study of newborns. The task of the mother is to ensure that the child is well examined and, if necessary, receives the necessary treatment. Sometimes it is enough to do a professional massage and special gymnastics to extinguish pathological reflexes; in severe cases, a neuropathologist will prescribe medications.