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REFLEXES PRESENT IN
INFANTS
SANDIPAN SAHA ROY
BDS IV YEAR
Contents
 Definition
 Types of reflex
 General body reflexes
 Facial reflexes
 Oral reflexes
 References
What is reflex???
A reflex is an involuntary, or automatic, action
that your body does in response to something,
without even having to think about it.
Types of reflex
•General Body Reflexes
•Facial Reflexes
•Oral Reflexes
GENERAL BODY
REFLEXES
1. Moro Reflex
any sudden movement
of the neck initiates this
reflex
Elicited by -- pulling
the baby half-way to a sitting position from the
supine & suddenly let the head fall back to a
short distance.
Consists of rapid abduction & extension of
arms with the opening of hands. The arms
then come together as in embrace.
 Clinical significance
Its nature gives an indication of
muscle tone
The response may be asymmetrical if
muscle tone is uneqal on the two
sides, or if there is weakness of an
arm or an injury to the humerus or
clavicle
This reflex usually disappears in 2 or 3
months
2. Startle Reflex
Similar to moro reflex, but is initiated by a
sudden noise or any other stimulus.
In this reflex, the elbows are flexed and the
hands remain closed, there is less of embrace,
outward and inward movement of the arms
3. Palmer/Grasp Reflex
When the baby’s
palm is stimulated, the
hand closes.
There is also a
corresponding planter
reflex..
Both normally
disappear by 24
months
Clinical significance
Exceptionally strong grasp reflex may be
found in the spastic form of cerebral palsy &
Kernicterus.
May be asymmetrical in hemiplagia & in
cases of cerebral damage.
Persistence beyond 2-3 months indicate
spastic form of crebral palsy.
4. Walking/stepping reflex
 When the sole of foot is pressed
against the couch, baby tries to walk.
 it persists as voluntary standing.
5. Limb placement reflex
 When the front of
the leg below the
knee, or the arm
below the elbow is
brought into contact
with the edge of a
table, child lifts the
limbs over the edge
6. Asymmetric tonic neck reflex
 When the baby is
at rest and not
crying he lies at
inervals with his
head on one side,
the arm extended
to the same side,
and often with a
flexion of the
contralateral knee.
7. Babinski’s reflex
 Stroking of the lateral surface of the
planter surface of the foot from the
heel to the toe results in flexion of the
toe.
8. Parachute reflex
Reflex appears at
about 6-9 months &
persists thereafter.
Elicited by holding the
child in ventral
suspension &
suddenly lowering him
to the couch.
Arms extend as a
defensive reaction.
• Clinical significance
Absent or abnormal in children with
cerebral palsy
Would be asymmetrical in spastic
hemiplagia
9. Landau reflex
Seen in horizontal suspension with the
head, legs & spine extended.
If the head is flexed, the hips, knees &
elbows also flex.
Normally present from 3 months, difficult
to elict after 1 year.
• Clinical significance
Absence of reflex occurs in hypotonia,
hypertonia or severe mental
abnormality.
10. Tendon reflexes
Simple monosynaptic
reflexes, which are
elicited by a sudden
stretch of a muscle
tendon
Occurs when the
tendon is tapped
Present throughout
life
FACIAL REFLEXES
1. Nasal Reflex
Stimulation of the face or nasal cavity with
water or local irritants produces apnea in
neonates.
Breathing stops in expiration with laryngeal
closure and infants exhibit bradycardia &
lowering of cardiac output.
Blood flow to skin, splanchnic areas, muscles &
kidney decreases.
Flow to the heart & brain remains protected.
2. Blink Reflex
 Various stimuli provoke blinking.
 Whether the child is awake or sleep,
pupils of the eye react to changes in
the intensity of light.
3. Doll’s eye Reflex
 Though a complex
mechanism, infants
hold fixation of faces,
movements or
changing intensity of
light within their visual
fields.
 During the first week
they are able to
maintain these
fixations against
passive movement of
their bodies.
Eye
Head
4. Corneal Reflex
 Consists of blinking
when the cornea is
touched.
 The satisfactory
demonstration of
these reflexes shows
that the stimulus,
whether sound, light
or touch, has been
received, that cerebral
depression is unlikely,
and that the
appropriate muscles
5. Pupil Reflex
 The pupil reacts to
light, but in the
preterm baby and
some full term babies
the duration of of
exposure to the light
may have to be
prolonged to elict the
reflex.
 The light should not
be bright, for a bright
light will cause closure
of the eyes
ORAL REFLEXES
1. Rooting Reflex
 When the infant’s cheek
contracts the mother’s
breast, the baby’s mouth
results in vigorous
sucking movements
resulting in the baby
rooting for milk.
 When corner of mouth is touched, lower lip is
lowered, tongue moves towards the point
stimulated
 When finger slides away, head turns
to follow it
 When center of lip is stimulated, lip
elevates
 Onset -- 28 weeks IU
 Well established – 32-34 weeks IU
 Disappears – 3-4 months
2. Sucking
Onset~ 28
weeks iu
Well-
establised
~ 32-34
weeks iu
Disappear
~ around
12 months
Elicited
by~
introducing
a finger
into the
mouth
3. Swallowing
 Begins around 12
and half weeks IU
life.
 Full swallowing and
sucking is
established by 32-36
weeks of IU life.
 Their absence in full-
term baby would
suggest a
developmental
defect.
types
INFANTILE SWALLOW ACQUIRED
CONGENITAL REFLEX
•Until primary molars
erupt, infant swallows with
jaws separated and the
tongue thrust forward
using facial muscles.
•This is non-conditional
congenital reflex.
After eruption of posterior
primary teeth, from18
months of age onwards,
the child tends to swallow
with teeth brought
together by masticatory
muscle action, without a
tongue thrust.
3. Gag reflex
In buccal cavity and
pharynx, the
ectoderm/endoderm zone
is towards the posterior
third of tongue.
Seen at 18 and half
weeks of IU life.
Touching here elicits a gag
reflex, a protective reflex.
4. Cry
It is a non-
conditioned
reflex which
accounts for
its lack of
individual
character
and is of
sporadic
nature.
Starts as
early as
21-29
weeks IU
life.
5. Mastication
 It is a conditioned reflex, learned
initially
by irregular and poorly coordinated,
chewing movements.
 The proprioceptive responses of TMJ
and
PDL of erupting dentition establishes a
stabilized chewing
pattern, aligned to
the individual dental
intercuspation.
Reference
 Text book of Pedodontics
by Shobha Tandon
(2nd edition)
Reflexes present in infants
Reflexes present in infants

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Reflexes present in infants

  • 2. Contents  Definition  Types of reflex  General body reflexes  Facial reflexes  Oral reflexes  References
  • 3. What is reflex??? A reflex is an involuntary, or automatic, action that your body does in response to something, without even having to think about it.
  • 4. Types of reflex •General Body Reflexes •Facial Reflexes •Oral Reflexes
  • 6. 1. Moro Reflex any sudden movement of the neck initiates this reflex Elicited by -- pulling the baby half-way to a sitting position from the supine & suddenly let the head fall back to a short distance. Consists of rapid abduction & extension of arms with the opening of hands. The arms then come together as in embrace.
  • 7.  Clinical significance Its nature gives an indication of muscle tone The response may be asymmetrical if muscle tone is uneqal on the two sides, or if there is weakness of an arm or an injury to the humerus or clavicle This reflex usually disappears in 2 or 3 months
  • 8. 2. Startle Reflex Similar to moro reflex, but is initiated by a sudden noise or any other stimulus. In this reflex, the elbows are flexed and the hands remain closed, there is less of embrace, outward and inward movement of the arms
  • 9. 3. Palmer/Grasp Reflex When the baby’s palm is stimulated, the hand closes. There is also a corresponding planter reflex.. Both normally disappear by 24 months
  • 10. Clinical significance Exceptionally strong grasp reflex may be found in the spastic form of cerebral palsy & Kernicterus. May be asymmetrical in hemiplagia & in cases of cerebral damage. Persistence beyond 2-3 months indicate spastic form of crebral palsy.
  • 11. 4. Walking/stepping reflex  When the sole of foot is pressed against the couch, baby tries to walk.  it persists as voluntary standing.
  • 12. 5. Limb placement reflex  When the front of the leg below the knee, or the arm below the elbow is brought into contact with the edge of a table, child lifts the limbs over the edge
  • 13. 6. Asymmetric tonic neck reflex  When the baby is at rest and not crying he lies at inervals with his head on one side, the arm extended to the same side, and often with a flexion of the contralateral knee.
  • 14. 7. Babinski’s reflex  Stroking of the lateral surface of the planter surface of the foot from the heel to the toe results in flexion of the toe.
  • 15. 8. Parachute reflex Reflex appears at about 6-9 months & persists thereafter. Elicited by holding the child in ventral suspension & suddenly lowering him to the couch. Arms extend as a defensive reaction.
  • 16. • Clinical significance Absent or abnormal in children with cerebral palsy Would be asymmetrical in spastic hemiplagia
  • 17. 9. Landau reflex Seen in horizontal suspension with the head, legs & spine extended. If the head is flexed, the hips, knees & elbows also flex. Normally present from 3 months, difficult to elict after 1 year.
  • 18. • Clinical significance Absence of reflex occurs in hypotonia, hypertonia or severe mental abnormality.
  • 19. 10. Tendon reflexes Simple monosynaptic reflexes, which are elicited by a sudden stretch of a muscle tendon Occurs when the tendon is tapped Present throughout life
  • 21. 1. Nasal Reflex Stimulation of the face or nasal cavity with water or local irritants produces apnea in neonates. Breathing stops in expiration with laryngeal closure and infants exhibit bradycardia & lowering of cardiac output. Blood flow to skin, splanchnic areas, muscles & kidney decreases. Flow to the heart & brain remains protected.
  • 22. 2. Blink Reflex  Various stimuli provoke blinking.  Whether the child is awake or sleep, pupils of the eye react to changes in the intensity of light.
  • 23. 3. Doll’s eye Reflex  Though a complex mechanism, infants hold fixation of faces, movements or changing intensity of light within their visual fields.  During the first week they are able to maintain these fixations against passive movement of their bodies. Eye Head
  • 24. 4. Corneal Reflex  Consists of blinking when the cornea is touched.  The satisfactory demonstration of these reflexes shows that the stimulus, whether sound, light or touch, has been received, that cerebral depression is unlikely, and that the appropriate muscles
  • 25. 5. Pupil Reflex  The pupil reacts to light, but in the preterm baby and some full term babies the duration of of exposure to the light may have to be prolonged to elict the reflex.  The light should not be bright, for a bright light will cause closure of the eyes
  • 27. 1. Rooting Reflex  When the infant’s cheek contracts the mother’s breast, the baby’s mouth results in vigorous sucking movements resulting in the baby rooting for milk.  When corner of mouth is touched, lower lip is lowered, tongue moves towards the point stimulated
  • 28.  When finger slides away, head turns to follow it  When center of lip is stimulated, lip elevates  Onset -- 28 weeks IU  Well established – 32-34 weeks IU  Disappears – 3-4 months
  • 29. 2. Sucking Onset~ 28 weeks iu Well- establised ~ 32-34 weeks iu Disappear ~ around 12 months Elicited by~ introducing a finger into the mouth
  • 30. 3. Swallowing  Begins around 12 and half weeks IU life.  Full swallowing and sucking is established by 32-36 weeks of IU life.  Their absence in full- term baby would suggest a developmental defect.
  • 31. types INFANTILE SWALLOW ACQUIRED CONGENITAL REFLEX •Until primary molars erupt, infant swallows with jaws separated and the tongue thrust forward using facial muscles. •This is non-conditional congenital reflex. After eruption of posterior primary teeth, from18 months of age onwards, the child tends to swallow with teeth brought together by masticatory muscle action, without a tongue thrust.
  • 32. 3. Gag reflex In buccal cavity and pharynx, the ectoderm/endoderm zone is towards the posterior third of tongue. Seen at 18 and half weeks of IU life. Touching here elicits a gag reflex, a protective reflex.
  • 33. 4. Cry It is a non- conditioned reflex which accounts for its lack of individual character and is of sporadic nature. Starts as early as 21-29 weeks IU life.
  • 34. 5. Mastication  It is a conditioned reflex, learned initially by irregular and poorly coordinated, chewing movements.  The proprioceptive responses of TMJ and PDL of erupting dentition establishes a stabilized chewing pattern, aligned to the individual dental intercuspation.
  • 35. Reference  Text book of Pedodontics by Shobha Tandon (2nd edition)