Fitness and healthy lifestyle 

First exam. Reflexes of the newborn. Basic reflexes of newborns: unconditioned and conditioned reflexes

The constant vomiting of gastric contents by the baby at the sight of food or after eating it can alert even the most experienced parents. Doctors define this phenomenon as an increased gag reflex in a child. For the first time, mothers can observe it during the introduction of the first complementary foods and in preschool children. Sometimes the problem is not resolved until an older age. Chewing and swallowing food is difficult for such children, and if they are scolded for this, then nausea arises from one type of food.

Why does the baby vomit after feeding?

Overfeeding is one of the common causes of spitting up food. Vomiting opens unexpectedly and does not pose a threat to health.

Sometimes newborns develop pyloric stenosis, a pathology in which food masses cannot enter the intestinal tract from the stomach. Mostly boys are affected by the disease. They gain weight poorly and suffer from constipation. The gag reflex to food is triggered almost every time they try to feed.

In the first months after birth, some babies vomit due to poor absorption of food components, often lactose or fructose. This factor provokes irritation of the stomach and the release of the masses that have entered it.
If a baby sucks his mother's milk too quickly and captures a lot of air, vomit from his digestive tract may leak due to aerophagia - "eating air." If vomiting opens directly with food, it signals the development of gastrointestinal diseases.

When a baby is in a hurry to feed or swallows small pieces of poorly chewed food, the food lumps create heaviness in the stomach. If the baby does not know how to control vomiting, undigested food inevitably breaks out.

But the occurrence of vomiting after eating is not always associated with gastrointestinal problems. Experts explain it by different moments in a child's life:

  • stress;
  • acetonemia;
  • prolonged crying;
  • teething;
  • debilitating cough;
  • diseases of the brain, bronchi or lungs;
  • runoff of mucus through the nasopharynx with a cold;
  • treatment with medications.

First aid for vomiting

Regardless of what kind of factor provoked vomiting, the child always needs help. Repeated triggering of the reflex is dangerous due to dehydration of the body, loss of salts and disturbance of the baby's condition, up to loss of consciousness and falling into a coma. Therefore, even a single episode of vomiting deserves the attention of parents.

If the child suffers from an increased gag reflex and vomits up masses at every opportunity, during the attack, the mother should do the following:

  1. soothe the baby and change clothes, help rinse your mouth and moisturize your face with a napkin;
  2. allow the baby to take a comfortable position, and with a repeated attempt to pull out, turn his head to one side, not allowing the masses to clog the airways;
  3. in case of poisoning with low-quality food, rinse the stomach by giving the child a glass of soda solution (0.5 tsp. soda per 1 liter of water). Next, you should put pressure on the root of the tongue and induce vomiting artificially. In an unconscious state, washing is not done for children.

If attacks occur more often than 1 time in 3 hours, you need to call the ambulance service.

How to deal with gag reflex

To restore the water and electrolyte balance, disturbed by frequent vomiting, the child is provided with an abundant drink. Water is given in a slightly warm form. Compotes, juices and soda are contraindicated in this case. If the baby refuses water, it is allowed to replace it with a decoction of wild rose, chamomile, St. John's wort or sweetened tea.

Children under 1 year old should be given about 70 ml of liquid after each vomiting. For babies over one year old, the dosage is increased to 100 - 150 ml. You should not force the baby to drink. Signs such as:

  1. lethargy;
  2. dry skin;
  3. irritability;
  4. sinking fontanelle;
  5. drying out of the mucous membrane of the lips;
  6. lack of urination for 3 to 4 hours.

It is better not to insist on taking any food at this time. A day or two children need to drink liquid, giving him 2 tsp. water every 5 - 10 minutes. As the state of health improves, the baby is offered half a cup of broth, water or tea.

  • up to 1 year: from 130 to 200 ml;
  • from 1 to 5 years: 100 - 170 ml;
  • from 6 to 10 years old: 75 - 110 ml.

Of the medicines for taming vomiting, children are given Regidron, Glucosolan, Atoxil. If the reflex has developed on a nervous basis, the condition is corrected with tablets of the nootropic drug Pantocalcin or its analogue, Pantogam syrup. It is convenient to give liquid medicine to infants, but its side effects in the form of Quincke's edema, conjunctivitis and urticaria can be dangerous for the little ones.

If the release of vomit occurs against the background of an increase in temperature and diarrhea, you should immediately call a doctor. A small amount of gastric contents can be collected in a vessel and transferred for laboratory examination.

Congenital reflexes- a gift of nature, necessary for the baby to survive outside the mother's body, which help the newborn to adapt to life in the world around him.

Even in the maternity hospital, immediately after the birth of the baby, the neonatologist checks congenital reflexes and assesses the development of the nervous system. If the physiological reflexes are well developed and muscle tone is normal, then the child is all right.

A healthy baby at birth should have a full set of physiological reflexes, which disappear by 3-4 months.

Their absence is considered pathology, as well as a delay in their reverse development.

It is unacceptable to stimulate the reflexes of the newborn, especially the automatic walking reflex.

Basic unconditioned reflexes of newborns

1 Breathing reflex

The first, immediately after birth, is the respiratory reflex - the baby's lungs open and he takes the first independent breath.

2. Sucking reflex

The sucking reflex occurs in a newborn in response to irritation of the oral cavity, when the lips and tongue of the newborn are touched. For example, when inserting a nipple, nipple, finger into the mouth, rhythmic sucking movements appear.

The sucking reflex is found in all healthy newborns and is a reflection of the child's maturity. After feeding, this reflex largely fades away and begins to revive again after half an hour or an hour. The reflex persists during the first year of life. The sucking reflex is reduced or even disappears when any of the cranial nerves involved in the sucking act are damaged. Sucking calms the baby. If he did not suck in infancy, then at an older age, he may begin to suck the ends of his hair or fingers, bite his nails, which will require the intervention of a psychotherapist or neuropathologist.

3. Swallowing reflex If something gets into the baby's mouth, then he swallows. The first days the child learns to coordinate respiratory movements with swallowing.

4. Reflex gag. The reflex makes the child push any solid objects out of the mouth with his tongue. The gag reflex appears immediately after birth. The reflex prevents the child from choking. This reflex fades away closer to 6 months. It is the gag reflex that explains why it is so difficult for a baby under 6 months to swallow solid food.

5. Search (search) reflex of Kussmaul

The reflex should be elicited carefully without causing pain to the newborn.

Stroking with a finger in the area of ​​the corner of the mouth (without touching the lips) causes the newborn to lower the corner of the mouth and lips, lick the mouth and turn the head in the direction from which stroking is performed.

Pressing the middle of the upper lip causes a reflex lifting of the upper lip upward and extension of the head.

Touching the middle of the lower lip causes the lip to sink, the mouth opens, and the baby's head performs a flexion motion.

With painful irritation, only the head turns in the opposite direction.

The search reflex helps the baby to find the nipple and is well pronounced before feeding.

It is normally caused in all newborns and should completely disappear by 3 months of age. Then there is a reaction to a visual stimulus, the baby revives at the sight of a bottle of milk, when the mother prepares the breast for feeding.

The search reflex is the basis for the formation of many mimic (expressive) movements: shaking the head, smiling.

The search reflex is absent or reduced, asymmetric in newborns with facial nerve damage. In the presence of cerebral pathology in newborns, the reflex can be delayed and does not disappear by the age of 3 months

1 - palmar-oral;
2 - proboscis;
3 - search;
4 - sucking

6. Proboscis reflex (oral Escherich reflex)

It is caused by a quick light touch with a finger, a nipple or a hammer on the upper lip of the child - in response, the facial muscles of the newborn contract - the lips are pulled out in the form of a proboscis.

Normally, the proboscis reflex is detected in all healthy newborns, and gradually fades away by the age of three months. Preservation of its proboscis reflex in children over three months of age is a sign of a possible pathology of the brain and is observed in children with damage to the nervous system.

7. Babkin's palmar-oral reflex

When pressing with the thumb on the palm of the newborn, the baby turns its head and opens its mouth.

The reflex is normal in all newborns, it is more pronounced before feeding. After two months, this reflex decreases, and by three months it disappears completely.

The lethargy of the reflex is observed with damage to the central nervous system (CNS), especially with a birth injury of the cervical spinal cord.

The rapid development of the reflex and its decline up to 3 months is a prognostically favorable sign in children who have suffered a birth trauma.

The palmar-oral reflex may be absent with peripheral paresis of the hand on the affected side. With damage to the central nervous system in a child older than 2 months, the reflex does not tend to fade, but, on the contrary, intensifies and arises even with a slight touch of the palms of passive hands.

8.Upper grasping reflex (Yanishevsky)

In response to a stroke touch on the palm of the newborn, the fingers are bent and the object is grasped into a fist.

In a normal infant, the grasping reflex is well evoked. Before feeding and during eating, the grasping reflex is much more pronounced.

The reflex is physiological up to 3-4 months, then, on the basis of the grasping reflex, voluntary grasping of objects is gradually formed.

In retarded children, the reaction is also weakened, in excitable, on the contrary, it is enhanced.

A decrease in the grasping reflex is observed in children born in asphyxia. And also the reflex is weakened on the side of the lesion of the cervical spinal cord. With paresis of the hands, the reflex is weakened or absent. The presence of a reflex after 4-5 months indicates damage to the nervous system.

9. Robinson's suspension reflex

In response to stroking the palmar side of the hand, flexion of the fingers and grasping of the object occurs. Sometimes, when this reflex is evoked, the child holds an object or finger so tightly that such a clinging child can be lifted up by the fingers - this phase of the reflex is called the Robinson reflex. Thus, it turns out that a newborn, seemingly completely helpless creature, can develop in his hands such a "muscle strength" that keeps his own body in limbo.

By 3-4 months, this unconditioned reflex is transformed into a conditioned one - the child begins to grab toys purposefully. A good expression of the grasping reflex and the Robinson reflex contributes to the rapid development of the conditioned reflex and thereby the development of muscle strength in the hands and contributes to the more rapid development of fine manual skill.

10. Lower grasping reflex (plantar, Babinsky's reflex)

It is caused by pressing with the thumb on the sole at the base of the II-III toes. The child performs plantar flexion of the toes (presses the toes to the foot)

Thumb pressure on the ball of the foot induces plantar flexion of the toes.

In healthy children, this reflex persists up to 12-14 months of life.

The absence of the lower grasping reflex occurs when the spinal cord is affected at the lumbar level.

11. Reflex Babinsky.

If you make dashed irritation of the sole along the outer edge of the foot in the direction from the heel to the toes, then there is a dorsal extension of the big toe and a fan-shaped divergence of the II-V fingers.

Most doctors now consider the Babinsky reflex to be the norm for the first year of life and that its presence is not a sign of pathology, and it will pass with age. They explain that this is due to insufficient development of the cerebral cortex and, accordingly, the system of the central motor neuron in early childhood, and that this reflex is now very common.

We want to warn the parents.

Healthy newborns should NOT have the Babinsky reflex.

Babinsky's reflex is pathological from the very first days of a child's life and is a subtle sign of pyramidal pathology, and the frequency of its detection is not evidence of its physiology, but evidence of the frequency of neurological disorders in newborns. Moreover, if this reflex is spontaneous from birth (that is, it does not need to be called, it appeared on its own)

12. Arshavsky's heel reflex

When pressing on the calcaneus, a cry or grimaces of crying is caused in a child.

Their absence, a decrease in the severity or asymmetry may indicate damage to the nervous system.

13. Moro's embrace reflex

It is caused by various methods: if you suddenly slap with both hands on both sides on the surface on which the child lies, at a distance of 15 cm from his head (no need to hit with all his might!), Then the newborn moves his arms to the sides and opens his fists - I phase of the reflex Moreau. After a few seconds, the hands return to their original position (embryo posture) - phase II of the Moro reflex.

A similar movement in the hands occurs with a passive sudden extension (extension) of the newborn's legs, raising the baby's extended legs and pelvis above the bed, with pressure on the hips.

The reflex is expressed immediately after birth. In all healthy newborns, the Moro reflex is always symmetrical (the same) in both hands and is expressed until the 4th-5th month, then begins to fade away; after the 5th month, only some of its components can be observed.

With flaccid paresis of the hand, the reflex decreases or is completely absent on the side of the lesion, which indicates that the spinal cord in the cervical spine was injured during childbirth. In children with intracranial injury, the reflex may be absent in the first days of life. With pronounced hypertension, there is an incomplete Moro reflex: the newborn only slightly removes his hands.

In each case, the threshold of the Moro reflex should be determined - low or high. In infants with CNS lesions, the Moro reflex is delayed for a long time, has a low threshold, and often occurs spontaneously with anxiety and various manipulations. If a reflex manifests itself when trying to change a child's clothes or for no reason, then it should be shown to a neurologist.

14. Reflex Galant

The baby is laid face down, with his breast on his palm. Supporting on weight (when the baby calms down and completely hangs his head, arms and legs), run a finger along the spine (at a distance of 1 cm from it) on the right side - the baby will bend in an arc and squeeze the right leg. The reflex is also checked on the left side.

The Galant reflex is well evoked from the 5th - 6th day of life. Normally, the reflex lasts up to 2-4 months, disappears after 6 months.

The reaction from both sides should be the same.

In children with damage to the nervous system, it may be weakened or completely absent within 1 month of life. When the spinal cord is damaged, the reflex is absent for a long time. With damage to the nervous system, this reaction can be observed in the second half of the year and later.


1.Reflex Galant
2.Perez reflex
3. Moro embrace reflex

15. Perez reflex

The baby is laid face down, with his breast on his palm. Supporting on weight (when the baby calms down and completely hangs his head, arms and legs), gently pressing, run your finger along the spinous processes of the child's spine from the tailbone to the neck.

This is unpleasant for the baby; in response, the child has a breath holding followed by a cry. His spine bends, the pelvis and head are raised, arms and legs are bent, there is a short-term general increase in muscle tone, and sometimes there is a loss of urine and defecation.

Normally, the Perez reflex is well expressed during the first month of a newborn's life, gradually weakens and completely disappears by the end of the 3rd - 4th month of life.

Preservation of the reflex older than 3 months should be considered a pathological sign. In newborns with birth damage to the cervical spinal cord, the head is not raised, that is, the Perez reflex turns out to be "decapitated", as it were. Inhibition of the reflex during the neonatal period and a delay in its reverse development is observed in children with damage to the central nervous system.

16. Support reflex

If you take a newborn under the arms, then he reflexively flexes his legs at the hip and knee joints. At the same time, if you put him to the support, he unbends his legs and rests tightly with his whole foot against the surface of the table and so “stands” for up to 10 seconds.

Normally, the support reflex is constant, well-pronounced and gradually disappears by the age of 4-6 weeks.

With an injury to the nervous system, the child can lean on his toes, sometimes even with crossed legs, which indicates a lesion of the motor (pyramidal) pathway leading from the cerebral cortex to the spinal cord.

In newborns with intracranial injury, born in asphyxia, in the first weeks of life, the support reaction is often depressed or absent. In hereditary neuromuscular diseases, the support reaction is absent due to severe muscular hypotension.

1.protective reflex;
2. crawl reflex (Bauer);
3. support reflex and automatic gait;
4. grasping reflex;
5.Robinson's reflex.

17. Reflex of automatic walking, or step reflex

When leaning on the feet while slightly tilting the child's body forward, the newborn makes step movements.

This reflex is normally well evoked in all newborns and disappears by 2 months of age.

Alarming signs are lack of automatic walking reflex or walking on tiptoe with crossed legs.

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

18. Bauer Crawl Reflex

A hand is placed at the feet of the newborn, laid on its stomach. With a hand, lightly press on the soles of the baby - in response, the child reflexively pushes off from it with his feet and performs crawling movements.

The crawl reflex is normally triggered in all newborns. Crawling movements in newborns become pronounced on the 3-4th day of life and lasts up to 4 months, and then fades away. Attention should be paid to the asymmetry of the reflex.

The reflex is depressed or absent in children born with asphyxiation, as well as with intracranial hemorrhages, spinal cord injuries. In diseases of the central nervous system, crawling movements persist for up to 6-12 months.

19. Protective reflexes

a) Upper protective reflex. If the newborn is put on his stomach, then a reflex turn of the head to the side occurs and he tries to raise it, as if providing himself with the opportunity to breathe.

The protective reflex in healthy newborns is constantly expressed from the first day of life, and after one and a half months the child tries to hold his head on his own. In children with CNS damage, the protective reflex may be absent. A decrease or disappearance of this reflex can be either with especially severe damage to the upper cervical segments of the spinal cord, or with pathology of the brain. And, if you do not turn the child's head passively to the side, he may suffocate. In children with cerebral palsy, with an increase in extensor tone, there is a prolonged rise of the head and even throwing it back.

b) "Duck" reflex. If a jet of water or air hits the nasal area, the newborn will hold its breath.

c) Pupillary reflex. The bright light will cause the pupil to constrict.

d) Blinking reflex If you blow into the baby's face, he will squint his eyes.

20. Reflex withdrawal of the leg

In the position of the newborn on the back, when his lower limbs are relaxed, an injection is alternately applied with a needle to each sole. There is a simultaneous flexion of the hips, legs and feet.

The reflex must be triggered equally on both sides (symmetrical).

The reflex can be weakened in children born in breech presentation, with hereditary and congenital neuromuscular diseases, myelodysplasia. A decrease in the reflex is often observed with paresis of the legs. The absence of a reflex indicates damage to the child's lower spinal cord.

21. Cross reflex of extensors.

In the position of the newborn on the back, we unbend one leg and apply an injection in the area of ​​the sole - in response, the other leg is extended and slightly adducted.

In the absence of a reflex, pathology of the lumbar thickening of the spinal cord can be assumed.

22. Cervico-tonic reflexes or posotonic reflexes

Types of postural reflexes of a newborn baby
Asymmetric cervical tonic reflex (Magnus-Klein)

It manifests itself when the child's head is passively turned to the side. The arms and legs are extended on the side to which the child's face is facing, and the opposite ones are flexed. The hand to which the baby's face is turned is straightened. At this moment, the tone of the extensors of the shoulder, forearm, hand increases - the "fencer's" pose, and in the muscles of the arm, to which the back of the head is turned, the tone of the flexors increases.

Symmetrical tonic cervical reflexes

Passive flexion of the newborn's head increases the muscle tone of the flexors in the arms and extensors in the legs. At the same time, when the baby unbends the head, the opposite effect appears - the arms are unbend and the legs are bent.

Asymmetric and symmetrical cervical reflexes of the newborn are constantly expressed in newborns.
In premature babies, they are poorly expressed.

Labyrinth tonic reflex

In the position of the child lying on his stomach, the tone in the flexor muscles increases: the head bends towards the chest or tilts back, the back arches, the arms are bent and also brought to the chest, the hands are compressed into fists, the legs are bent at all joints and brought to the stomach. After some time, this posture is replaced by swimming movements, which turn into a spontaneous crawling reflex.

Reflex Landau

Give the child a “swimmer's position” - lift the baby into the air so that his face looks down, and he immediately raises his head, and then straightens (or even arches) his back, as well as straightens his legs and arms - swallow, from 6 months to one and a half years

1.asymmetric cervical topical reflex of Magnus - Klein;
2.symmetrical tonic cervical reflexes;
3. tonic labyrinth reflexes;
4. Landau reflex.

These reflexes normally disappear in the first 2-3 months. So, as the unconditioned and cervico-tonic reflexes fade away, the child begins to hold his head, sit, stand, walk and carry out other voluntary movements. A delay in the reverse development of tonic reflexes (over 4 months) indicates damage to the central nervous system of the newborn. The persisting tonic reflexes impede the further development of the child's movements, the formation of fine motor skills.

In recent years, there has been talk of swimming reflex in a newborn, which consists in the fact that the baby will flounder and will not drown if immersed in water. This reflex can only be tested in the presence of an instructor in the newborn pool.

Reflex problems are the first symptoms of central nervous system pathology. If you are alarmed by any deviations from the norm, then do not hesitate to consult a doctor. Re-examination must necessarily take place after the appointed time - it can be different depending on the alleged nature of the pathology - from several days to a month, which will help to exclude existing suspicions or, if necessary, carry out timely treatment. Remember that the child changes every day, and the manifestation of reflexes depends on a number of conditions (satiety, fatigue, and many others). It is very important to check innate reflexes in dynamics. Treatment started on time is a guarantee of the child's health in the future.

Congenital (unconditioned) reflexes - appear as a response to specific external stimuli. The state and health of the central nervous system depends on the manifestation of reflexes.

Some reflexes appear immediately after birth, and others after a while. Ideally, all unconditioned reflexes have their own specific time of appearance and disappearance: some appear and persist throughout life, while others are temporary. A month after birth, the neuropathologist will check all the baby's reflexes and control them for a year until they disappear completely.

All reflexes present in a newborn baby have their own unique functions; they protect the little man's body from the harmful effects of the environment.

In a healthy child, unconditioned reflexes should be observed equally on the right side and on the left, only in this case they will be symmetrical. If the symmetry of the reflexes is not observed, then it is necessary to urgently consult a doctor.

If there is a weakening of reflexes or their complete absence, then there may be a violation of muscle tone, infectious diseases or disruption of the nervous system.

Provided that the baby is in good health, you can check reflexes at home as a kind of gymnastics. At this time, the baby should be calm, not hungry and sleep well. The study of reflexes should take place in a bright and warm room.

Most of the unconditioned reflexes are laid in the womb, they are aimed at protecting the internal organs and adapting to adult and independent life. These include the following reflexes in newborns and infants:

Newborn babies fully realize the innate reflex at the time of breastfeeding (in the event that they receive the breast on demand), in artificial children there is no such possibility, therefore it is they who often ask for a dummy and get used to it faster

Proboscis reflex. If you lightly touch the lips of the newborn, the muscles of the mouth will contract, and the baby will stretch his lips into a tube or proboscis. The manifestation of the reflex persists for the first 2-3 months of a child's life, then disappears completely.

Search reflex. To detect this reflex, it is necessary to stroke the child's cheek, near the corner of the mouth, then the lower lip will protrude, and the baby will stick out the tongue and turn his head towards stroking. The reflex is especially pronounced just before feeding. The extinction of the search reflex occurs at 1.5 months after birth, completely disappears by the first year of life.

Sucking reflex. When an object is placed in the oral cavity, the child begins to actively suck on it. This reflex occurs in all healthy full-term babies, and plays an important role in learning about the world and self-feeding. The extinction of the reflex occurs at the age of 1-1.5 years, persists at night during sleep up to 3-4 years.

Babkin's palmar-oral reflex. If you press your finger on the baby's palm, he will bend his head and open his mouth slightly. Normally, the reflex should be clearly manifested in the newborn. If the reflex is weak or absent altogether, this may indicate problems in the functioning of the nervous system. By 2 months this reflex fades away, by 3 months it disappears completely.

Grasp reflex. When he touches his palm with a finger or a toy, the baby grabs into the fist what was touched. This reflex can also be triggered on the heel, for this you need to press your fingers on the sole at the base of the toes, between the second and third. After this action, the child's fingers will bend. The unconscious reflex action fades away by 3-4 months, after this period the baby gradually begins to control his actions.

Reflex Moro. If you hit the surface on which the newborn is located, retreating 15-20 cm from him, the child begins to stretch his limbs, unbend his fingers and raise his legs and butt. The essence of the reflex is as follows, first the baby spreads his arms, then, after some time, returns them to their original position. It is often not recommended to trigger the Moro reflex; this can scare the child. The reflex fades away by the 4th month of life.

Reflex Babinsky... It is checked as follows, you need to slide your finger along the sole of the heel, towards the toes, in this case, the baby should spread the toes, and also bend the legs in the shins, knees and hip joint.

Support reflex. Even taking into account the fact that a child will learn to stand on his own no earlier than 8 months, the support reflex is embedded in him from birth. If, holding the baby's armpits, put him on a support, he will rest with his full foot on the surface on which he stands.

Automatic walking reflex. You can continue the previous reflex as follows. It is necessary to tilt the child forward a little, while he will take small steps, without waving his arms. When checking this and the previous reflex, you must hold your head and take the bulk of the baby's weight on yourself.

Bauer's crawl reflex. If you put the child on his stomach, he slightly raises his head and spontaneously moves, as if trying to crawl. If you substitute your palm as a support, the baby will begin to crawl more actively, connecting his hands, he will try to push off from the support. The reflex will disappear when the child is at least 4 months old.

It is possible to provoke the manifestation of most of these reflexes as developmental workouts, but this must be done within the limits recommended by the neurologist. It is important that the baby at this moment is at least 1 month old. If the child is not in the mood or is unpleasant, then you do not need to force him to do these exercises or try to repeat them a little later.

Your baby is so tiny! It seems that all he can do is eat, sleep and loudly notify the world about his discomfort. What is the doctor trying to see, doing various manipulations - tickling around his tiny mouth, pressing his finger on his palm, patting the surface on which the child lies?

Your baby is so tiny! It seems that all he can do is eat, sleep and loudly notify the world about his discomfort. What is the doctor trying to see, doing various manipulations - tickling around his tiny mouth, pressing his finger on his palm, patting the surface on which the child lies?

What is a reflex?

Any reflex is a response to the stimulus from the external or internal environment of the body. It sounds, it would seem, a little difficult, but let's try to figure it out. Any peripheral cell of any organ and any tissue of the child's body contains a receptor capable of perceiving irritation. The receptor transmits the received information further - along the sensitive fibers (processes) of nerve cells. The next links of the reflex arc - the central part - the nerve center, i.e. nerve cells that perceive excitement and transmit it further. Here the impulse is met by motor nerve cells, and they, in response to this impulse, set the muscle in motion. Thus, along the reflex arc, a kind of command, a certain action, is launched and executed. The reflex arc itself is a set of formations of the nervous system involved in the emergence of a reflex.

According to this principle, reflexes determine the vital activity of the body of any person, including a child. But in the case of unconditioned, innate reflexes, their reflex arc is laid down even before birth in the structure of the nervous system. The formation of conditioned reflexes occurs throughout life, on the basis of acquired life experience.

Let's take a simple example. The curious baby became interested in his mother's cup, which had not yet cooled down. Touching hot - and now the hand twitches reflexively. How does this happen? Information “Hot! Dangerously!" from a receptor located in the skin, it is transmitted to a sensitive neuron, and then along a chain - to a motor neuron, which "wakes up" a particular muscle. The child's hand twitches.

Such a simple chain is called a reflex arc, and only if it is intact (i.e., when all of its components work normally) a reflex can be realized. As an example of an unconditioned reflex, one can cite the child's reaction in the first months of life to a slight dash irritation of the corner of the mouth, in response to which the baby turns his head to the source of irritation and opens his mouth - this is how the search reflex is realized.

Most of the reflexes of newborns reflect the evolutionary and individual age maturity of the child, which allows the doctor to judge the functional state of the baby's body as a whole and, in particular, its state. Only a few of them have a certain value for ensuring vital activity, for example, sucking and upper protective reflexes.

What the doctor will see

During the examination, the pediatrician needs to make sure that some of the basic unconditioned reflexes are intact - sucking, swallowing, searching reflex, upper protective reflex, upper grasping reflex. And a pediatric neurologist at 1 month will conduct a full sequential one to make sure that there are no lesions of the still immature, but already structurally formed nervous system of the newborn.

To begin with, the doctor will assess the child's appearance. A healthy newborn has a semi-flexion position (the legs and arms are bent at the knees and elbows), which is associated with a physiological, that is, age-specific increase in muscle tone - the flexors of the arms and legs. While awake, the baby makes spontaneous movements - periodically bends and unbends the legs, randomly waves his arms, reacts to loud sounds, bright light.

Premature babies have reduced spontaneous motor activity (chaotic movements of arms and legs, reaction to light, sounds) and muscle tone, and unconditioned reflexes (these are all reflexes of a newborn, which we will discuss below), as a rule, are depressed.

What reflexes are we talking about and how are they evaluated? The main physiological reflexes are divided into oral and spinal. The reflex arc of the former is closed at the level of the brain, and of the latter, at the level of the spinal cord.

Oral reflexes of newborns

Oral reflexes include the following.

Sucking- the baby's nipple or mother's breast inserted into her mouth begins to actively suck. It persists during the first year of life, then fades away.

Search (Kussmaul reflex)- in response to a slight line irritation of the corner of the mouth, the child turns his head to the source of irritation and opens his mouth. It fades away by the 6-7th week of life.

Proboscis- with a light and quick blow with a finger on the lips of the child, the lips protrude in the form of a proboscis (there is a contraction of the circular muscle of the mouth). It fades away by 2-3 months.

Palmar-oral (Babkin reflex)- refers to mixed, oral-spinal reflexes. When pressing on both palms, closer to the elevation of the thumb, the child opens his mouth, tilts his head, bends his shoulders and forearms, as if pulling himself up to the fists. It weakens by 2 months, fades away by 3 months of life.

The absence or suppression of these reflexes indicates damage to the central nervous system of various origins.

It should be noted that the severity of these reflexes is significantly influenced by whether the baby is hungry or full. A healthy, hungry baby will react actively, first looking for a source of irritation around the mouth and then greedily grabbing at the mother's breast (or nipple). A well-fed baby will react less actively. Therefore, be sure to inform the doctor about the time of feeding the crumbs, as well as the amount of food taken.

In order for the visit to be as informative as possible for a specialist and comfortable for a child, it is better for the mother to take care in advance that the room is warmed up to at least 22-24 ° C, it is advisable to inspect it no earlier than half an hour after feeding and in natural light.

Spinal reflexes of newborns

Upper protective reflex- when laying on the stomach, the child turns his head to the side, makes several rocking movements and tries to raise his head, thus restoring free access of air to the nasal passages.

The essence of the reflex is to prevent disturbance of external respiration, for which the head is lifted and its position changed in a newborn lying on his stomach. This is one of the most important reflexes, which, along with the sucking, searching and swallowing reflexes of newborns, initially provides a tiny man with the ability to survive in a new environment for him. Normally, the protective reflex is expressed from the first hours of life; in children with damage to the nervous system, it is reduced or absent. It fades away by 1.5 months of age.

Reflex of support, straightening and automatic walking- if the baby is lifted, holding by the armpits, then first the child bends his legs in all joints; when the child's legs touch the support, he straightens the torso and stands on bent legs on a full foot. The support reflex fades away by 3 months. If at the same time the child is slightly tilted forward, then he makes step movements along the surface, without accompanying them with hand movements (automatic gait of a newborn). The automatic gait reflex is physiological (normal) for up to 1.5 months. By the age of 3 months, these reactions fade away, and only by the end of the first year of life does the ability to stand and walk independently appear. In children with damage to the nervous system, the automatic gait is delayed (remains) for a long time.

Crawl reflex (Bauer)- if the newborn is put on his stomach, then he begins to make crawling movements (spontaneous crawling), if at the same time put his palm to the soles of the child - he reflexively pushes off from it and crawls more actively. Normally, this reflex is triggered from the 3-4th day to 3-4 months of life, then it fades away.

Upper grasping reflex (Janishevsky) and suspension reflex (Robinson)- the fingers of the mother or the doctor put into the baby's hand are captured by the child, firmly held and squeezed. Sometimes the grasping of the adult's fingers in the child's palm is so strong that the baby can be lifted with outstretched arms. The reflex is physiological up to 3-4 months.

Lower grasping reflex (plantar, Babinsky reflex)- analogue of the upper grasping reflex. It is caused by pressing with the thumb on the sole at the base of the II-III toes. The child performs plantar flexion of the toes (presses the toes to the foot); if, with your finger, you make a line irritation of the sole along the outer edge of the foot in the direction from the heel to the toes, then the back extension of the big toe and a fan-shaped divergence of the II-V fingers occur. It fades away by 12 months.

Hug reflex (embrace, Moro reflex)- called by various methods. In particular, by hitting the changing table with a hand at a distance of 15 cm from the baby's head or by a sudden noise. In response to this, the baby first spreads his arms, unclenches the fingers, straightens the bent legs (1st phase of the reflex). After a few seconds, the hands return to their original position, the child can wrap his arms around himself (2nd phase). Normally, the 1st and 2nd phases of the reflex, depending on the time of examination and the condition of the child, can be expressed differently. It is called from the first days of life, physiological up to 4-5 months.

Talent Reflex- when holding the thumb and forefinger along the spine of the child from both sides in the direction from the neck to the tailbone, he arches his back and head in the direction of the stimulus. The reflex is called from the 5-6th day of life and remains normal up to 3-4 months.

Reflex Perez- a child lying on his stomach is held with a finger from the coccyx to the neck, slightly pressing on the spinous processes of the vertebrae. The child raises his head, he has lumbar lordosis (forward bending of the spinal column), he raises the pelvis, bends his arms and legs. Sometimes the child begins to cry, urination and defecation are observed. Normally, it is observed up to 3-4 months. With damage to the central nervous system, inhibition of the reflex is observed. Necessarily checked by a neurologist along with other spinal automatisms.

The suppression or absence of the above-described spinal automatisms is an alarming sign that speaks of a possible damage to the central nervous system at the level of the spinal cord.

Posotonic reflexes

These reflexes characterize the ability of a newborn child to adequately redistribute muscle tone depending on changes in body position. Normally, they fade away as the baby independently masters the basic motor skills - the ability to raise his head, sit, stand, walk.

Asymmetric cervical tonic reflex (Magnus-Klein)- is called when the child's head is passively turned to the side. The arms and legs are extended on the side to which the child's face is facing, and the opposite ones are flexed. The hand, to which the face is turned, straightens, the tone of the extensors of the shoulder, forearm, hand increases - the “fencer's” pose, and in the muscles of the hand to which the back of the head is turned, the tone of the flexors increases.

Symmetrical tonic cervical reflexes- with passive flexion of the newborn's head, the muscle tone of the flexors in the arms and extensors in the legs increases. When the head is extended, the opposite effect is observed - the arms are extended and the legs are bent. Asymmetrical and symmetrical cervical reflexes are constantly observed in newborns. In premature babies, they are poorly expressed.

Labyrinth tonic reflex- in the position of the child on the stomach, the tone in the flexor muscles increases: the head is brought to the chest or tilted back, the back is arched, the arms are bent and also brought to the chest, the hands are compressed into fists, the legs are bent at all joints and brought to the stomach. After a few minutes, this posture is replaced by swimming movements, turning into a spontaneous crawling reflex.

The reflex test is over. Your baby passed one of his first little exams, and we hope that it is excellent. However, if warning signs are identified (absence, weakening of one or more reflexes, or, conversely, their presence at the time when this or that reflex should have already died out), then the doctor will offer you an additional examination. Most often, this is an ultrasound examination of the brain - echoencephalography. If the changes are identified by a pediatrician, then he prescribes a consultation with a neurologist, who, in turn, will carry out additional studies.

Parents themselves should not check the baby's reflexes - the actions taken for this (in particular, to test the reflexes of Talent and Perez) can cause severe discomfort and anxiety for the baby. And yet, if you think this or that baby's reaction is alarming, be sure to tell the doctor about it.

Only a doctor can correctly conduct an examination and draw the appropriate conclusions, who, when assessing the situation and the condition of the baby, takes into account not only the specific manifestations, but also the conditions in which the study was carried out, other indicators of the baby's health, as well as the history of pregnancy, childbirth and even such a short time. but still the development of the crumbs.

If you or the doctor were alarmed by some deviations from the norm, then at the next examination, pay special attention to these particular nuances. Remember that a child at this age changes every day, and, as we have already mentioned, the manifestation of reflexes depends on a number of conditions (satiety, fatigue, and many others). Re-examination must necessarily take place after the appointed time - it can be different depending on the alleged nature of the pathology - from several days to a month, which will help to exclude existing suspicions or, if necessary, carry out timely treatment.

Zainiddinova Rabiyat, neonatologist, Ph.D. honey. Sci., Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Article provided by the magazine on pregnancy and childbirth "9 months" No. 1, 2009

In this article:

The fourth month of life prepares your baby for new knowledge. Now the child no longer looks like a helpless baby. He makes sounds and knows how to demonstrate his mood, pleasure or displeasure with the help of intonation.

Baby colic is a thing of the past. Sleep returned to normal. An interesting and tasty complementary food has appeared. Everything around became brighter, clearer and more tempting. Now, when the baby is not worried about anything, he begins to master new skills - to crawl and reach for toys.

What does your baby look like at 4 months

Of course, your baby is the most beautiful, intelligent and very special, but still he must meet some standards. For children at this age, there are certain norms for weight, height, duration of sleep.

Boys usually
are slightly heavier than girls, which means they are slightly larger. The average weight of a four-month-old baby is 5-8 kg with a height of 60 to 65 cm. Since the teeth are not yet being cut, and the night worries common for babies have already faded into the background, a child's night sleep can be a full 8 hours. During the day, the baby can sleep up to 2 hours continuously or twice for 30-60 minutes.

Reflexes of a newborn and new reflexes of a baby at 4 months

By the age of four months, the child begins to outgrow the primary reflexes, to model and improve them. What happens to the grasping reflex? He does not disappear, but starts looking for a target. If earlier the child intuitively clenched his fist when he came across any, a variety of objects, now he seeks to grab exactly what he likes best. If your baby clings to everything bright,
colored, oblong, squeaking, this is a sure sign of good motor skills.

A child under 4 months of age has an active self-preservation reflex. If you slap your palm next to the child so that the surface vibrates, the child will sharply spread its limbs, and then, like a flower in a bud, will gather back. By the age of 5 months, this reflex disappears, since children can already distinguish different sounds and are aware of the presence of their parents.

A baby, turned over on his tummy, begins to crawl reflexively if a palm is placed on his heels. By the 4th month, the reflex disappears and there is a desire to crawl on its own.

Do not forget, that at the appointed time the child must be shown to the district pediatrician. He will conduct a basic examination and determine if the disappearance of reflexes, which should no longer bother your little one, are normal. By touching the child's spine with the index finger, the doctor will check the Talent reflex and the Perez reflex and, if available, will give directions to a neurologist and for a standard massage. While the child is small, you should not lose sight of even such trifles as children's reflexes, because they are very important for his proper development.

Baby skills at 4 months


At this age, it is still too early to leave the baby in a sitting position, but you can do exercises with pulling the arms from a lying position.

Emotions of a four month old baby

A 4-month-old baby can react to his mother’s voice by actively helping himself with his hands and feet to express the joy that he has learned a relative. "Gulit", makes dull and open sounds. The memory of the mother's breast is formed, because it means delicious food. Shapes and outlines of the chest
learned; at the sight of her, the baby becomes silent and waits for the start of feeding.

At 4 months old, the child feels resentment, feels frightened, begins to show a conscious interest in things in order to study subjects.

The child already recognizes his reflection in the mirror. Now he likes to examine himself in it, touch his head, nose, feel the body.

A 4-month-old baby knows voices and smells, remembers images. But if you change your appearance a little, you will become unrecognizable for the child. Even if a mother puts on glasses, the baby may be frightened by a stranger next to him.

At 4 months, the baby becomes more attached to the mother.
or to a person who is constantly with him. Begins to feel his inner world and emotions. He is wary of new faces, but communication interests him more and more.

By the age of four months, the child begins to react to bright light and distinguish between the main colors: green, yellow, blue, red. Hearing develops and distinguishes between rustles, melodies, voices. The child distinguishes the voices of loved ones from unfamiliar timbres.

What to do with a four month old baby?

Many chores, such as a short night's sleep, frequent changes in the color and consistency of stools, endless reclining in my mother's arms, fade into the background. The child wants to develop
and explore the world. His sleep is reduced to 15 hours a day. The main sleep time is at night, and 2-4 hours - during the daytime.

If the baby somehow deviates from the norms, does not perform one or more of the mandatory actions described above, you need to pay attention to this and, for your peace of mind, consult a doctor as soon as possible. Then the possible problems will most likely be easily eliminated with special massage or exercises.