Reference — Neonatal
Newborn Reflexes Reference
Primitive reflexes confirm an intact newborn nervous system — each has a way to elicit it, an age it should disappear, and a meaning when it is absent, asymmetric, or persists too long.
Educational use only. Abnormal, absent, or asymmetric reflexes are reported for provider evaluation. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Reflex Table
| Reflex | How to Elicit | Normal Response | Disappears By |
|---|---|---|---|
| Moro (startle) | Sudden head-drop motion or loud noise | Symmetric arm extension and abduction, then flexion and cry | 4–6 months |
| Rooting | Stroke the cheek or corner of mouth | Head turns toward stimulus, mouth opens | 3–4 months |
| Sucking | Place nipple or gloved finger in mouth | Rhythmic, coordinated sucking | Around 4 months (becomes voluntary) |
| Palmar grasp | Press finger into the palm | Fingers curl and grip | 3–4 months |
| Plantar grasp | Press at the base of the toes | Toes curl downward | 8–10 months |
| Babinski | Stroke lateral sole from heel upward | Toes fan with big-toe dorsiflexion (positive is normal in infancy) | By about 12 months |
| Tonic neck (fencing) | Turn the head to one side while supine | Arm and leg extend on the face side; opposite side flexes | 4–6 months |
| Stepping | Hold upright with soles touching a surface | Alternating stepping movements | 1–2 months |
| Galant (trunk incurvation) | Stroke along one side of the spine, prone | Trunk curves toward the stroked side | 1–2 months |
What Abnormalities Suggest
Absent or weak
A globally absent reflex in a term newborn suggests CNS depression — sedating medications, hypoxic injury, or prematurity. An absent Moro is always significant.
Asymmetric
One-sided Moro or grasp points to a focal problem: clavicle fracture or brachial plexus injury (Erb palsy) are the classic causes.
Persistent
Primitive reflexes that persist well beyond their disappearance age raise concern for neurologic abnormality such as cerebral palsy — flag for developmental follow-up.
NCLEX Pearls
- ✦An asymmetric Moro after a difficult delivery: think clavicle fracture or brachial plexus injury.
- ✦A positive Babinski is normal in infants — the same finding in an adult is pathologic.
- ✦Rooting and sucking are feeding reflexes — weak ones predict feeding difficulty before the first poor feed.
- ✦Know the big disappearance ages: stepping 1–2 mo, rooting 3–4 mo, Moro and tonic neck 4–6 mo.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Academy of Pediatrics (AAP) · Neonatal Resuscitation Program (NRP) · AWHONN. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →