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Newborn Reflexes

Newborn (primitive) reflexes are involuntary motor responses mediated by the brainstem and spinal cord. Their symmetric presence confirms neurological integrity; absence or asymmetry suggests CNS damage, birth trauma, or peripheral nerve injury. Each reflex appears at birth (sucking by ~32 weeks gestation) and disappears on a predictable timeline as the cortex matures — persistence beyond the expected age or an asymmetric response is the abnormal finding.

High-yield primitive reflexes — how to elicit and when each normally disappears. A symmetric response is expected; an asymmetric or absent response in a term newborn is the concerning finding.

Eliciting the Moro reflex correctly — the single most clinically loaded newborn reflex because symmetry, not mere presence, is the assessment parameter.

Reassuring caregivers about normal reflex behavior and what is age-appropriate.

Report Nowescalate immediately

REPORT NOW — absent or asymmetric primitive reflexes signal neurologic injury or birth trauma and require provider notification.

Asymmetric Moro reflex Hallmark
One arm fails to abduct/extend; suggests clavicle fracture or brachial plexus injury (Erb palsy), often after shoulder dystocia
Absent sucking reflex in term newborn
Warrants neurological evaluation
Absent rooting reflex in term newborn
Warrants neurological evaluation
Absent primitive reflexes at birth
Globally absent reflexes in a term newborn suggest CNS depression/injury

Clinical Pearl

Moro should be a mirror — both arms out, both arms in. If one arm stays still, think clavicle fracture or Erb palsy and report immediately.

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