Information 

  • Performed to assess a child’s neurological development and function

Health check recommendations

  • All children from birth to 6 months at each scheduled health check

1. Procedure

  • Perform each reflex assessment. See Table 1.
  • Use the online videos to assist with reflex assessment. See Resource 1.
  • Determine if the infant requires a referral according to a present or absent age related reflex and place on a follow-up and recall register

Table 1. Reflexes summary 1,2

Reflex

Stimulation

Response

Duration

Moro

  • Sudden move, loud noise
  • Startles, throws out arms and legs and then pulls them toward body
  • Diminishes at 3–4 months, disappears by 6 months

Blink

  • Flash of light or puff of air
  • Closes eyes
  • Permanent

Stepping

  • Infant held upright with feet touching ground
  • Moves feet as if to walk
  • Diminishes at 3–4 months

Grasping

  • Palms touched
  • grasps lightly
  • Weakens at 3 months; disappears by 1 year

Sucking or

Rooting

  • Cheek stroked or side of mouth touched by an object
  • Turns toward source, opens mouth and sucks on object
  • Disappears at 3–4 months

Plantar or Babinski

  • Sole of foot
  • Fans out toes and twists foot in
  • Disappears at 9–12 months
  1. Moro reflex (1 week–2 months) 1,2
    • Support infant in the semi-sitting position and allow the head and trunk to drop back to a 30 degree angle
    • Observe the arms splay outwards (adduct) in a wide embracing motion followed by relaxed flexion. The legs may respond similarly
    • Reflex diminishes in strength by 3–4 months and disappears by 6 months
  2. Blink reflex (1 week onwards) 1,2
    • Shine a light at the infant’s open eyes or bring an object close to their face
    • Observe a rapid closure of the eyes
    • No response can indicate poor visual perception
    • Reflex is permanent and should not diminish with time
  3. Stepping reflex (1 week–2 months) 1,2
    • Support infant upright, allowing the soles of their feet to touch a table surface
    • Observe alternate flexion and extension of the legs, simulating walking
    • Reflex diminishes between 3–4 months and disappears before voluntary walking
  4. Grasp or palmar reflex (1 week–3 months) 1,2
    • Avoid touching the back of the infant’s hand when assessing this reflex
    • While the infant’s head is in midline, touch the palm of the hand with a finger tip
    • Note a strong grasp of your finger
    • Sucking or applying light traction to the arm also facilitates the grasp reflex
    • Reflex is strongest at 1–2 months of age, diminishes by 3 months and disappears by 12 months old
  5. Rooting or sucking reflex (1 week–4 months) 1,2
    • Touch one corner of the infant’s mouth
    • The infant’s mouth should open and head turn in the direction of the touch
    • Minimal or no response is expected if the infant has been recently fed
    • Disappears by 3–4 months
  6. Plantar or Babinski reflex (1 week–6 months) 1,2
    • Firmly stroke the sole (plantar) of the infant’s foot
    • The big toe should move upwards while the other toes fan out
    • Disappears by 12 months

2. Results

  • Infant reflexes disappear as the child gets older and are usually absent after 6 months of age except for the blink reflex which persists throughout life

3. Brief intervention

  • Provide the parents with reflex progression resources. See Resource 1.

4. Referral

  • Refer to the MO/NP or paediatrician if:
    • there are any age related reflex deficits
    • any infant reflexes persist beyond the recommended time frames
    • the parent has any concerns

5. Follow-up

  • Place the child on a recall register if required
  • Ensure all referrals are actioned
  • Provide the parent with details for the next scheduled follow-up appointment

6. References

7. Resources

  1. Example videos at Embryology–Newborn reflexes

Last updated: September 2024

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