From the Guidelines
Primitive reflexes in infants, including the gag reflex, are crucial for protecting against aspiration during swallowing and typically disappear between 3-12 months as the infant's central nervous system matures. These reflexes are automatic, involuntary movements that develop during fetal life and are present at birth to help with survival and neurological development 1. Some of the key primitive reflexes in infants include:
- Rooting reflex (turning toward touch on the cheek)
- Sucking reflex (automatic sucking when something touches the roof of the mouth)
- Moro reflex (startle response with arms extending outward)
- Palmar grasp (gripping objects placed in palm)
- Plantar grasp (curling toes when foot is stimulated)
- Stepping reflex (making walking movements when held upright)
- Asymmetric tonic neck reflex (fencing position when head is turned) The gag reflex, in particular, plays a vital role in preventing choking among children, as it helps to protect against aspiration during swallowing 1. However, despite a strong gag reflex, a young child’s airway is more vulnerable to obstruction than that of an adult due to its smaller diameter and higher resistance to air flow 1. Regular pediatric check-ups monitor the presence and disappearance of these reflexes as part of normal developmental assessment, and persistence of primitive reflexes beyond their expected disappearance timeframe may indicate neurological issues and should be evaluated by a healthcare provider. The gradual integration of these reflexes is an important developmental milestone that allows for more complex voluntary movements, and healthcare providers should be aware of the typical timeline for their disappearance to identify any potential developmental delays or issues 1.
From the Research
Primitive Reflexes in Infants
- Primitive reflexes are a set of automatic movements that are present in infants and typically disappear as the child develops [(2,3)]
- These reflexes can be used as a tool to assess the central nervous system integrity of infants and young children 2
- The presence or absence of certain primitive reflexes, such as the asymmetric tonic neck reflex, Moro, palmar grasp, and plantar grasp, can be indicative of neurological abnormalities [(2,3)]
Types of Primitive Reflexes
- There are several types of primitive reflexes, including:
- Myotatic reflexes
- Cutaneomucous reflexes
- Spinal cord or defence automatism reflexes
- Posture and attitude reflexes 4
- Primitive pathological reflexes, remote reflexes, synkinesias, and signs of meningeal irritation can also be assessed 4
Relationship between Primitive Reflexes and Motor Development
- Research has shown that primitive reflexes are unrelated to motor development in full-term infants with normal developmental outcomes 5
- The presence or absence of primitive reflexes does not appear to be correlated with motor development, and observational assessment of spontaneously generated movement may be more valuable in assessing a child's overall level of maturation 5
Clinical Significance of Primitive Reflexes
- Primitive reflexes can be used as a simple and predictive screening test for the early identification of infants at risk for cerebral palsy 2
- The combined examination of primitive reflexes and postural reactions can be useful in both developed and underdeveloped countries, where time and specific resources may be limited 2