The sucking blinking grasping reflexes of a newborn refer to. Reflexes of newborn children: unconditioned, conditioned, congenital

Miscellaneous

14.12.202327.05.2017

Innate physiological reflexes

The main unconditioned reflexes of a newborn and infant are divided into two groups:

segmental motor automatisms

spinal – provided by segments of the spinal cord

oral - provided by segments of the brain stem

suprasegmental posotonic automatisms

myelencephalic postural reflexes – provided by the centers of the medulla oblongata

Segmental motor automatisms

Spinal motor automatisms

Newborn protective reflex

If a newborn is placed on his stomach, a reflexive turn of the head to the side occurs. This reflex is expressed from the first hours of life.

Support reflex and automatic gait of newborns

The newborn is not ready to stand, but he is capable of support reaction. If you hold a child vertically in weight, he bends his legs at all joints. The child, placed on a support, straightens his torso and stands on half-bent legs on a full foot. A positive support reaction of the lower extremities is a preparation for stepping movements. If the newborn is slightly tilted forward, he makes stepping movements (automatic gait of newborns).

The support reaction and automatic gait are physiological up to 1 - 1.5 months, then they are suppressed and physiological astasia-abasia develops. Only by the end of 1 year of life does the ability to stand and walk independently appear, which is considered as a conditioned reflex and for its implementation requires normal function of the cerebral cortex.

Crawling reflex (Bauer) and spontaneous crawling

The newborn is placed on his stomach (head in the midline). In this position, he makes crawling movements - spontaneous crawling. If you place your palm on the soles, the child reflexively pushes away from it with his legs and crawling intensifies. In the position on the side and on the back, these movements do not occur. There is no coordination of movements of the arms and legs. Crawling movements in newborns become pronounced on the 3rd - 4th day of life. The reflex is physiological until 4 months of life, then it fades away. Independent crawling is a precursor to future locomotor acts.

Grasp reflex

Appears in a newborn when pressure is applied to his palms. Sometimes a newborn clasps his fingers so tightly that he can be lifted up (Robinson reflex). This reflex is phylogenetically ancient. Newborn monkeys are held on the mother's hair by gripping their hands.

The reflex is physiological until 3–4 months; later, on the basis of the grasping reflex, voluntary grasping of an object is gradually formed.

The same grasping reflex can be evoked from the lower extremities. Pressing the ball of the foot with the thumb causes plantar flexion of the toes. If you apply a line of irritation to the sole of the foot with your finger, then dorsiflexion of the foot and a fan-shaped divergence of the toes occurs ( PHYSIOLOGICAL BABINSKI REFLEX ).

Galant reflex

When the skin of the back is irritated paravertebrally along the spine, the newborn bends its back, forming an arch open towards the irritant. The leg on the corresponding side is often extended at the hip and knee joints. This reflex is well evoked from the 5th - 6th day of life. The reflex is physiological until the 3rd - 4th month of life.

Perez reflex

If you run your fingers, lightly pressing, along the spinous processes of the spine from the tailbone to the neck, the child screams, raises his head, straightens his torso, and bends his upper and lower limbs. This reflex causes a negative emotional reaction in the newborn. The reflex is physiological until the 3rd - 4th month of life.

Moro reflex

It is caused by various techniques: a blow to the surface on which the child is lying, at a distance of 15 cm from his head, raising the straightened legs and pelvis above the bed, sudden passive extension of the lower extremities. The newborn moves his arms to the sides and opens his fists - phase 1 of the Moro reflex. After a few seconds, the hands return to their original position - phase II of the Moro reflex. The reflex is expressed immediately after birth, it can be observed during the manipulations of the obstetrician. In healthy children, the reflex is well expressed until the 4th - 5th month, then it begins to fade; after the 5th month, only individual components can be observed

Oral segmental automatisms include

Sucking reflex

When the index finger is inserted 3-4 cm into the mouth, the child makes rhythmic sucking movements. The reflex is observed within 1 year of life.

Search reflex (Kussmaul reflex)

When stroking the corner of the mouth, the lip lowers, the tongue deviates, and the head turns toward the stimulus. Pressing on the middle of the upper lip causes the mouth to open and the head to straighten. When you press on the middle of the lower lip, the lower jaw drops and the head bends. This reflex is especially pronounced 30 minutes before feeding. Pay attention to the symmetry of the reflex on both sides. The search reflex is observed for up to 3-4 months, then fades away.

Proboscis reflex

A quick tap on the lips with a finger causes the lips to stretch forward. This reflex lasts up to 2-3 months.

Palm-oral reflex (Babkin reflex)

When pressing with the thumb on the area of the newborn's palm, closer to the thenar, the mouth opens and the head bends. The reflex is clearly pronounced in newborns. After 2 months it fades away by 3 months. disappears.

Suprasegmental posotonic automatisms Myelencephalic postural reflexes

Asymmetric cervical tonic reflex (Magnus-Klein)

If you turn the head of a newborn lying on his back so that the lower jaw is at shoulder level, then the limbs towards which the face is facing are extended and the opposite ones are flexed. The reaction of the upper extremities is more constant: the arm to which the face is turned straightens (the tone of the extensors of the shoulder, forearm, and hand increases - the “fencer” pose), and the flexor tone increases in the muscles of the arm to which the back of the head is turned.

Symmetrical tonic neck reflexes

When a newborn flexes the head, the muscle tone of the flexors of the upper limbs and extensors of the lower limbs increases; When the head is straightened, the muscle tone of the arm extensors and leg flexors increases. Asymmetrical and symmetrical neck reflexes are constantly observed in newborns.

Tonic labyrinthine reflex

In the supine position, the muscle tone of the extensors of the neck, back, and legs increases; under the influence of the same reflex, in the position on the stomach, the child assumes the position of the embryo (the head is brought to the chest or thrown back, the arms are bent and also brought to the chest, the hands are in fists, the legs are bent and brought to the stomach).

Twenty-eight days is exactly how long the newborn period lasts, during which the child’s body experiences adaptation to completely new conditions of now extrauterine life, so the reflexes of a newborn child play a major role here.

This is explained by the fact that a very recently born baby is still deprived of many useful skills - nature takes care of him.

Basic reflexes

During this period, the baby has only developed unconditioned reflexes - that is, those that are laid down as if by default. Gradually, some of them disappear, giving way to conditional ones.

Conditioned reflexes can also be called the “personal experience” of a child, since they are acquired in the process of further development and maturation of the brain.

Why are unconditioned (innate) reflexes needed?

A baby has as many as fifteen clinically significant unconditioned reflexes - and their “fate” is very different: some are needed only to survive the difficult process of birth (therefore they quickly disappear after birth), others - to give impetus to the development of new ones, and still others stay for life.

Pediatrician-neonatologists divide the innate reflexes of newborns into several groups:

Ensuring general normal functioning (respiratory, sucking, swallowing, as well as spinal reflexes)
Aimed at protecting the child’s body from external influences of bright light, cold, heat and other irritants
“Temporary” reflexes - for example, the breath-holding reflex necessary for the mother to move through the birth canal.

Click to enlarge (Basic reflexes)

Oral reflexes

The ability to suck on the mother's breast or bottle nipple is called sucking reflex, and the ability to swallow food eaten is swallowing.

Swallowing reflex remains for life.

Proboscis reflex - another type of oral reflexes. If you lightly touch the baby's lips, they stick out funny into a tube - just like a baby elephant's trunk, because at this moment the orbicularis oris muscle involuntarily contracts. The proboscis reflex disappears by two to three months.

Babkin reflex (palm-oral) - a mixed type of reaction of a child, in which he opens his mouth slightly if you lightly press your thumbs on both palms at the same time. It is best expressed in the first two months of life, in the third it begins to fade and then disappears completely.

Kussmaul reflex (search) - an attempt to find food: if you touch the corner of a child’s mouth, he turns his head towards the stimulus. It disappears quite quickly - three to four months after birth. In the future, the search for food occurs visually - the baby sees the breast or bottle.

Spinal reflexes. When examining a baby immediately after birth and throughout the entire neonatal period, the pediatrician also pays attention to spinal reflexes—a set of reactions responsible for the condition of the muscular system.

Upper protective reflex. One of the most important unconditioned reflexes, triggered already in the first hours of life, is the upper protective reflex. It manifests itself if a newborn baby is placed on his stomach: the head immediately turns to the side, and the baby tries to lift it. This is protection against possible breathing problems: the child thus restores air access to the respiratory tract. The reflex disappears a month and a half after birth.

Grasp reflexes

Janiszewski and Robinson reflexes in a newborn child, they appear when he firmly grabs the mother’s (doctor’s) fingers with both hands and is able to hold them so tightly that he can even be lifted in this way. They are expressed up to three to four months, then weaken. The preservation of these reflexes at a later age is evidence of existing neurological problems.

Babinski reflex – it is also called the plantar reflex: lightly stroking the edges of the soles from the outside causes the toes to open in the form of a fan, while the feet bend on the back side. The evaluation criteria are energy and especially symmetry of movements. One of the longest-lived congenital reflexes - it is observed up to two years.

Other motor reflexes

Moro reflex – a two-phase reaction in which the child responds to a rather loud knock on the changing table or any other sharp sound.

The first phase - the baby spreads his arms to the sides and unclenches his fingers, while straightening his legs.
The second phase is a return to the previous position. Sometimes the child can even seem to hug himself - that’s why the Moro reflex has another name - the “hug reflex.”

Pronounced until the baby is five months old.

Kernig reflex – the reaction of the hip and knee joints to an attempt to release them with force after flexion. Normally this cannot be done. Disappears completely after four months.

Automatic gait reflex , which is a very funny sight, consists of a newborn trying to walk in a very real way if he is lifted and his body is slightly tilted forward. The evaluation criterion is the degree of completeness of support when “walking” on the entire foot. Relying on your toes and clinging your feet to each other is a sign of disorders that require observation by a pediatric neurologist.

Support reflex - the baby’s attempt to stand on his feet when, carefully holding him, he is placed on a flat surface (on a table, for example). This is a two-phase reflex: first, the baby, feeling the touch of the support, sharply bends his legs at the knees, and then stands with both feet and presses the soles tightly to the table. Well-defined support reflexes and “automatic” gait persist for one and a half months.

Bauer reflex (spontaneous crawling) can be observed by placing the baby on his stomach and placing his palms on his soles: he begins to crawl, pushing off from the created support and helping himself with his hands. Appearing on days 3-4, this reflex disappears after 3-4 months.

Galant reflex – reaction of the spine to an external stimulus. If you run your finger along the entire length of the ridge, the child arches his back, while extending his leg on the side of the stimulus.

There are also postural reflexes newborns - attempts to redistribute muscle tone when body posture changes in the absence of the ability to hold the head, sit and walk.

Magnus-Klein reflex - the reaction of the extensor and flexor muscles of the shoulder, forearm and hand, in which the child takes the “fencing pose”. This happens if the baby's head is turned to the side. You can observe how the arm and leg straighten on the side where the child’s face is located. On the opposite side, on the contrary, they bend. This reflex lasts up to two months.

Weak reflexes or when to sound the alarm

It happens that some of the baby’s reflexes turn on late or do not appear very clearly. This may be due to trauma received during childbirth, illness, and may also be an individual reaction to certain medications.

Also, weakness of oral and spinal reactions is usually observed in premature babies and those born with mild asphyxia.

Interestingly, weak reflexes in a newborn baby associated with the search for food and its absorption (sucking and swallowing) can be explained simply by the fact that the baby is simply not hungry. They appear most clearly before feeding.

The most frightening situation is when there are no reflexes at all. The complete absence of reflexes in a newborn baby is a reason for immediate resuscitation, which should only be carried out by specialists.

The reasons for this are different - intrauterine defects, severe birth injuries, deep asphyxia (suffocation by the umbilical cord).

However, you should remember: the reserves of a child’s body are enormous, so in many cases it is quite successfully restored, and the baby grows up healthy.

Video consultation: Newborn reflexes

Olga Petrovna Tselekhovich, a doctor of the highest category, tells what basic unconditioned reflexes should be normal in infants.

When a tiny baby is born, it seems that he is completely defenseless in front of a new world for him. However, nature took care of his protection, rewarding him with a certain set of abilities important for his life, instincts that are responsible for successful adaptation and development. We are talking about conditioned and unconditioned reflexes, thanks to which the baby is able to survive.

The unconditioned reflexes of a newborn are what are primarily assessed by neonatologists in the maternity hospital, and then pediatricians use these reactions to “read” how developed it is, whether there are any pathologies or abnormalities.

Conditioned reflexes are those “developments” of the baby that will remain with him for the rest of his life, what he acquired in the course of development and experience. Simply put, this is what a little person does consciously, understanding the goals and reasons for his actions.

Why are they needed?

The innate reflexes of newborns are triggered automatically as soon as the child comes into this world. These are peculiar small programs that begin to be executed immediately. Even the first breath is considered reflective, because no one taught the baby to breathe.

There are several dozen of them (about 75), but in pediatrics there are 15 clinically important unconditioned reflexes of newborns, the tasks of which are very different: some disappear instantly after the birth of the baby, since they are programmed only to facilitate this very birth, others are needed to stimulate the development of new ones, and There are those that stay with a person for life.

The life of a newborn depends entirely on the adults who care for him. He is not able to independently obtain food, drink or warm himself. The well-being of the little man depends only on the guardians; only they can make sure that he is not cold and hungry.

But at the same time, the child’s ability to accept this care will depend on the innate reflexes of newborns, on their activity. What does this mean? Let's take feeding a baby as an example. In order to feed him, you will need breast milk or a bottle of formula. But the baby will have to suck on the breast or bottle! The outcome of feeding will depend on the severity of his sucking reflex: the more active this reflex is, the more likely the baby will get to the hind milk - the fattest and most nutritious one. So this skill ensures his survival.

Unconditioned (innate) reflexes

In the supine position

Kussmaul search reflex

If you touch or stroke lightly the corner of the child’s mouth next to the cheek, he will turn his head towards the stimulus, lift it slightly and open his mouth slightly. This is how the baby looks for food. The reaction will fade away by 3 months, since by this age he will see food with his eyes - a breast or a bottle. In infants with damage to the facial nerve, this reflex is weak or completely absent.

Sucking

This is a vital mechanism that allows the baby to survive. Thanks to him, he takes food - sucks milk from the breast or formula from a bottle. Essentially we are talking about the normal feeding process.

After the baby is satisfied, the sucking reflex fades away. But after half an hour or an hour it resumes again. It remains in the baby for up to a year.

Remember: the absence or weakening of sucking and swallowing reflexes may be due to the fact that the baby is not yet hungry. They are most pronounced only before feeding.

But if there is no sucking reflex, if the baby sucks poorly, grasps the nipple incorrectly, fluid leaks from the corner of his mouth, he takes in a lot of milk, but cannot swallow, then all this is cause for concern.

Gag reflex

It is necessary for the baby if he chokes. Immediately after birth, babies, although able to suck, still cannot eat “like clockwork,” which is why they often choke and choke. The gag reflex helps him spit out the milk he choked on.

Babkin's palmo-oral reflex

If you put your fingers into the palms of a month-old baby and press a little on them, he will immediately grab them and raise his head along the midline. Some children can open their mouths and even stick out their tongues. This reaction is especially pronounced during the newborn period, lasts up to 2 months, and disappears by the third month.

Prehensile

If you put your fingers into your baby's palms and press lightly on them, he will reflexively grab them, and very tightly. The grasping reflex, which exists up to 3-4 months, gradually transforms into a conditioned one, when the child no longer unconsciously grabs the toy, but purposefully.

Robinson reflex

The baby is able to squeeze the fingers of an adult with such force that he can lift himself up. The Robinson reflex is similar to the grasping reflex and has all its features.

Inferior prehensile (plantar)

If you press on the baby's feet closer to the toes, he will respond by squeezing those toes. Disappears by the age of one year.

Moro reflex (grasping)

If you slap your palm on the place where the baby is lying, 20-30 cm from him, in response there should be an opening of the arms to the sides and unclenching of the fingers (the first phase) and a bringing together with an attempt to grasp or hug oneself (the second phase). Often, in the first week after the baby is born, only the first phase appears. The absence of the second does not indicate a deviation. This is a more stable reflex, it lasts up to almost 5 months, and its individual elements can be seen at 6 months.

Babinski reflex

If you irritate the outer edges of the child's soles from the heel to the toes, the response will be a pronounced extension of the big toe, and the remaining toes will open like a fan. May occur in children under 12 months of age.

Standing

Automatic walking or step reflex

The stepper is checked as follows: the doctor puts the baby on his feet, while he stands either on a full foot or can stand on his toes. If you rock him and tilt him forward, he will make stepping movements. This is reflexive automatic walking, inherent in infants in the first month of life. This is how the baby prepares to verticalize the body in space. However, this skill will disappear at 2 months; this reflex is the fastest to fade.

Support reflex

There are two phases:

The child bends his legs at the knee and hip joints when an adult takes him under the arms.
The child straightens his legs and stands with his full foot on a hard surface, for example, a changing table.

He will retain this skill for no longer than 2 months.

Reflexes on the stomach

Protective

If a newborn is placed on his tummy, he will slightly raise his head and turn it to the side. He protects himself so as not to suffocate. He appears one of the first, literally in the delivery room. The baby is placed on his mother's stomach in the first minutes after his birth, and he turns his head to the side.

Spinal

With the help of spinal reflexes, a pediatrician will be able to check the set of reactions that are responsible for the functioning of the muscular system of an infant.

Galant reflex. For example, a child lies on his stomach, his arms and legs are bent, and if you pass some stimulus along the child’s spine (parallel to it), his body will arch and his leg will straighten towards the stimulus.

Perez reflex. If you run your finger along the spine from bottom to top, from the butt to the neck, the baby will simultaneously bend his legs and bring them to his tummy, and his back will arch. An opening of the anal sphincter is often observed, and the baby may wet himself. This reaction is the last to be tested, as it causes discomfort in the child, and the baby begins to scream loudly. Therefore, it is not recommended to check it yourself. The Perez reflex manifests itself up to 4 months.

Bauer's crawling reflex

An adult's hands are placed under the baby's legs. The baby will begin to make crawling movements. Sometimes it is necessary to push the baby to provoke these movements. It is observed in newborns from birth and is recorded up to 4 months.

The absence of reflexes in a newborn requires immediate resuscitation

Weak or not at all

In some newborns they are very weak, do not appear clearly or appear a little later. This may be due to birth injuries, certain diseases, etc. In premature babies and babies who have experienced mild asphyxia, oral and spinal reactions are weakly manifested.

But if they are not there at all, then the baby must be immediately provided with resuscitation care, which is carried out only by specialists. The absence of reactions can indicate the most unpleasant things - from intrauterine defects and severe birth injuries to severe asphyxia or strangulation by the umbilical cord. The faster the problem is fixed, the less unpleasant the consequences will be. True, the child’s body is very flexible, the reserves that nature has endowed it with are enormous. Therefore, in most cases everything works out well, and the body recovers quickly.

After the birth of a newborn child, all its organs and systems begin to adapt to completely new living conditions. Very young children are deprived of basic human skills, which they will have to master in the future as they grow up. An important role and significance in the adaptation process is played by the reflexes of newborns, with the help of which the baby survives and can later live fully without them.

When a baby appears, he is first examined by a pediatrician and a neurologist. A very important part of the examination is to check innate reflexes. With normal functioning of the central nervous system, all physiological reflexes should be normal in the child. Their testing is carried out by specialists in a warm, well-lit room. In this case, the baby, awake, dry and well-fed, is placed on a flat, semi-rigid surface, which is also important for correct diagnosis.

Contents [Show]

Main groups of reflexes

The innate reflexes of newborns are nothing more than a specific response to certain external stimuli. Each of the reflexes appears and disappears at a certain time. Some tend to appear immediately at birth and fade away as the baby grows, while others tend to appear during the process of growing up.

All reflexes in a healthy newborn child should be symmetrical. We are talking about the same response of the left and right sides to stimuli. An abnormal reaction is considered when the reflex is present on one side, but absent on the other.

This may indicate problems with the nervous system.

Reflexes can be roughly classified into two main groups:

unconditioned reflexes of newborns, which are inherent in nature itself, take place immediately after birth and subside over time, giving way to conditioned ones;
conditioned reflexes of newborns, which the child acquires from his own life experience in the process of brain maturation and physical, as well as psycho-emotional development.

Among the innate or unconditioned reflexes, there are about 15 types. They are the ones who help the child survive the difficult process of adaptation associated with adapting to completely new living conditions. Some of them play a pushing role for the acquisition of other reflexes, and some even remain with the child for life.

Among the innate reflexes, several groups can be distinguished:

with the help of which the normal functioning of all systems of the baby is ensured - respiratory, swallowing, sucking, as well as spinal;
with the help of which a weak child’s body can protect itself from external irritants, for example, cold or heat, bright light, etc.;
temporary, play a one-time role in the life of the baby, for example, during labor, when passing through the birth canal, the baby is able to reflexively hold his breath.

Oral reflexes of newborns

This concept should be understood as the baby’s ability to suck the mother’s breast or pacifier during artificial feeding, as well as swallow the food he receives.

Among the main oral reflexes it should be noted:

Sucking- begins to manifest itself literally from the first hours of the baby’s life. It manifests itself in the form of the child’s readiness to grab with his lips any irritants that touch the lips or enter the oral cavity. Active and rhythmic sucking movements provide the child with nutrition and appear until about 1 year of age, after which they begin to gradually subside. (more about the sucking reflex)

Swallowing- with the help of which the child can swallow incoming food.

Proboscis- at the slightest touch to the child’s lips, he sticks them out, curled into a tube that resembles a proboscis. The orbicularis oris muscle is responsible for this, which involuntarily contracts when touched (often disappears by 2-3 months).

Search or Kussmaul reflex- in which the child lowers his lower lip and turns his head towards the stimulus, actively searching for his mother’s breast. The reflex occurs with every gentle touch to the corners of the baby’s mouth and, most often, is also present only in the first months of the child’s life.

Palmo-oral or Babkin reflex- is expressed in the opening of the child’s mouth with a simultaneous movement of the head in the direction of the stimulus with light, simultaneous pressure on his palms. It is clearly expressed only in the first months and by the third month of the child’s life it begins to gradually fade away.

Spinal- representing a set of specific reactions that indicate the state of the baby’s muscular system. Specialists check these reflexes throughout the newborn period.

Protective- activated in the first hours of a child’s life. If the baby is placed on his tummy, his head turns to the side and he tries to lift it (read more about holding the head). Thus, by nature, the child has a protective function against breathing disorders.

Grasping and motor reactions

Robinson and Janiszewski reflexes or grasping- are expressed in the grasping movement of both arms of the baby and quite strong holding of the mother’s fingers in the arms. Sometimes the gripping force is so strong that in this way it is even possible to slightly lift the child. This reflex begins to weaken around 3-4 months of a newborn’s life. If it accompanies the baby at a later age, this may indicate the presence of neurological problems.

Babinski reflex or plantar reflex, when lightly stroking the outer part of the child’s sole is accompanied by the opening of the toes in the form of a fan. At the same time, the back of the foot is slightly bent. This skill is judged by its energy and symmetry.

Moro reflex- occurs in two phases, which are a specific reaction of the baby to a loud knock or other sharp sound. At the same time, in the first phase, the child spreads his arms to the sides, unclenching his fingers and straightening his legs. In the second phase, the baby returns to its previous position. Sometimes it is called the hug reflex, since in its second phase the child makes a movement that resembles hugging himself. Remains clearly expressed until approximately 5 months of age.

Kernig reflex- manifests itself in the form of a specific response to attempts to unclench the legs at the knee joints and move them to the sides at the hip joint. A normal healthy child cannot make this movement. It appears before the baby reaches 4 months.

Automatic gait reflex or stepping- the baby makes movements with his legs, simulating independent walking. This happens when you lift it a little, slightly tilting your body forward. At the same time, he should step on the entire foot, which is a good signal. If the feet begin to cling to each other or the child stands on his toes, then this may be a signal to contact a neurologist.

Galant reflex, which determines the degree of response of the child’s spine to external stimuli. The baby should arch his back when you run your finger along the spine (in the future, arching the back may indicate problems).

This is not a complete list of all reactions. There are some other congenital reactions that will definitely be checked by a specialist in the maternity hospital.

When should parents be concerned?

In cases where congenital reflexes appear with a weak degree of intensity or are slightly delayed, it is necessary to seek advice from a specialist. Such deviations may indicate certain health problems, for example:

the baby getting injured during labor;
the presence of certain diseases;
birth of a child prematurely;
birth with asphyxia;
specific individual reaction to taking certain medications, etc.

A particularly dangerous situation will be when reflexes are completely absent due to serious birth injuries, severe intrauterine defects, and deep asphyxia. This fact is the basis for emergency resuscitation measures. However, if the child is helped in a timely manner, problems can be easily avoided, since the baby’s body reserves are enormous.

In order for a newborn baby to survive after birth and quickly adapt to new living conditions, nature gave the babies reflexes. This is the name for reactions to any stimuli, both external and internal to the baby. At the same time, a newly born baby has many reflexes that he needs only in the first months of life. Checking and evaluating them helps determine whether the baby is healthy.

The reflexes of a newborn serve as an indicator that the child is healthy and developing normally. Basic reflexes and their types

Innate reflexes, also called unconditioned, are extremely important for the survival of a newborn. Thanks to them, the child can take his first breath, find his mother's breast, suck milk, or grab onto his mother if he feels a fall. These are physiological reflexes that should be present in all healthy babies. Many of them fade and completely disappear by 3-4 months of age.

If they remain at an age when they should have been absent for a long time, these will be pathological reflexes. However, there are many unconditioned reflexes that do not disappear. For example, important physiological reflexes that remain in the child even after the neonatal period are represented by gag, corneal, swallowing and other reflexes.

If the reflexes do not go away by the due date, a consultation with a neurologist may be necessary.

Further, as the toddler grows, new reflexes appear in his life, based on the baby’s experience. They are called conditional, because certain conditions are needed for their development, for example, if a mother breastfeeds a toddler in a certain position, then when she puts the baby in this position, the baby will immediately begin to make sucking movements. Conditioned reflexes that are important for a baby in the first year of life include grasping objects with hands, chewing and walking independently.

Pediatricians divide all innate reflexes into groups depending on their direction. They highlight reflexes that:

Provide vital functions. A baby will not be able to live without sucking, swallowing and breathing reflexes, as well as without spinal reflexes (the so-called reactions associated with the state of the child’s muscular system).
Protect the baby from external irritants. Such irritants can be heat, cold, bright light and other factors.
The baby needs it temporarily. An example of such reflexes is holding your breath when the baby moves through the birth canal, as well as the expulsion reflex, thanks to which the baby is protected from solid food entering the digestive tract until a certain age (so that the child does not choke).

Unconditioned reflexes of the newborn, which are caused by influence on or near the mouth, are called oral. This group of reflexes includes sucking, proboscis, swallowing, searching (also called the Kussmaul reflex), Babkin reflex and others. Reflexes for which the spinal cord is responsible are called spinal. These include the Moro, Galant, Bauer, support, grasping, defensive and other reflexes.

Table of basic congenital reflexes

Name of reflex, age of manifestation	How to trigger and what reaction is normal
Sucking (from the first hours after birth to 3-4 years.)	Run along the baby's cheek, insert your index finger into the baby's mouth, or give the baby a breast or bottle - the baby will begin to make sucking movements.
Protective (from the first hours after birth to 1.5 months)	Place the baby on his stomach - the baby will reflexively turn his head to the side.
Prehensile (from birth to 3-6 months)	Press something on the baby's palms - the child will wrap his hands around the object or your fingers.
Supports (from birth to 1-2 months)	Place the baby vertically so that the baby's legs touch a solid support - the baby will straighten his torso and stand on his full foot.
Stepper (from birth to 1-2 months)	Place the baby upright and slightly tilt the child forward - when tilted, the baby will make several automatic stepping movements.
Search (from birth to 3-4 months)	Stroke the cheek or corner of the baby's mouth - the child will turn his head in the direction of irritation, lower his lip and move his tongue. If you press on the baby's upper lip, the baby will straighten his head and open his mouth, and when you press on the lower lip, the baby will bend his head and lower his lower jaw.
Holding your breath (from birth to 4-5 months)	Place the baby in the water, splash water on the little one's face, or direct a stream of air into the baby's face - the baby will hold his breath for a few seconds and close his eyes.
Galanta (from 5-6 days of life to 3-4 months)	Run your hand along the child's back along the spine - the baby will arch his back, and the leg on the side of the reflex call will straighten in the joints.
Proboscis (from birth to 2-3 months)	Quickly touch the baby's lips with your finger - the baby will stretch his lips forward.
Babinsky (from birth to 1-2 years)	Draw a stroke along the child's sole - the foot will bend on the back side, and the toes will fan out.
Robinson (from birth to 3-6 months)	Give the baby thumbs and lift the baby - the baby will tightly clasp his fingers with his palms and hold on.
Perez (from birth to 3-4 months)	Run your fingers along the baby's spine (along its spinous processes), moving upward from the coccygeal bone to the cervical region - the baby will begin to scream (the challenge of the reflex is perceived negatively by the baby), raise his head, straighten up and bend his legs and arms.
Babkina (from birth to 2-3 months)	Press your thumbs on both baby's palms - the baby will open his mouth and bend his head.
Moro (from the first day after birth to 4 months)	Place the baby on his back and hit the surface on both sides of his head, raise the baby's legs together with the pelvis, sharply lower the baby in his arms 20-30 cm down, and then lift him back - the baby will move his arms to the sides and open his fists, after why he will return his hands back as if he was hugging someone.
Bauer (from 3-4 days of life to 4 months)	Lay the child on his stomach, and then place his palm on his feet - the baby will begin to crawl spontaneously, pushing off the hand with his legs, but without coordinating his movements (this determines the second name of this reflex - “spontaneous crawling”).

The innate reflexes of a newborn are called unconditioned reflexes

You can see how to test many important reflexes by watching the following video.

Causes of an abnormal reaction to a reflex challenge

Reflexes may be weakened or absent when:

Hypoxic damage to the central nervous system during childbirth.
Intracranial birth injury.
Muscle hypotension.
Spinal cord injuries.
Suppression of the nervous system by medications.
Paresakh.

How to develop reflexes?

For the successful development of conditioned reflexes in a young child, it is important to act systematically and regularly. For example, to stimulate the grasping reflex, the baby needs to constantly put different objects in his hands, hang toys over the crib that the baby wants to touch, and offer to grab things that he likes.

With regular exercises, parents can develop the reflexes of crawling, walking, chewing and many others, which the baby masters in the first year of life.

To develop a child’s reflexes, you need to work with him regularly. What should you do if the reflexes are reduced or absent?

In some infants, reflexes do not appear immediately or their activation is delayed, which is often associated with birth injuries or diseases of the central nervous system. Immediately after birth, the pediatrician should check the basic reflexes and provide assistance to the baby if they are absent.

The doctor checks the baby for reflexes immediately after birth

The sucking reflex is especially important, because with the help of it the baby receives food. If it is absent, the baby has to be fed through a bottle or tube, and in some cases, nutrients must be administered intravenously.

After discharge from the maternity hospital, all children are examined monthly by a pediatrician, and in a situation where any reflex is poorly expressed or persists beyond the period in which it should fade, the doctor will refer the baby for a more detailed examination to a neurologist. The specialist will evaluate all reflexes and, if necessary, prescribe the necessary treatment for the baby.

In the next video, the popular doctor Komarovsky will tell you even more about the unconditioned reflexes of a newborn baby.

A newborn child has a number of automatisms (unconditioned, atavistic, physiological, conditioned), which are of great importance at each stage of his development. Some skills, for example: innate, are acquired immediately after the baby is born, others - as she grows up. Whether the newborn’s reflexes are properly developed, as well as the functioning of the nervous system, is assessed by a pediatrician or neurologist.

Basic reflexes in infants: unconditioned and conditioned

What are “reflexes” (automatisms)? According to the Great Soviet Encyclopedia, this is a physiological reaction of the body of young children to external stimuli that manifest themselves in some actions. By how the baby’s physical abilities are expressed (for example: proboscis, sucking, grasping), one can assess its psychophysical development.

There are 2 main groups - unconditional and conditional.

Unconditioned reflexes of newborns - what are they for?

During the newborn period (the first few months), only unconditioned reflexes are clearly expressed: swallowing, corneal, tendon. These and other innate skills allow infants to adapt to a new life outside the womb as quickly as possible.

The presence of unconditioned reflexes in a child plays an important role, namely:

protect the body, help to survive and adapt to new conditions;
ensure normal activity of the nervous system and survival in the external environment for the first months after birth;
help to develop correctly and form new reflexes in older age.

Important! If the child does not show any reflex reactions to the stimulus, he must be shown to a doctor.

Weakening or absence of basic reflexes in an infant may indicate neurological disorders and negatively affect its further development.

Conditioned reflexes of a newborn - how they manifest themselves

Relying on the medical encyclopedia, conditioned reflexes of newborns are considered to be among the innate reactions of the infant body to internal and external stimuli. They are formed during the development of the child and serve as a “foundation” for adaptation to new living conditions.

Depending on the type of contact irritation, simple (sexual, food, orientation, defensive) and complex (have a pronounced emotional character) are distinguished.

Physiological reflexes of a child

It seems to parents that the newborn child is a helpless creature who does not know how to do anything. However, some physiological abilities that help the baby survive are already inherent in the mother’s womb.

So, let's study the oral reflexes that newborn babies have.

Sucking

This reflex is necessary for nutrition and develops from the first days of an infant’s life. As a rule, it lasts up to 1-1.5 years, and then gradually fades away. If you put a pacifier (pacifier) in the baby's oral cavity or give it the mother's breast, sucking movements with the lips and tongue will appear.

Swallowing

This is an innate automatism for swallowing food through the oral cavity. It is controlled by the nervous system and remains for the rest of your life.

Proboscis reflex

It appears when the child’s lips are lightly touched with the index finger. The response to the stimulus is contraction of the facial muscles of the upper and lower lips and protrusion forward in the form of a “proboscis” (tube). This reflex allows the baby to tightly grasp the nipple while attaching to the breast.

Palm-oral (Babkina)

Babkin's automatism exists until 3 months of age. It is checked by pressing a finger on the baby’s palm. The child’s reflex to this action is to turn his head towards the palm and open his mouth.

Search (Kussmaul)

The essence of the reflex is that if you gently touch the corner of the mouth (cheek) of a newborn, he will begin to turn his head to find his mother's breast. In response to the gentle manipulation, the baby opens its mouth and begins to eat milk.

Experienced mothers are already familiar with this oral reflex, so before starting breastfeeding they touch the nipple to the baby’s cheek.

Defense reflex

No less significant is the protective reflex that manifests itself during tummy rolls. Being in the “lying on his stomach” position, the baby will immediately turn his head to the side. In the first month of a baby’s life, its presence contributes to the development of respiratory function.

Spinal reflexes in a baby

Spinal unconditioned automatisms or motor reflexes appear from the first minutes of a newborn’s life. By their severity, you can determine the state of the child’s skeletal muscles. Only a specialist can give an objective assessment and dynamics of their development. Therefore, routine examinations play an important role in foster care of the baby.

According to the medical reference book, spinal reflexes include:

Superior grasp reflex (Janiszewski or Robinson)

Grasping reflexes determine the reaction of the child’s palms to external stimuli. If you touch a newborn's palm or place a rattle, he will grasp it tightly with his hand. Sometimes the compression with the fingers is so strong that the baby can be easily lifted. The atavistic Janiszewski reflex exists for a short time - from 1 to 4 months, after which it fades.

Cervical tonic reflex (asymmetric and symmetric)

The asymmetric tonic reflex in babies occurs during the newborn period. It is characterized by high excitability and increased muscle tone. In healthy children, the manifestation of tonic automatism is observed at the age of two to four months, and closer to six months it weakens or disappears altogether.

Cervical automatism is diagnosed as follows: for example, when a child turns his head to the left, he will bend his right leg and arm, and automatically straighten the two opposite ones. This body position is somewhat reminiscent of a “perfectionist”.

In children with cerebral palsy pathology, the presence of an asymmetric reflex remains for a long period of time. It is very difficult for this category of children to navigate in space (there is no focusing of their gaze) and to coordinate their movements.

The symmetrical tonic reflex manifests itself in any position of the newborn’s body. It can be strong or weak.

With strongly pronounced cervical reflexes, the child cannot take a comfortable position, it is difficult for him to curl up, sit down and even crawl. After six months, a partial delay in the development of fine motor skills is possible.

You can independently determine the degree of stretching and contraction of muscles using a simple exercise: tilt the child’s head to the chest and make several movements to straighten and flex the arms and legs. If there is strong resistance in the arms during extension and in the legs during flexion, the baby should be shown to an orthopedic doctor.

Support reflex

The support reflex manifests itself in a newborn up to 2 months of age. If the baby is placed with his feet on a hard surface, he will straighten his legs and try to stand.

Crawling (Bauer)

The spinal Bauer reflex is normal in a child up to 4 months. A baby placed on its tummy will make attempts to crawl (pushing movements from the palms of an adult) if its legs feel the slightest support.

Stepper (automatic gait)

Like crawling, this reflex fades away at 2 months of a child’s life. The manifestation of automatic gait in a newborn can be observed if his feet are placed on a table or other hard surface. While standing upright, it will begin to automatically move its left and right legs.

Galanta

The Galant reflex is manifested by running your fingers or palm (top to bottom) along the spine. In response to an external stimulus in the paravertebral region, the child arches his back. In children, this automatism persists for the first time for 2-3 months.

Plantar

If you run your palm along the sole (from the ball to the heel), the big toe will begin to straighten. At the same time, four other fingers fan out to the sides and extend. This baby’s reaction to an external stimulus is also called the Babinsky reflex.

Moro reflex in infants

You can check in 3 ways: by clapping on the changing table or other surface, at a distance of 10-15 cm from the baby; passive straightening of the legs; lowering the body down and raising it to the starting position. In response to irritation, the newborn reacts as follows: first, he moves his arms in different directions, and then returns them to the body, as if enveloping it. This automatism can be observed in children from the first days of newbornhood. As a rule, it fades away after 4 months; in premature babies it can last much longer.

Kerning

It is tested in an infant up to 2-3 months old, by bending the legs at the knee joints for resistance. The Kerning reflex is considered normal if it is impossible to straighten the legs at the knees and hip joints.

How to check for reflexes in a baby

Most young parents do not know what to do if the child’s reflexes are weakened, absent or do not fade after 5-6 months of development.

Sometimes the cause of the extinction of automatisms in children can be postpartum trauma, prematurity, contraindications to medications taken or diseases during pregnancy.

The appearance and extinction of innate reflexes can be checked by a neurologist, both during routine examinations of the baby, and independently at home.

With each breastfeeding or bottle feeding, check how the baby reacts to light touches on the cheek or upper lip - whether he opens his mouth, whether he is looking for an irritant. In this way, the mother will check the reaction to the newborn’s oral reflexes.
When playing with a 2-3 month old baby, give toys (rattles) to the hands as often as possible. It is very simple to check the degree of development of the grasping reflex: place your index finger in the palm of the baby, and you will notice how he squeezes with his hand at lightning speed. In case of depression, consult your doctor.
Observe whether the baby turns its head to the side when lying on its tummy. Weakening or absence of head movements may indicate the presence of such an unpleasant disease as cerebral palsy.
While holding the baby in an upright position, place his feet against the support, he should make active movements with his legs. This tests the support and automatic gait reflexes.

It is necessary to constantly monitor the body's responses, especially during the first months of a newborn's life. In case of any deviations, this may indicate pathological disorders in the development of the muscular, skeletal and nervous systems.

It is much easier for parents who know what reflexes should be normally, when they occur, and their meaning, to raise and raise a healthy child.

A reflex is an unconscious reaction of the body in response to stimuli coming from the environment. They are divided into unconditional and conditional.

Unconditioned reflex- This is an innate response at the level of instinct to certain stimuli.

Conditioned reflex- this is a reaction of the body that is developed under the influence of certain conditions during the life of the baby.

Unconditioned reflexes fade away as the nervous system develops. They play the greatest role in babies during the newborn period and are an essential diagnostic sign of many disorders, primarily in the nervous and muscular system of the baby.

Reflexes in newborns:

The presence of correct congenital (unconditional) signals indicates normal and complete development of the fetus and a sufficient level of maturation of its nervous system.

All deviations from the norm indicate disorders in the nervous system and require consultation with a neurologist and monitoring of the child’s condition and development.
Such disorders may be temporary and result from adaptation disorders and fetal immaturity, even in the case of full-term pregnancy.

Reflexes in newborns manifest themselves with the participation of certain muscles and the impact of stimuli on them. Normal manifestation of the reflex is possible only with normal muscle strength and tension in combination with an undisturbed chain reaction from the stimulus to the response to it.

The deeper the baby's prematurity, the weaker the reflex reactions of his muscles.

Sucking, swallowing and searching reflexes:

Sucking and swallowing reflexes appear independently of each other and are the initial signs of the maturity of the fetal nervous system. The correct formation of these reflexes ends by the 32nd week of pregnancy, which allows the newborn to be able to suck and swallow immediately after birth.

The most mature unconditioned reflex of a newborn is sucking. It can be caused by irritants that are not at all related to the feeding process. Lightly touching the baby's cheek, he immediately turns his head in your direction, protrudes his lips and begins to look for a pacifier or breast.

The search reflex indicates normal tension and strength of the neck muscles. But very quickly it disappears.

The sucking reflex is one of the most important unconditioned reflexes of newborns.

Moro reflex:

The Moro (spinal) reflex begins to appear in all full-term newborns. It is typical for babies under 1 month of age.

This reaction occurs in two stages:

1. Having hit the surface where the baby lies, at a distance of 15 cm from the head, or suddenly straightening the legs, he will spread his arms to the sides, while straightening his fists;

2. Returning the hands to the starting position after a few seconds.

The first phase of this reflex is caused by the child’s fear, the second by the desire to find protection from the mother.
This type of reflex manifests itself most strongly in the first 2 weeks of the baby’s life. Most often, its manifestation can be noticed during swaddling, changing clothes, and bathing.

This reflex in a child is a reaction to fear. Therefore, it is necessary to approach the baby very smoothly and carefully.
The absence or weak severity of such a reaction in newborns indicates very weak muscle tone or other disorders in the nervous system. It is also important to consider and control the symmetry of the manifestation of the Moro reaction.

The Moro reflex fades by the age of one month

Grasping reflex:

It occurs in two stages:

1. When you press your finger on the baby’s palm or foot, he will squeeze his fingers;

2. The baby wraps his hand around the adult’s fingers so tightly that he can be lifted by the arms.

This reflex can last up to 4 months. In return, he should receive voluntary and conscious grasping of objects with children's hands.

The grasp reflex exists until 4 months of age.

Postural reflexes:

These reflexes last throughout the entire period of exposure to the stimulus. Observing these reflexes allows the doctor to assess whether the baby's motor development is proceeding normally. This category of reactions includes the following:

1. Support reflex;

2. Automatic walking;

3. Crawling reflex.

Crawl:

You need to lay the baby on his tummy and place your palm on his feet. The child will instinctively push away from it, and the extensor muscles of the lower limbs will alternately contract. The baby will begin to crawl.

Reflex crawling (Bauer reflex)

Support and automatic walking reflex:

It is necessary to take the baby under the armpits and hold the head. The feet should be in full contact with the surface. A healthy child will strongly straighten his legs and rest his foot on the surface. When this happens, tilt the child slightly forward - he will take several small steps. In some cases, during this “walking”, children cross their legs in the area of the lower leg and foot. This reaction is called automatic walking. It is important to evaluate the symmetry of such leg crossings and their strength.

Automatic walking reflexes

Neck reflex:

Lay the baby on his back. Passively turn his head to the side. With this rotation, the limbs will automatically extend in one direction and bend in the other. Otherwise, such a reflex is called asymmetric cervical-tonic. The same reflex can be evoked by placing the child on his back, placing the palms of an adult's hands under the shoulder blades and bringing the head to the chest. When you bend your head, the arms will bend and the legs will straighten. When the head returns, the reactions of the legs will be the opposite.
This type of reflex does not appear in all newborns. It is seen most often in older infants.

In newborns, this reflex is often manifested by turning the body towards the head.

Galant reflex:

This reaction has been formed since the 27th week of pregnancy. The baby must be laid on his back and alternately run a finger from the tailbone to the neck on both sides of the spine. In response to this, the baby bends sideways in an arc that is open to the side of the stimulus. The severity of this reflex indicates the state of tone and work of the back muscles and their symmetry.

Galant reflex

Paper's ocular reflex:

This reaction allows you to determine at a very early age whether your baby can see. It is necessary to direct the light of a small flashlight towards the child’s eyes. In response to this, the baby’s pupils will narrow, he will close his eyelids and throw his head back. If you bring your hand to the baby’s eyes at this time, no reaction will follow. This type of unconditioned reflex disappears very quickly as the organ of vision gets used to the light.

Doll's eyes reflex:

Sometimes this reflex is called “running eyes”. Its essence is that when the baby's head turns sideways, the eyeballs move in the opposite direction. This reflex almost completely disappears before the tenth day of life, since the optic nerves develop and mature very quickly.

Kehrer reflex:

Refers to auditory reflexes. At a sharp sound, the child closes his eyelids tightly. If such a reaction is absent, then never consider this phenomenon as deafness in the baby. It is recommended to repeat such checks several times. Only after a long absence of reaction is it necessary to more carefully monitor the child’s condition.

Cross extension reflex:

It is necessary to lay the baby on his back and gently straighten his leg at the knee. At the same time, run your finger along the sole. As a result of this impact, the child’s second leg will first bend at the knee, then straighten and touch the irritant with the foot - the adult’s finger.

This reflex manifests itself most strongly from the 34th to 36th week of pregnancy, but in some cases it can also be observed in premature babies from the 28th week of pregnancy.

It is important to check such a reflex on both sides for symmetry and compliance with the sequence of the reaction. Asymmetry, as a rule, indicates a disorder in the nervous system and musculoskeletal system (hip joint defects).

Perez reflex:

Indicates normal development of the neck muscles and their tone. It is determined this way: lift the baby to a vertical position and pay attention to the angle between the head and back. The smaller it is, the lower the tone of the neck muscles in a newborn. This reflex is especially noticeable in premature babies when their head tilts back strongly.
If a similar picture is observed in full-term babies, then this may indicate diseases that lead to weakness of the neck muscles. This condition is also often observed in children after taking painkillers or due to postpartum acidosis.

Increased tone of the neck muscles can be easily determined this way: lift the baby vertically by the arms. If he easily holds his head in this position like a 2-3 month old child, this is a signal of the presence of a certain pathology, which requires monitoring of the baby. The most common cause of this condition is hypoxia. From the first days of life, such children are prescribed a special set of exercises and a relaxing massage.

Plantar reflexes:

Such reflexes are physiological only in newborns and infants. In older children they indicate the presence of pathology.

Run your finger along the outer edge of the foot in the direction from the heel to the big toe. In this case, all fingers should bend towards the sole, except the thumb - it leans back. Very often the child withdraws his leg when exposed to a stimulus. This reaction is called the Babinski reflex.

Another version of this reflex: apply gentle and jerky blows to your toes from the side of the sole. In response to this, the fingers will bend. This reaction is otherwise called the Rossolimo reflex.

Both types of plantar reflexes have no diagnostic value in children of the first year of life.

Proboscis reflex:

It consists of protruding the child’s lips when an adult’s finger touches them. This reaction is explained by the contraction of the baby's mouth muscle - the sucking muscle. This reflex persists for 2-3 months, then disappears. If this reflex persists for up to six months, then you need to inform your pediatrician about it.

Regular checking of reflexes and monitoring the dynamics of their development are of important diagnostic importance. Often, deviations in reflexes are the earliest signs of diseases of the central nervous system.

... one of the most reliable among pathological reflexes.

The Babinski sign or reflex is considered one of the earliest and most subtle manifestations of upper (central) motor neuron syndrome and is one of the most frequently tested pathological signs in neurological practice. Named after the French neurologist of Polish origin Joseph Babinski, who introduced this pathological phenomenon in 1896, and in 1898 published a detailed description of this symptom (despite the fact that publications about this pathological sign were made by Gall in 1841 and Remak in 1893, the symptom is named after Babinsky, since it was he who first gave its detailed pathophysiological interpretation and connection with damage to the pyramidal tracts).

The Babinski reflex is a cutaneous reflex that consists of an isolated extension movement (dorsiflexion) of the big toe or the simultaneous spreading of the other toes ("fan sign") upon stroke stimulation of the outer edge of the sole (which causes contraction of the muscle that extends the big toe). Normally, such stimulation causes a plantar reflex in the form of involuntary flexion of the thumb, and often all five fingers. The implementation must be easy and not cause pain, otherwise pain receptors are activated, which causes the foot to be withdrawn, and this phenomenon will be observed as one of the components of the Bekhterev-Marie-Foy protective reflex.

The pathophysiological basis for the formation of Babinski's symptom is a pronounced slowdown in the conduction of excitation along the motor tracts and disruption of excitation processes at the level of stem structures and segmental formations of the spinal cord, which is caused by a deficiency of the activating influences of the upper motor neuron system. At the same time, a deficiency of descending corticospinal and reticulospinal activating influences on interneurons of the spinal cord (an increase in the time of central motor conduction during transcranial magnetic stimulation and an increase in latency and an increase in the threshold of a long-latency reflex response in the study of evoked abdominal reflexes) is observed to a greater extent with isolated damage to the spinal cord. This may be explained by the topically compact arrangement of descending fast-conducting fibers at the spinal level and the involvement of a large number of these motor pathways in the presence of a pathological focus in the thoracic spinal cord. Interest at the cerebral level leads to a greater extent to a decrease in the excitability of interneurons and motor neurons at the cortical level (increased thresholds of motor responses during transcranial magnetic stimulation), which is likely due to the direct impact of the local pathological process in the brain on the cortical mechanisms of excitation or facilitation.

Thus, the presence of Babinski's symptom (reflex) indicates damage to the central motor neuron system, when supraspinal control is disrupted and the function of inhibitory neurons is disrupted, which leads to an imbalance of antagonistic spinal centers and the appearance of pathological extensor foot signs. Thus, with the Babinski reflex, the excitability of the extensor motor neurons increases, followed by reciprocal inhibition of the flexor center (normally, the a-cells of the flexors have a lower excitation threshold than the extensors).

In newborns and children under two years of age, this phenomenon is not a sign of pathology, which is associated with insufficient development of the cerebral cortex and, accordingly, the central motor neuron system at this age. It is interesting that even 400 years before the discovery of the foot reflex, world-famous masters of Renaissance painting (Raphael, Leonardo Da Vinci, Gentilo de Fabriano, Van der Weyden, Jacob von Kempter, etc.) unconsciously depicted it in the infant Christ on their canvases.

It should be noted that for the clinician, of undoubted interest is not only the fact of detection of a pathological phenomenon, but also a certain diagnostic significance of the Babinski reflex with damage to the upper motor neuron at different levels. So a bright, fast and often fan-shaped reflex response with possible prolonged extension of the thumb and strong tonic tension of its extensor muscle and tendon in combination with proximal paresis, pelvic disorders and the absence of superficial abdominal reflexes “addresses” the neurologist to the pathological focus at the level of the spinal cord, and a slow tonic reaction when inducing the Babinski reflex in combination with predominantly distal paresis, hyperreflexia and synkinesis - to the cerebral level of damage to the upper motor neuron. Consequently, the combination of such components as a certain “motor pattern” when inducing the Babinski reflex, the distribution of paresis and the identified symptoms in patients with damage to the upper motor neuron can be useful for a differentiated approach to diagnosing the pathological focus.