Newborn reflexes are a vital part of early assessments that every nurse, registered nurse, and RN nurse should be comfortable evaluating. These primitive reflexes help determine if a newborn’s nervous system is developing properly. They’re also a common topic on the NCLEX and a must-have in any nursing bundle for pediatric or maternity review.
🩺 Why Are Newborn Reflexes Important?
Newborn reflexes are automatic responses to certain stimuli. They show the brain and spinal cord are working correctly. If absent or abnormal, they may signal neurologic or developmental problems that require quick intervention from the nurse.
🟡 Normal Newborn Reflexes
Here’s a nursing breakdown of the most common normal newborn reflexes:
✅ Rooting Reflex
- Present at birth
- When you stroke the cheek, the baby turns toward the stimulus
- Helps with breastfeeding
✅ Sucking Reflex
- Present at birth
- Elicited by placing a finger or nipple in the infant’s mouth
- Essential for feeding
✅ Moro Reflex (Startle Reflex)
- Present at birth, fades by 4–6 months
- Loud noise or sudden movement causes the baby to extend arms and then pull them back in
✅ Palmar Grasp Reflex
- Strong grip around a finger placed in the palm
- Disappears by 3–4 months
✅ Babinski Reflex
- Stroking the sole of the foot causes toes to fan outward
- Normal up to 1 year
✅ Tonic Neck Reflex (Fencer’s Reflex)
- When the head turns to one side, the arm on that side stretches out while the other arm bends
- Disappears by 4–6 months
✅ Stepping Reflex
- Holding the baby upright with feet touching a surface triggers stepping movements
- Disappears around 2 months
⚠️ Abnormal Newborn Reflexes
Every RN nurse and registered nurse needs to know what’s not normal:
❌ Asymmetrical reflexes (could mean nerve injury or paralysis)
❌ Reflexes that persist beyond normal timeframe
❌ Absent reflexes at birth
❌ Extremely weak or exaggerated responses
Example:
- Persistent Moro after 6 months may signal neurologic dysfunction.
- Absent Babinski could indicate spinal cord injury.
These red flags should be reported immediately and documented thoroughly, which is an essential NCLEX practice standard.
🩹 Nursing Role in Reflex Assessment
As a nurse caring for newborns, your job includes:
✅ Performing a thorough head-to-toe assessment including reflex testing
✅ Explaining reflex findings to parents in simple terms
✅ Documenting the presence, strength, and symmetry of each reflex
✅ Notifying the provider of any abnormal or absent findings
Tip for your nursing bundle: Add a reflex checklist to your newborn assessment notes for quick NCLEX review!
👩⚕️ Patient and Family Education
Registered nurses should reassure families about normal reflexes. Explain that these movements are protective and fade as the baby’s nervous system matures. Also, educate parents to report if their baby seems to stop responding normally to touch or sounds.
📝 NCLEX Tips
👉 Rooting and sucking = feeding
👉 Moro = startle
👉 Babinski = normal until 1 year
👉 Asymmetry = always a concern
👉 Disappearing on schedule is expected
Keep these in your nursing bundle to ace maternal-newborn questions on the NCLEX.
💡 Cheat Sheet for Nursing Students
✅ Know normal reflex patterns and timeframes
✅ Watch for asymmetry
✅ Document thoroughly
✅ Notify quickly about absent or persistent reflexes