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Retained Neonatal Reflexes (RNR)

What are Retained Neonatal or Primitive Reflexes?

What are reflexes in general?

Reflexes put simply are “predicable and unconscious motor reactions that occur in response to stimuli which are mostly protective in nature”. Most of us can relate to putting our hand on something hot and finding that within a split second our hand withdraws. This is a useful and safe reflex we have to avoid burning.

In general, there are many types of reflexes, some and not all which are controlled. From the time of conception, the nervous system begins developing primitive reflexes to assist the child during its time in the womb, at birth and up until they reach one year of age. The purpose is to ensure survival as the nervous system gains maturity and control.

What is normal is that during development, these reflexes will cease to have an influence on the body’s response to previous stimulus or triggers. This process is called “integration”.

In certain situations, the body fails to integrate these “Neonatal Reflexes”, which then leads to neurological confusion and overload. The causes may be due to environmental, emotional, toxic, genetic and nutritional triggers which leads to this neurological glitch.

The process of correction is explained in the “Elimination of Retained Neonatal Reflexes” – learn more.

Important Neurological Developmental Reflexes

Fear Paralysis Reflex (FPR)

This reflex is one which is generally present only within the womb. It involves the opposite of “fight or flight” and can be seen even as early as soon after conception.

Retention symptoms present:

  • Low tolerance to stress
  • Dislike of change or surprise
  • Fatigue
  • Fear of social embarrassment
  • Temper tantrums
  • Hypersensitive to touch, sound, change in visual field

Moro Reflex

The Moro Reflex is present at 9-12 weeks after conception and is normally fully developed at birth. It is the baby’s “danger signal”. The baby is ill-equipped to determine whether a signal is threatening or not, and will undergo instantaneous arousal. This may be due to sudden unexpected occurrences such as change in head position, noise, sudden movement or change of light or even pain or temperature change. This activates the stress response system of “fight or flight”.

If the Moro Reflex is present after 6 months of age, the following signs may be present:

  • Reaction to foods
  • Poor regulation of blood sugar
  • Fatigues easily, if adrenalin stores have been depleted
  • Anxiety
  • Mood swings, tense muscles and tone, inability to accept criticism
  • Hyperactivity
  • Low self-esteem and insecurity

Juvenile Suck Reflex

This is active together with the “Rooting Reflex” which allows the baby to feed and suck. If this reflex is not sufficiently integrated, the baby will continue to thrust their tongue forward, pushing on the upper jaw and causing an overbite. This by nature affects the jaw and bite position.

This may affect:

  • Chewing
  • Difficulties with solid foods
  • Dribbling

Rooting Reflex

Light touch around the mouth and cheek causes the baby’s head to turn to the stimulation, the mouth to open and tongue extended in preparation for feeding. It is present from birth usually to 4 months.

Some of the signs present if retained are:

  • Fussy eating and possibly difficulty swallowing
  • Thumb-sucking
  • Dribbling
  • Manual dexterity due to the Babkin Response
  • Speech and articulation problems
  • Hormonal imbalances

Palmer Reflex

This reflex is present from 18 weeks in utero, together with the Plantar Reflex, and is strongly active during the first 12 weeks of life. It should be transformed by 4-6 months to a pincer grip. This is commonly seen as the “grip response” from stimulation of the palm. There is also a direct link with the “Babkin Response” which is associated with feeding (neck flexed, mouth open and eyes closed). Andre Thomas (1954) found that by stimulating the “Palmer/Grasp Reflex”, the “Moro Reflex” may be inhibited. Placing an object in the hand inhibited arm movement.

Retention following 3 months of age include:

  • Problems with fine muscle co-ordination
  • Difficulty with speech and articulation
  • Difficulty with manual dexterity
  • Messy handwriting and jumbling letters

Plantar Reflex

The Plantar Reflex, similar to the Palmer Reflex, is used for grasp and emerges in utero being fully present at birth. It is normally integrated by 6-9 months of age. It is elicited by stroking the baby’s foot from the heel up to towards the ball of the foot causing the toes to spread and foot to turn slightly inward. It has involvement with balance, walking and co-ordination, especially if this is retained.

If the Plantar Reflex is retained, there may be issues with:

  • Balance and walking
  • Running
  • Plantar strains and shin splints
  • Recurrent ankle injuries
  • For adults, this may play a role with chronic low back pain and dysfunction

Palmomental and Plantomental Reflexes (PMR)

This is a primitive reflex which consists of movement of the mouth muscles when the thumb or big toe is stimulated. This reflex appears at 9 weeks in utero and is usually integrated at 3 months of age. The Plantomental Reflex is related to the “Stepping Reflex” which aids in crawling and locomotion.

Common signs of a Retained Reflex include:

  • Movement of the tongue and mouth when writing
  • Difficulty eating with a knife and fork
  • Difficulty with facial expression
  • Tension in the jaw and neck when concentrating
  • History of biting

Often an improvement of speech, hand and facial mobility is noted when this reflex is integrated.

Tonic Labyrithinine Reflex (TLR)

This reflex is linked with the “Moro Reflex”. The TLR begins around 12 weeks in utero. It is mostly involved with balance perception and body in space awareness. It aids in maintaining fetal position within the womb and also assists the baby during the birthing process. It allows the infant with a primitive method of responding to gravity. There are two parts to this reflex – forwards and backwards. Head flexion or down will cause the limbs to fold and is mostly integrated by 4 months. Head extension or backwards will lead to extension or straightening of the limbs and is integrated gradually from 6 weeks up to 3 years.

Retention of this reflex will produce:

  • Stooped posture
  • Tendency for children to walk on their toes
  • Fatigue while writing or sitting to study at a desk
  • Difficulty judging distance, speed, depth and space
  • Motion sickness
  • Poor balance
  • Can also be associated with auditory processing disorders

Sagittal Labyrinthine Reflex (SLR)

The SLR is known to be involved with poor concentration and posture whilst sitting. It is associated with TLR and STNR Reflexes and plays a role in the integration of these reflexes.

This reflex is commonly seen with the child who prefers to slump or sit in what appears to be a lazy position. They have their chair pushed back, leaning forward and are propped by the hands resting on the table.

Retention of this reflex can lead to:

  • Tiredness at the end of school
  • Poor concentration in the classroom
  • Poor posture
  • Prefer reading or doing homework laying on stomach

Asymmetrical Tonic Neck Reflex (ATNR)

This reflex begins 18 weeks after conception and should be present at birth. Rotation of the infant’s head to one side will lead to extension/straightening of the arm on that side and bending of the arm on the opposite side. This aids in development of muscle tone and during the birthing process, together with the “Spinal Galant Reflex”. It also assists the newborn free passage of air when laying on their tummy. It also aids in development of hand-eye co-ordination, increasing extensor tone of the body.

Retention of this reflex will effect:

  • Affects normal crawl pattern
  • Poor balance when walking, as arms will want to extend on head rotation
  • Hand-eye co-ordination
  • Inability to cross over the midline of the body
  • Problems with written performance (expression of ideas on paper) and ease with oral expression
  • Visual tracking problems, especially at the midline, which can affect reading
  • Ambidexterity (inability to determine a dominant hand past the correct age)
  • Kicking and catching can be difficult

A retained ATNR in an adult can also lead to shoulder, elbow and wrist problems.

Spinal Galant Reflex

The Spinal Galant Reflex begins about 18 weeks after conception and is usually integrated by age one. This reflex plays an important role during the birthing process, by activating the ATNR Reflex. Stimulation of the side of the trunk causes the trunk to flex to the side, hip is flexed and the knee extended. The head also turns to the side of trunk flexion. If both sides are stimulated at once, the “Pulgar Marx Reflex” is activated. This leads to voidance of bowel and bladder, few seconds of rigidity (hypertonia), apnoea and cyanosis.

Common retention symptoms include:

  • Children who have “ants in their pants”
  • Attention and concentration problems
  • Bladder problems (predominantly bedwetting)
  • Postural problems which may lead to scoliosis due to the muscular contraction on one side of the spine

Symmetrical Tonic Neck Reflex (STNR)

This reflex tends to emerge after birth at around 6-9 months and are inhibited by 9-11 months. It should be integrated by the age of one, getting the infant ready for crawling. Capute (1986) suggested that it is not a separate reflex, but a stage of the TLR. There are two parts to this reflex; flexion of the head causes the arms to flex and legs to extend (this prepares the eyes to move to near distance vision), whereas head extension causes the arms to extend and legs to flex (this prepares the eyes for far distance vision).

Common retention symptoms include:

  • Injury-prone and clumsy children
  • Difficult to co-ordinate upper and lower body
  • Poor hand-eye co-ordination
  • Slouched posture
  • Eye tracking problems
  • Poor sensory integration

Segmental Rolling Reflex (SRR)

The Segmental Rolling Reflex is a postural reflex which begins around 6-10 months after birth and remains for life.
It allows an infant to be able to move from their tummy to their back and vice versa. This is important in preparation for sitting, kneeling on all fours and eventually standing. This gives the child the ability to move from lying down to standing and eventually more active movements such as running and jumping.


The Chiropractic Office of Dr. Bob Apol
Birmingham (205) 251-1251