Healthynewbornchildis bornasfullan organism thatcanlive up to lifeat this stage but hisorgans andsystemsyetimmature andnot "trained"tointeraction withexternalthe world. From the first minutes of life begins their "learning" and differentiation. The nervous system is no exception and goes through the most subtle evolutionary process.
In the neonatal period, the state of the nervous system can be assessed by unconditioned reflexes, the so-calledcongenital automatismwhich are characterized by a specific response of the newborn to the irritation of the reflex zones. By their presence, liveliness or depression, one can judge the state of the nervous system of a baby. More specifically, when assessing, the physician draws attention to their presence, symmetry, equal strength with repeated summoning, quick response, and the duration of the reflex.
In premature babies, as a rule, most congenital automatisms are absent.This suggests immaturity of the brain and inability to respond to typical stimuli.
For example, oral reflexes appear most early and are the most resistant. It has been proven that absolutely all peripheral receptors are functioning in the premature, only the nervous system cannot give an adequate response during this period. Premature babies develop all differently, and many catch up with their full-term peers very quickly. Therefore, there is no direct relationship between the gestational age and the recovery time of all the functions of the child’s body.
Now let's take a closer look at the types of innate reflexes themselves.
In neonatology, to evaluate the state of the nervous system, we study such congenital automatisms as search, proboscis, sucking, palmar-oral, prehensile, Babinski reflex, supports and automundity, crawling. apgarwalking
Search- If you make a tangential movement on the skin around the mouth, the child will produce movements, similar to when searching for a nipple. Unstable appearance of this reflex is noted at 32 weeks, at 34 - persistent manifestation, and it fades away by about 3-4 months.
Proboscis- the child tries to stretch the lips with a light touch or tapping. Its extinction occurs by the 4th month.
Sucking- If you introduce a pacifier to the child in the mouth - he begins to carry out sucking movements. The reflex is called up with 34 weeks. gestation in the future goes into a lifelong conscious reflex.
Palatine oral(Babkina) - by holding light pressure with the thumbs on the middle of the child’s palm, we get a response in the form of opening the mouth. Called steadfastly from the moment of birth (in full-term) and extinguished by 4-5 months.
Prehensile- putting the fingers in the palm of a newborn, in response we get the closure of the brushes. And if at the same time the head of the child can also be raised from the support - this reflex is referred to as Robinson. Initial manifestations appear at the age of 32 weeks, and at the age of 2-3 months it is already conditional prehensile and lifelong.
Babinski Reflex- stroke irritation of the sole leads to extension and fan-shaped divergence of the fingers. Extinguished by the year.
Reflexes support and automatic walkingarise in newborns raised under the arms, when they are lowered until the feet touch the support. The support reflex consists of two phases: bending the legs when the soles touch the surface and then straighten them with the support on the foot. Large children and deeply premature may be absent. Manifested from 3-4 weeks of age and disappears in 3-4-5 months.
Crawling(according to Bauer) - an adult's palm is applied to the feet of a child lying on the tummy and they receive a reflex repulsion.
Evaluation of the reflexes of the newborn after birth is carried out at least three times. If during the three reflex studies he gave a positive result, even if with each test he weakens a little, the reflex is considered normal.
If the reflex is initially reduced and with each subsequent study dies away - it is considered reduced.
If the amplitude of the reflex is increased (its severity) and, possibly, increases with subsequent studies, it is considered increased.
A change in the activity of the reflexes of newborns may be due to various pathological states of the nervous system:
Of course, the study of the state of the nervous system of a newborn child should always be approached comprehensively and abstractly, since almost half of the children have transient physiological changes. For example, on the first day they may be in the form of transient strabismus, episodically floating movements of the eyeballs, a decrease in the response to the examination, unstable tremor (trembling), a slight increase in muscle tone, a decrease in the step reflex and support.