Updated: Nov 2, 2021
Primitive Reflexes and Developmental Milestones
Dr. Tara Sutton
Prenatal and Pediatric Chiropractor
Dr. Tara Sutton is the founder and director of Advanced Vitality Family Health and Wellness in Brampton Ontario. Dr. Tara has advanced training and certifications through the International Chiropractic Pediatric Association in prenatal and pediatric chiropractic care and has studied with some of the most respected experts in the field. Dr. Tara is committed to the effort of sharing knowledge and educating as many parents as possible about how to give their children the best chance at success with clarity and context. Her discussion below emphasizes Developmental Milestones and Delays and how to ensure your child's developmental milestones are being achieved appropriately. Today's information comes from the extensive work by Dr. Robert Mellilo creating the Brain Balance Achievement Centers and his book entitled Disconnect Kids: The Groundbreaking Brain Balance Program for Children with Autism, ADHD, Dyslexia, and Other Neurological Disorders.
Developmental milestones represent the brains growth and ability to accomplish higher functioning tasks. Within the first year, each child must learn to hold their head up, roll over, sit, crawl and eventually walk in the classic human upright bipedal pattern, which is arguably the most complex movement pattern in the animal kingdom.
The Brain is like a computer and the developmental milestones represent the extremely specific order and sequence of the brain booting up. When this doesn’t happen appropriately, we need to consider why?
Here are some common reason's during pregnancy that may lead to developmental delays:
Breech and transverse in-utero positioning
Difficult, long or very fast/short labour and delivery
KEY: the biggest input for brain growth in a baby is MOVEMENT!
MOVEMENT GROWS THE BRAIN!
The brain has built in default settings that we call primitive reflexes. Primitive reflexes are designed to force movement, brain growth and milestone achievement.
Primitive Reflexes require no thought, they are completely instinctual. They play a necessary part in the growth of the fetus, as well as allowing the fetus to move into a head down position and ultimately navigate their way through the vaginal canal for birth.
In a newborn, they represent the basic necessities for survival (like rooting, sucking and grasping). Through the first year these primitive reflexes drive the movements necessary to grow the brain and achieve what we know as developmental milestones. Achieving a milestone, means that your baby’s brain has grown enough and they now have appropriate brain control and muscle control. Therefore, the primitive reflex should diminish and eventually go away completely.
Most primitive reflexes are gone and replaced by postural reflexes between the age of 4-6 months. Sometimes these reflexes are weak and the baby is unable to move enough to grow the brain and achieve the next milestone.
RETAINED PRIMITIVE REFLEXES
Retained primitive reflexes are reflexes that haven’t disappeared when they should have. Retained primitive reflexes have been seen in babies that were in breech or transverse positions; children with behavioural disorders, spectrum disorders, and even children and adults that have sustained traumatic brain injuries such as a concussion.
As a pediatric chiropractor, I asses and monitor the presence of these reflexes and support parents with tips and exercises to help their baby grow and development appropriately. By using the simple exercises below, caregivers and their babies can make impressive progress.
FEEDING AND NURSING DIFFICULTIES
When this happens the ROOTING REFLEX and/or SUCKING REFLEX is often underdeveloped or weak. Especially if your baby was a preemie. By stimulating this reflex you can help your baby “turn it on” or strengthen it which can ultimately make breast feeding easier and more comfortable.
Pacifiers are a great way to strengthen these reflexes. If you have a babe that doesn’t like the pacifier and your having difficulties with breast feeding, you might want to try these exercises.
Remember the gag! Babies gag reflex is very shallow and as they mature it moves backwards toward the throat so don’t be worried if your baby gags. Just back off and try again slowly.
1. Stimulating the Rooting Reflex
Use your finger, a paint brush or a gentle cloth to stroke your baby’s cheek toward the corner of their mouth
Look for your baby to turn their head to that side and open their mouth
If you don’t see this happen, repeat the stroke 5 times in a row, on each cheek
2. Stimulating the Sucking Reflex
Use a pacifier, bottle nipple or clean pinky finger to gently press the roof the mouth
If your baby gags or tries to push your finger out with their tongue, use gentle stroking motions from the back to the front of the roof of the mouth using your fingers to stimulate the suck reflex
The suck reflex will create a strong seal around your finger and move it quite far to the back of your baby’s throat.
If the reflex is weak, your baby may take 2-3 sucks and then get tired and take a break. If this happens, re-stimulate the suck reflex by stroking the roof of the mouth.
Look for shallow quick sucks to start that turn into long deep sucks (this represents the let down phase of breast feeding). Often, babies with a weak suck reflex aren’t able to stimulate the let down during a feed.
Repeat this exercise for 3-5minutes, 5x/day for about 3 weeks. Do it when your baby is awake, happy and has energy.
The sucking reflex is also a natural soothing mechanism. It stimulates the cranial movements that encourage cerebral spinal fluid (CSF) flow. The CSF is responsible for cleaning and protecting the brain and spinal cord. With as much growth that is happening in that brain, your baby needs to be able to clean any metabolites out efficiently – hence their suck reflex and pacifiers.
Appropriate brain development supports rolling over between 3-4 months of age. If your baby is not rolling over around this time, you can check the ASYMMETRICAL TONIC NECK REFLEX (ATNR). This reflex allows the corkscrewing motion to navigate through the birth canal and eventually, rolling over.
Lie your baby on his/her back. You should be positioned at their head.
Gently turn their head to one side.
You should see the arm and leg on the side that you turned toward start to straighten out and the opposite arm and leg bend. You may also notice this position when your baby is sleeping if they aren’t swaddled.
If you don’t see this, hold this position for 10-15 seconds and return to the starting position. Repeat on the other side and do this 3-5x, 5x/day
Crawling is a contentious milestone. Many people will tell you it’s not necessary or not really a motor milestone. And ultimately, if the goal is to walk, it definitely isn’t. However the cross crawl movement develops the pathways and connections between the right and the left brain in a structure called the Corpus Callusum. This leads to improved physical coordination but also has direct effect on things like language, reading and focus later on in life.
Your baby should crawl on their hand and knees in a criss-crossed pattern by the age of 6-8 months. Other forms of moving like bum scooting unfortunately do not produce the same brain benefits.
To help your baby with crawling you can do 3 exercises:
1. Cross Crawl
Manually move your baby’s opposite arm and leg together, 10x during each diaper change.
Hold your baby’s hand and the opposite knee.
Start in a stretched-out position and then bring them together above the tummy.
You can start this is early as you want after birth.
2. Symmetrical Tonic Neck Reflex (STNR) Remediation
This is the “head up, bum down” and vice versa movement that you may notice your child do during tummy time.
Stimulate this reflex by stroking your baby's back with 2 fingers on either side of their spine from the bottom up. You should use moderate pressure.
Your baby should lift their head up (extend the spine)
If you baby isn’t crawling yet and this reflex is still present, repeat the stroke until she/he no longer lifts the head in response to your finger stroke. (5-10 reps, 5x/day)
NB: If this reflex may be retained in older children, you may see:
Inability to sit still
"W" sitting (knees knocked in and feet splayed out to the sides when sitting on the ground)
By integrating this reflex in an older child, you can help them achieve a better overall posture and brain balance.
3. Galant Reflex Remediation
This may be present or both or only one side.
Gently stroke your stroke finger down one side of your baby’s spine. Looking for them to bend in a c-shape to that side.
If our baby isn’t crawling still, and you see this bend or twitch toward the side, repeat that stroke until your child no longer bends to the side. (5-10 reps, 5x/day)
Movement is KEY for brain development
AVOID postures, toys and devices that are developmentally advanced for your child
Give your child LOTS of safe space to move and develop on their own.
Avoid the temptation to do things for your child.
Practice tummy time using the Tummy Time! Method every day.
Check Out the Full Workshop Video
If you need more information or if your baby hates tummy time, contact us and we can provide you with more information!