Newborn reflexes and conditions

• The Apgar score measures an infant's condition at 1 and 5 minutes after birth.
• Heart rate, respiration, color, muscle tone, and response to stimuli are scored from 0-10.
• The acronym Apgar: "A" is for appearance (color), "P" is for pulse (heart rate), "G" is for grimace (response to stimuli), the second "A" is for activity (muscle tone) and the "R" is for respiration (respiration rate).
• Immediate intervention is required to babies with low Apgar scores.
• Umbilical cord blood analysis investigates acid-base status.
• Arterial blood gas measurements and maternal-fetal blood compatibility are carried out through umbilical cord blood analysis .
• Life-threatening disorders require immediate treatment like acidosis and asphyxia.
• Acidosis means an abnormal accumulation of acid indicated by a pH less than 7.20.
• Acidosis is caused by increased hydrogen ion concentration.
• Asphyxia is a condition of oxygen deficiency, also called hypoxia.
• Hypercapnia is the condition of increased carbon dioxide in the blood.
• The Coombs test detects Rh antibodies in maternal blood.
• The Coombs test helps diagnose hemolytic disease in newborns.
• The Coombs test determines blood type compatibility.
• Phenylketonuria (PKU) is an inborn error of metabolism.
• An enzyme deficiency prevents the change of phenylalanine into tyrosine.
• Untreated PKU can cause brain damage and mental development delay.
• Newborns are tested for PKU because symptoms may not appear until four months old.
• Treatment for PKU begins at birth with a protein-restrictive diet
• Many reflex patterns mediated by the brain stem and spinal cord are present at birth.
• Absence or persistence of reflexes may indicate central nervous system damage.

Reflexes

• The Moro reflex, also called the startle reflex, involves extremity extension/abduction and finger fanning followed by flexion/adduction.
• The Moro reflex typically disappears around three months.
• The Dance reflex, also called the stepping reflex, simulates walking when held erect and inclined forward.
• The Dance reflex disappears between three to six weeks old.
• The Sucking reflex occurs when anything touches the lips.
• The Sucking reflex disappears between four and seven months old.
• The Rooting reflex involves head turning and sucking when the cheek is touched.
• The Rooting reflex disappears between three and seven months old.
• The Palmar Grasp reflex is finger flexion caused by palm stimulation.
• The Palmar Grasp reflex disappears by six months old.
• The Plantar Grasp reflex involves toe flexion when the sole is stroked.
• The Plantar Grasp reflex disappears by six weeks old.
• The Crossed Extension reflex, present in the first two months, involves adduction and extension of one leg when the other is stimulated.
• The Crawling reflex, also called the symmetric tonic neck reflex, involves assuming a crawl position by extending arms and bending knees when the head and neck are extended.
• The Crawling reflex disappears with neurologic/muscular development.
• The Tonic Neck reflex, also called the asymmetric tonic neck reflex, appears at two months and disappears at five months.
• The Tonic Neck reflex involves extending the arm/leg on the side where the head turns and flexing the opposite side.
• The Neck Righting reflex appears between four and six months and should no longer be seen at 24 months.
• The Neck Righting reflex involves shoulders and trunk rotation in the direction of head turning, enabling rolling over from the supine to the prone position.
• The Landau reflex appears at three months and disappears at 24 months.
• The Landau reflex involves maintaining a convex arc with the head raised and legs flexed when held prone.
• The reflex is poor in those with floppy infant syndrome.
• The reflex is exaggerated in hypertonic and opisthotonic infants.
• The Parachute reaction or reflex appears at nine months and persists for life.
• The Parachute reflex involves extending arms, hands, and fingers in a protective movement when dropped.

Glossary of Terms

• Appropriate for Gestational Age (AGA): Infant with normal intrauterine growth at birth.
• Fetal Death: Death of the fetus after 20 weeks of gestation and before delivery.
• Intrauterine Growth Retardation/Restriction (IUGR): Infant with slower than expected intrauterine growth.
• Low Birth Weight (LBW): Infant with a birth weight less than 2500 grams.
• Large for Gestational Age (LGA): Infant with a birth weight above the 90th percentile.
• Neonatal Death: Death in the first 28 days of life.
• Perinatal Mortality: Number of fetal and early neonatal deaths per 1,000 total births.
• Small for Date (SFD): Infant with slowed intrauterine growth delivered at term or post-term.

Conditions and Diseases

• Prematurity: Birth before 37 weeks of gestation due to immature organ development.
• Treatment: supportive care such as NICU, ventilation, and temperature regulation.
• Infant Respiratory Distress Syndrome (IRDS): Insufficient surfactant causes difficulty breathing.
• Premature lungs lack surfactant causing IRDS.
• Treatment: Surfactant replacement therapy, oxygen, and mechanical ventilation.
• Bronchopulmonary Dysplasia: Chronic lung disease in premature infants.
• Prolonged mechanical ventilation and oxygen use causes Bronchopulmonary Dysplasia.
• Treatment: Oxygen therapy, medications (steroids, diuretics), and nutritional support.
• Retinopathy of Prematurity (ROP): Abnormal retinal vessel growth causing blindness.
• High oxygen exposure in premature infants causes ROP.
• Treatment: Laser therapy, anti-VEGF injections, or surgery.
• Necrotizing Enterocolitis: Inflammatory intestinal disease.
• Prematurity, bacterial infection, and formula feeding cause Necrotizing Enterocolitis.
• Treatment: Bowel rest, antibiotics, surgery for perforation or necrosis.
• Robinow Syndrome: Genetic disorder causing facial and skeletal abnormalities.
• Genetic mutation (autosomal dominant/recessive) causes Robinow Syndrome.
• Treatment: Supportive care, orthodontic, and orthopedic treatments.
• Hypertrophic Cardiomyopathy: Thickened heart muscle impairs function.
• Genetic mutation causes Hypertrophic Cardiomyopathy.
• Treatment: Medications, lifestyle adjustments, surgery, or implantable devices.
• Down Syndrome: Chromosomal disorder (trisomy 21) causing intellectual disability and physical traits.
• Trisomy 21 causes Down Syndrome.
• Treatment: Supportive therapies, surgery for heart defects, and educational interventions.
• Cerebral Palsy (CP): Group of disorders affecting movement and posture.
• Brain injury during or after birth causes Cerebral Palsy CP.
• Treatment: Physical therapy, medications (spasticity control), surgery, and assistive devices.
• Muscular Dystrophy (MD): Progressive muscle degeneration; Duchenne MD is most common.
• Genetic mutation in the dystrophin gene causes Muscular Dystrophy.
• Treatment: Physical therapy, corticosteroids, mobility aids, and experimental gene therapies
• Spina Bifida Occulta: Mildest form of spina bifida, with incomplete closure of the vertebrae.
• Neural tube defect causes Spina Bifida Occulta.
• Often requires no treatment; monitor for complications
• Meningocele: Sac-like protrusion of meninges through the spine.
• Neural tube defect causes meningocele.
• Treatment is surgical repair.
• Myelomeningocele: Severe form of spina bifida with spinal cord involvement.
• Neural tube defect causes Myelomeningocele.
• Treatment: Surgery, physiotherapy, and management of associated conditions (e.g., hydrocephalus).
• Hydrocephalus: Excess cerebrospinal fluid in the brain ventricles.
• Blocked CSF flow, overproduction, or poor absorption causes Hydrocephalus.
• Treatment: Shunting to drain fluid, medications, and treatment of the underlying cause.
• Anencephaly: Missing parts of the brain and skull.
• Neural tube defect causes Anencephaly.
• There is no cure for Anencephaly
• Treatment: Supportive care or palliative management.
• Clubfoot (Talipes equinovarus): Abnormal foot positioning, inward rotation.
• Unknown, possibly genetic/environmental causes of Clubfoot.
• Treatment: Casting, bracing, or surgery (Ponseti method).
• Developmental Dysplasia of the Hip (DDH): Hip joint instability or dislocation.
• Unknown, possibly genetic/environmental causes of Developmental Dysplasia of the Hip.
• Treatment: Pavlik harness, bracing, or surgery.
• Cleft Lip and Palate: Openings in the lip and/or roof of the mouth.
• Genetic and environmental factors cause Cleft Lip and Palate.
• Treatment: Surgical repair, speech therapy, and dental care.
• Cryptorchidism: Undescended testes.
• Unknown, possibly hormonal or anatomical causes of Cryptorchidism
• Treatment: Hormonal therapy and surgical orchiopexy.
• Wilms Tumor (Nephroblastoma): Kidney cancer in children.
• Genetic mutations cause Wilms Tumor.
• Treatment: Surgery, chemotherapy, and radiation therapy.
• Phimosis: Inability to retract foreskin over the glans.
• Natural adhesion or scarring cause phimosis.
• Treatment: Topical steroids, manual stretching, and Circumcision.
• Congenital Pyloric Stenosis: Hypertrophy of pyloric sphincter causes gastric obstruction.
• Unknown, possibly genetic predisposition causes Congenital Pyloric Stenosis.
• Treatment: Surgical pyloromyotomy.
• Hirschsprung Disease: Absence of ganglion cells in intestines causes blockage.
• Genetic mutation causes Hirschsprung Disease.
• Treatment: Surgical removal of the affected bowel.
• Cystic Fibrosis (CF): Genetic disorder causing thick mucus in lungs and digestive system.
• Mutations in the CFTR gene cause Cystic Fibrosis.
• Treatment: Chest physiotherapy, enzyme supplements, and CFTR modulators.
• Phenylketonuria (PKU): Metabolic disorder, cannot metabolize phenylalanine.
• Genetic enzyme deficiency causes Phenylketonuria.
• Treatment: Protein-restrictive diet and low-phenylalanine foods.
• Klinefelter Syndrome: Male genetic condition with an extra X chromosome (XXY).
• Extra X chromosome (nondisjunction) causes Klinefelter Syndrome.
• Treatment: Testosterone therapy, speech and occupational therapies, and educational support.
• Turner Syndrome: Female genetic condition missing one X chromosome.
• A Missing or incomplete X chromosome causes Turner Syndrome.
• Treatment: Growth hormone therapy, estrogen replacement, and supportive care.