The Moro Reflex - a Startling Test

The Moro reflex is an important tool for any pediatric osteopath. The Moro reflex allows the pediatric osteopath to assess the neurological status of the infant and also to assess torticollis.

In the Moro reflex video we will learn the following:
a) The exact definition of the Moro Reflex
b) How to execute the Moro Reflex
c) What the Moro Reflex tells us about the patient

d) When and to whom to refer the infant
d) Differential diagnosis of the Moro Reflex findings

What is the Moro Reflex?

The Moro reflex is an involuntary motor response or natural reflex of the baby to a threatening stimulus such as a noise or sudden movement. It is a two-step process and develops shortly after birth.  

The Moro reflex is one whereby the infant throws back its head, splays its arms at the shoulder and extends its legs. This is then followed by the baby curling its legs and arms back to its body followed occasionally by the baby letting out a cry. 

The practitioner can test the Moro reflex by gently cupping the baby's head in his hands and releasing it suddenly allowing it to fall back for a short moment and then supporting it again.

3 outcomes of the Moro Reflex:

There are 3 possible outcomes of the Moro reflex. 

1) A normal symmetrical Moro reflex

2) An absent Moro Reflex

3) An asymmetrical response of the Moro reflex

Both an asymmetrical Moro reflex or an absent Moro reflex require further investigation for the following reasons: both an absent and an asymmetrical Moro reflex are as a result of birth trauma:

Absent Moro Reflex

An absent Moro reflex is normally as a result of trauma to the higher centers such as in the case of cerebral palsy.  For this reason, an infant that exhibits an absent Moro reflex requires a thorough neurological examination. 

An asymmetrical Moro Reflex

An asymmetrical Moro reflex on the other hand is normally as a result of a local trauma either to a peripheral nerve such as the brachial plexus or as a result of fracture to the clavicle.  For this reason an infant that presents with an asymmetrical Moro reflex requires further examination in the form of neurological examination, local palpation and X-ray.

Fractures of the clavicle in the infant:

Fractures of the clavicle in the newborn are the most common fracture to occur during delivery even in natural, spontaneous deliveries. Clavicular fractures often go unnoticed which is why it is so important for the osteopath to consider fractures of the clavicle even when there has not been a previous diagnosis made in the hospital. 

The Moro Reflex and Torticollis:

From an osteopathic points of view, the Moro reflex can also be used to assess torticollis.  The osteopath will note that the side on which the torticollis is suspected will maintain a more flexed position than the contralateral arm.

How long does the Moro Reflex last?

The Moro reflex typically lasts between 2 to 4 months and disappears by the sixth month once the baby's neck can support its head.  A continuation of the Moro reflex beyond the six-month mark could be a sign of a more serious problem and requires further neurological investigation.