Moro Reflex - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes Moro Reflex in infants.
The Moro reflex is an infantile reflex that is normally present in all newborns or infants. The Moro reflex is normally seen at birth and it is an involuntary response to stimulation. This reflex is present up to 4-5 months of age as a response to a sudden loss of support. The infant feels as if it is falling. The doctor will check for this reflex after birth and during well-child visits. The Moro reflex evaluates the integration of the central nervous system.
How does the reflex work?
The head is gently lifted with enough support to begin to move the body weight of the infant from the examination table. Support of the infant is then released suddenly, allowing the infant ti fall backward for a moment, but then quickly supported again. The normal response for the infant is to have a startled look. As the reflex ends, the infants draws its arms back to the body and then relaxes.
The absence of the Moro reflex in infants is abnormal. If the reflex is absent or abnormal, tests may be needed to examine the child’s muscles. These tests may include shoulder x-rays or test for disorders associated with a brachial plexus injury. Absence on both sides suggests damage to the brain or spinal cord. Absence on only one side suggests either a broken shoulder bone or an injury to the brachial plexus. Infants that are born vaginally with forceps may not move correctly and suffer an injury to the upper extremity (brachial plexus injury). Palpation of the shoulder may cause the infant to cry. The infant may have an associated clavicle fracture.
The Moro reflex involves three distinct components:
1-Spreading out of the arms (Abduction)
2-Unspreading the arms (Adduction)
3-Crying (usually)
An intact Moro reflex signals that the infant does not have a true brachial plexus injury.
Differential diagnosis of brachial plexus injury on newborns:
1-Clavicle fracture with pseudoparalysis (most common): isolated clavicle fracture is most common. Infants with pseudoparalysis from a fractured clavicle usually have an intact Moro reflex. Most infants recover in 7-10 days from pseudoparalysis. The patient should be followed up for clavicle fracture and for observation of pseudoparalysis. The condition is easily distinguished from a brachial plexus injury because infants with isolated clavicle fractures have an intact Moro reflex. Clavicle fractures occur in association with a brachial plexus injury in approximately 10-15% of patients.
2-Proximal humerus epiphyseal separation
3-Posterior shoulder dislocation.
Persistence of the Moro reflex beyond 4-5 months of age occurs in severe neurological problems. Persistence of the Moro reflex beyond 24 months of age indicates a poor prognosis for independent ambulation, especially if sitting balance is not achieved by two years of age.
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Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step

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