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Reflexes of the newborn. Conditioned and unconditioned reflexes. When do reflexes come and go? The main features and stages of development of the grasping reflex in newborns

With help reflexes of the newborn doctors check how the child's central nervous system works. This article will help you understand what the doctor is doing and what this or that behavior of the baby means, because the absence of reflexes can be a sign of some kind of disease, as well as if the reflex does not fade for too long.

Grade reflexes of the newborn should be carried out in a warm, well-lit room, on a flat, semi-rigid surface. The baby should be in a state of wakefulness, dry and full.

Temporal reflexes of the newborn

Sucking reflex

reflex of the newborn which manifests itself in a child in response to any significant irritation of the oral cavity - if any object, including a nipple or nipple, enters the baby's mouth, the baby immediately starts rhythmic sucking movements. This most important reflex is already present in a full-term newborn and usually persists throughout the first year of life.

proboscis reflex

proboscis neonatal reflex- this is a protrusion of the baby's lips in the form of a kind of "proboscis" in response to a quick jerky touch (light "tapping") of the adult's fingers on them. Usually the proboscis reflex persists during the first 2-3 months of life, then fades away.

Search reflex

With careful, gentle stroking of the corner of the baby's mouth, the child begins to lower the lower lip, deflect the tongue towards the irritant and actively "search" for the mother's breast. An important point: when checking this reflex, you should not touch the child's lips (get a proboscis neonatal reflex). And one more thing: irritation of the corner of the mouth really should be the easiest - if the baby feels discomfort, he will turn his head in the opposite direction. The reflex usually persists in the first 3-5 months of life, but can sometimes be present for longer.

Palmar-mouth reflex of the newborn

With moderate pressure on the baby’s palms, the fingertips cause the child’s mouth to open and his head to move forward, towards the examiner. Like the search neonatal reflex, this one is especially well expressed before feeding the baby. It usually lasts up to two months of age.

Weakening or asymmetry (on the one hand, the reflex is more pronounced than on the other) of this reflex in newborns, as well as its preservation in children older than 2-3 months of life, may indicate possible disorders of the nervous system - this means that the baby should by all means to show to the children's neuropathologist.

Protective reflex of the newborn

Try to lay the child on his stomach - and he will immediately “automatically” turn his head to the side. The biological meaning of this reflex is understandable without much explanation - it allows the baby to breathe even in such an uncomfortable position as the prone position. Reflex of the newborn usually present in the first hours of life.

Crawl reflex

Present in a child from the first day of life. If you put the baby on his stomach, touch his soles, the baby will try to push off from the palms of an adult, as if from a support. And move forward. Some newborns tend to carry out crawling movements without support - this is the so-called spontaneous reflex crawling. Normally, these movements can exist up to 4 months of life, after which they fade away.


Support reflexes and automatic walking

If you give the body of a newborn a vertical position and ensure that the soles of his feet are in contact with a horizontal hard surface, then the baby will straighten his legs and will “stand” (with support, of course). Remains in children up to the age of 8-12 months. If the newborn “standing” in this way is tilted forward somewhat, shifting the center of gravity of the body, then the baby immediately begins to “step over” with its legs - this is automatic walking. During its implementation, many children cross their legs - you should not be afraid of this: in the first 1.5 months of life, this is normal.

The grasping reflex of the newborn

The kid unconsciously squeezes the fingers of the palms if something is put into them. Sometimes such a grip is so strong that a baby grabbing an adult's fingers can be lifted into the air. Prehensile neonatal reflex it is considered natural up to the age of 4 months - then it disappears, and it is replaced by an arbitrary, quite conscious grasping of objects with hands.

Moro reflex

This newborn reflex can be caused in a child of the first months of life in different ways: by clapping the palms on the surface on which the child lies, produced simultaneously at a distance of 15 cm to the right and left of his head; sudden passive extension of the legs of a lying child; lifting the lower half of his torso by straightened legs. The reaction of the baby to these irritations proceeds in two phases: first, the child sharply takes the arms to the sides, simultaneously opening his fists, then, as it were, covers himself with his hands.

Newborn reflexes that appear and become more complex over time

cervical rectifying response represents a subsequent turn of the torso in the direction where the baby's head had previously turned. The functioning of this automatism helps the child to learn the motor skill that pleases parents so much - turning from back to side. At the age of 6-8 months, this simple reflex is replaced by another - the straightening reflex of the body. After turning the head to the side, the baby turns the shoulder girdle, torso, and then the pelvis in the same direction. Such rotation of the body around the longitudinal axis is an absolute condition for mastering turns from the back to the stomach and from the stomach to the back, the skills of self-sitting, standing up, etc. With each passing month, the rectifying reactions of the baby become more complicated, changing into complex voluntary motor acts.

Defensive hand reaction- various movements of the handles (pulling forward, breeding, etc.) in response to a change in the position of the child's body in space.

Landau reflex

Give the child a “swimmer position” - lift the baby into the air so that his face looks down, and he immediately raises his head, and then straightens (or even arches) his back, and also unbends his legs and arms.

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At birth, every baby goes from a comfortable and familiar environment into an unknown and so frightening world for him. To adapt to new conditions and survive outside the body of the mother, the baby is helped by innate reflexes, which should be present in all newborns. The absence of any physiological reflex is usually considered a pathology and indicates various developmental abnormalities.

Brief information

Even in the maternity hospital, neonatologists check the main reflexes of a newborn child and assess whether the nervous system of the baby is properly developed. A healthy baby has a whole set of innate (unconditioned) reflexes, which are often called automatisms. The baby needs them in order to survive the process of childbirth, adapt faster in the postpartum period and fully develop in the future. Some of the unconditioned reflexes of a newborn that are present from birth disappear with time, while others accompany a person until the end of his life.

But a newly born baby cannot have conditioned reflexes. The child acquires such reactions as he develops, mastering the world around him and gaining invaluable experience.

Types and norms

All the main reflexes of a healthy newborn can be divided into two types: oral (due to the work of segments of the brain stem) and spinal (due to the work of the spinal cord). This classification is considered generally accepted in world pediatrics.

Oral reflexes of babies, in turn, are divided into the following varieties:

  1. Sucking. This reaction appears in newborns at the time of birth and disappears by about a year. The baby should make rhythmic sucking movements, grabbing the nipple of the mother's breast, a pacifier, a finger, a bottle of food, etc. with his lips.
  2. Swallowing. The baby should not only suck milk, but also swallow it. This skill remains with a person for the rest of his life.
  3. Proboscis. If you lightly touch the child's mouth, he will stretch his lips into a tube (proboscis). Such innate automatism persists for up to 2-3 months.
  4. Babkin's reflex. This palmar-oral automatism is especially pronounced in the first two months of a baby's life. If you press both palms of the crumbs at the same time, he will definitely open his mouth.
  5. Kussmaul reflex. This automatism is aimed at ensuring that the child can find food. If you touch the corner of the baby's mouth, he will automatically turn the head towards the irritant. Such search automatism usually disappears by 3-4 months. After that, the baby is able to look for food with his eyes.

Spinal reflexes in a healthy newborn are as follows:

  1. Protective. If the parents put the baby on his tummy, he will immediately begin to turn his head to one side or the other and will try to rise. The protective reflex of the newborn is necessary so that the baby can protect himself from respiratory disorders (by turning his head, the baby provides himself with oxygen). In infants, protective automatism is observed up to one and a half months.
  2. Upper grasping (Yanishevsky reflex). If you touch the baby's palm with your finger, he should squeeze his fingers into a fist. The strongest upper grasping reflex in newborns is expressed at the time of feeding or when the children are hungry. This automatism is preserved up to 3-4 months.
  3. Lower grasping (Babinsky reflex). If you run your thumb over the child's foot, the baby will begin to unbend the toes and bend the leg at the joint. This automatism usually disappears after a year.
  4. Moro reflex. This automatism, which is often called the hug reflex, consists of two phases: if the baby hears a sharp loud sound (for example, a slap on the changing table where he lies), then first he will spread his arms to the side, straighten his fingers and stretch his legs, and only after a few seconds will return the limbs to their previous position. The Moro reflex in newborns begins to fade by about 4-5 months.
  5. Support reflex. If the baby is taken by the armpits and lifted, he will begin to bend the legs at the knees and hips. When his feet touch a horizontal surface (such as the floor), he will automatically straighten his foot and rest it against the surface. With normal development, such a reaction will disappear in about a month and a half.
  6. Bauer's crawling reflex. Putting the baby on his stomach and putting his hands on his heels, parents should see that their baby is trying to push off and crawl, helping himself with his hands. This automatism passes for 4-5 months of life.
  7. Reflex Galant. If you run your finger along the spine of the crumbs, he will arch the back and straighten the leg on the side where the irritant is located. This reaction in children lasts up to 3-4 months.
  8. Peres reflex. A child lying belly down in the palm of his mother, when pressing on the processes of the spine from the coccyx to the neck, should scream, bend his limbs, raise his head. This action of the parents causes a negative reaction in the baby. This automatism finally disappears by 3-4 months of life.
  9. Automatic walking reflex. If the baby is lifted, put on its feet and tilted forward a little, it will automatically move its legs, as if taking steps. A healthy baby should move his legs at the level of automatism up to 1-1.5 months.
  10. Landau reflex. If you lift the baby into the air with his face down, holding his palms on his stomach, he will raise his head and upper body, arch his back, straighten his legs and arms. This automatism most often manifests itself not immediately after birth, but by 3-4 months. This reaction disappears after a year.

Deviations from the norm

Many parents begin to worry if they see that their baby is missing or severely weakened by certain innate reflexes. Indeed, such a pathology may indicate that there are problems in the development of the child. Most often, there are no automatisms in those children who were born prematurely, had a difficult birth, had birth injuries or intrauterine malformations, suffered during pregnancy from asphyxia (suffocation by the umbilical cord) or hypoxia (lack of oxygen). In such situations, moms and dads need to show the baby to a neurologist, who will identify abnormalities and prescribe treatment.

In some cases, the physiological reflexes of a newborn may, on the contrary, increase significantly (usually this happens with motor automatisms - automatic walking, crawling, etc.) and not disappear by a certain age. The cause of such deviations may be muscle tone, disorders of the nervous system, previous diseases, etc. A child who has an increase in automatisms should also be examined by a doctor. At the same time, parents should make every effort to quickly begin to carry out therapeutic manipulations (massages, drug therapy, etc.).

Reflex -(from lat. reflexus - turned back, reflected), the reaction of the body caused by the central nervous system when the receptors are irritated by agents of the internal or external environment; manifests itself in the emergence or change in the functional activity of organs and the body as a whole ["Great Soviet Encyclopedia"].

What are the abilities of a newborn?

    Set of unconditioned reflexes, facilitating adaptation to new living conditions:

    reflexes that ensure the work of the main body systems (respiration, blood circulation, digestion, etc.), in particular the sucking reflex, reflexes of food and vestibular concentration (calming down, inhibition of movements);

    protective reflexes (for example, when touching the eyelids, the child closes his eyes, closes his eyes in bright light);

    orienting reflexes (search reflex, turning the head to the light source);

    atavistic reflexes, i.e. those reflexes that gradually fade and disappear (for example, a grasping reflex, or Robinson's reflex; spontaneous crawling reflex or Bauer's reflex; automatic gait, etc.).

The presence of unconditioned reflexes indicates the functional maturity of the CNS of the newborn, however, during the first year of life, most of them fade away.
At the same time, there is a clear connection between the maturation of the brain and the disappearance of most of these simple reflexes. The reason is that many of them are controlled by subcortical structures, primarily by the midbrain, which develops in the fetus with a large lead. The simplest reflexes gradually give way to more complex reflex reactions and conditioned reflex behavioral complexes, in which the cerebral cortex plays a decisive role.

To date, more than seventeen congenital reflexes of newborns are known. Why nature “invented” so many innate reflexes is hard to say, but some of them young parents should not only be able to identify in a baby, but also stimulate them. For what? Stimulation of innate reflexes, which is accompanied by active contact between the child and parents, expands not only motor initiative, but also his ability to communicate with the environment, and this contributes to the development of the baby.

Consider basic reflexes of newborns:

The sucking reflex fades by 12 months, which is one of the reasons pediatricians recommend continuing breastfeeding until 1 year of age.

Psychologists note that an unrealized sucking reflex in formula-fed children can subsequently lead to obsessive-compulsive disorder: sucking a finger, a pen, a corner of a pillow, etc.

    Search (search) Kussmaul reflex
    Stroking in the corner of the mouth of the newborn causes the lowering of the lips and turning the head towards the stimulus. Pressing on the middle of the upper lip causes a reflex lifting of the upper lip up and extension of the head. When the middle of the lower lip is irritated, the lip drops, and the child's head makes a flexion movement. The reflex exists up to 3-4 months. It is important to pay attention to the symmetry of the reflex on both sides. The asymmetry of the reflex is observed when the facial nerve is damaged. In the study of the search reflex, it should also be noted what is the intensity of the turn of the head, whether there are grasping movements of the lips.

    The search reflex is the basis for the formation of many mimic (expressive) movements: shaking the head, smiling. Observing the feeding of the child, it can be noted that, before grasping the nipple, he makes a series of rocking movements with his head until he firmly grasps the nipple.

    "proboscis" reflex.
    If you sharply touch the skin of the newborn at the nasolabial fold, then the baby pulls out the lips with a “proboscis” and begins to turn the head in search of the nipple. By 3-4 months, the reflex fades, except in children with CNS damage.

    Palmar-mouth reflex (Babkin reflex) - pressure on the palm area causes the mouth to open and the head to bend. The reflex is normal in all newborns, it is more pronounced before feeding. Sluggishness of the reflex is observed when the central nervous system (CNS) is affected. The rapid formation of the reflex is a prognostically favorable sign in children who have undergone birth trauma. The palmar-mouth reflex may be absent with peripheral paresis of the hand on the side of the lesion. In the first 2 months of life, the reflex is pronounced, and then begins to weaken, and at the age of 3 months, only some of its components can be noted.In case of damage to the central nervous system in a child older than 2 months, the reflex does not tend to fade, but, on the contrary, intensifies and occurs even with a light touch on the palms of passive hands.

    Breath holding reflex
    This reflex helps the baby safely through the birth canal and not swallow the amniotic fluid. In the future, it can be used when teaching the baby to swim. However, it must be remembered that during the first full immersion in water, the duration of reflex respiratory arrest is no more than 5-6 seconds. By six months with regular exercises, you can bring it up to 25-30 seconds, and by the year - up to 40 seconds.

Attention! Staying a child under water for longer than the specified time can lead to serious and even irreversible consequences. Before you start teaching your baby to swim, consult with a specialist who will teach you how to do it correctly.

    Swimming reflex
    A child immersed in water increases the motor activity of the arms and legs, which is characteristic of him during sleep. This activity has nothing to do with real swimming movements, but the child can lie on the water for some time without support. To learn the complex coordinated movements required for any style of swimming, a child can not earlier than 2.5 - 3 years. However, children whose swimming reflex is stimulated from birth grow physically stronger, more resistant to stress, get sick less and subsequently love water and swimming very much. Even if for some time in their lives they will not have the conditions to practice swimming, at the first opportunity they will regain their ability to float and quickly master the style in which they will be taught. In this they will be helped by their infantile experience.

The reflex is depressed or absent in children born in asphyxia, as well as in intracranial hemorrhages, spinal cord injuries. Pay attention to the asymmetry of the reflex. In diseases of the central nervous system, crawling movements persist for up to 6-12 months, like other unconditioned reflexes.

  • "Stop" reflex. If the baby is pressed vertically to the chest and lightly slapped with the palm of his hand on his soles, then an active motor reaction of extension and tension of the entire skeletal muscles occurs. The kid seems to be stretched out at attention!
    Stimulation of this reflex develops skeletal muscles well, which is a prevention of subsequent posture disorders. This exercise is good to carry out after feeding (provided that the baby is not sleeping) to release air that has entered the stomach during sucking.
  • Calcaneal reflex (Arshavsky reflex)
    It is caused by moderate pressure on the calcaneus, which leads to generalized extensor dyspnea activity, with a grimace of "crying" and a cry. The reflex is well expressed only in physiologically mature newborns.
  • Step reflex
    Hold the baby over the table so that one foot rests on its surface. This leg will tighten up, and the other, on the contrary, will fall on the table, as if the child was about to go. If you lift his toe off the surface of the table, he will tuck his foot in, as if he is about to stomp on the table. When stimulating the stepping reflex, be sure to finish the exercises by applying to the chest. If the reflex is not stimulated, it disappears by two to three months.
    Experts have noticed that stimulation of the step reflex accelerates the overall physical and mental development of the baby. Such children begin to walk at 8-9 months, their fine motor skills are well warmed up, they speak by the age of 3-4 phrases, often have absolute pitch and the ability to speak languages.

Attention! Stimulation of the step reflex, as well as the “stop” reflex, is possible only in infants who do not have orthopedic abnormalities: hip dysplasia, dislocations and subluxations of the hip joints, congenital clubfoot.

    Posture reflexes or defensive reflex
    Survival behaviors are called posture reflexes. Such reflexes help the baby to keep the torso, head, arms and legs in the most comfortable position for breathing and normal development. If the baby is placed face down, he will raise his head a little (just enough to lift off the surface) and turn it to the side so that there is air for the nose. If you cover the child's head with a diaper, he will first bite it, as it were, and then begin to vigorously turn his head from side to side and move his arms, trying to remove it from his face so that nothing interferes with looking and breathing. In children with CNS damage, the protective reflex may be absent, and if the child's head is not passively turned to the side, he may suffocate. In children with cerebral palsy, with an increase in extensor tone, a prolonged rise of the head and even tipping it back is observed.

    gag reflex
    During the period when the baby is learning to suck and swallow, this reflex makes him push any object out of the mouth (this protects the baby from shock). If the back of the baby's throat is acted upon, his lower jaw and tongue will perform a downward and forward pushing motion to free the throat. The gag reflex remains in a person for life, but the tongue is involved only in the first 6 months. Now that we know about this reflex, it becomes clear why it is difficult for babies to swallow solid food.

    Resting neck reflex (swordsman reflex)
    When the baby is lying on his back, turn his head to the side, and you will see that he will move his arm and leg in the same direction, assuming the position of a swordsman preparing to attack. This reflex both promotes and hinders muscle development. On the one hand, thanks to this reflex, the child looks at his own hand and fixes his attention on the toy clamped in it. On the other hand, the reflex does not allow the head, hands of the baby and the toy to be in the center. By 3-4 months, this reflex disappears, and the child begins to hold toys directly in front of him.

    Withdrawal reflex
    This reflex protects the child from pain. If the baby's leg is pricked (for a blood test during a laboratory test), he will pull it back to avoid pain, and the other at that time will begin to push, as if pushing the offender away from himself.

Information sources:

    Child care from birth to 5 years. - M., 2008.

    Local pediatrician. Help Guide/ Ed. M. F. Rzyankina, V. P. Dairy. - M., 2008.

    Shapovalenko I.V. Developmental psychology: Developmental psychology and developmental psychology. - M., 2005.

Since the highest analytical center - the cerebral cortex - in a child of the first months of life is not yet able to function in a volume sufficient for autonomous existence in the environment, nature insures a small person with the help of so-called unconditioned reflexes. Unconditioned reflexes- the simplest "automatic" actions controlled by more primitive centers of the brain and spinal cord. Alone reflexes in newborns are present already at the time of birth, others develop somewhat later. different unconditioned reflexes of newborns and according to the duration of their existence: some of them remain with a person throughout life, others are transient (transient) in nature. Even more unconditioned reflexes differ from each other in their tasks and manifestations - but their biological meaning is always universal: protecting vital organs and allowing them to adapt to environmental conditions, they, in fact, ensure the survival of a human being at different stages of his life.

Unconditioned reflexes, such as, for example, corneal (manifested by an "emergency" blinking of the eyelid even with a very light touch of the cornea of ​​​​the eye) are of a pronounced protective nature and therefore appear already in a newborn child, and persist throughout a person's life. The same, in principle, can be said about the conjunctival, pharyngeal and some other reflexes of newborns. The swallowing reflex is also preserved for life - as well as tendon reflexes, the method of "hammer" testing of which is well known to adults who have been to a neurologist.

Other unconditioned reflexes of newborns, subtly referred to as motor segmental and suprasegmental postural automatisms, persist only for several months.

It is worth talking about them in more detail - since parents will have to see more than once or twice how a pediatric neuropathologist or pediatrician evaluates them.

Among the motor segmental reflexes, a special group is distinguished - the so-called. oral automatisms of newborns. Oral means mouth. The segments of the brainstem responsible for their appearance, in fact, provide the baby with the opportunity to eat.

The reflex, called sucking, manifests itself in a child in response to any significant irritation of the oral cavity - be it the placement of a mother's breast nipple, a pacifier, a medical spatula, etc. into it. The baby immediately starts rhythmic sucking movements. This most important reflex is already present in the newborn (for premature babies, it is a criterion of maturity) and usually persists throughout the first year of life.

proboscis reflex- protrusion of the baby's lips in the form of a kind of "proboscis" in response to a quick jerky touch of the adult's fingers on them. The reflex is due to the automatic contraction of the circular muscle of the child's mouth - one of the most important "sucking" muscles. Usually the proboscis reflex persists during the first 2-3 months of life, then fades away.

Kussmaul search reflex- another oral automatism characteristic of newborns. Careful, gentle stroking with an adult finger of the corner of the baby's mouth, the latter begins to actively "search" for the mother's breast: at the same time, the lower lip descends, "stretches" towards the stimulus, and the baby's tongue also deviates there. An important point: when checking this reflex, you should not touch the child's lips (get a proboscis reflex :). And one more thing: irritation of the corner of the mouth really should be the easiest - if the baby feels at least discomfort, then instead of demonstrating a search reflex, he will turn his head in the opposite direction and immediately express his displeasure with your manipulations in particular and your presence in the world in general :) The Kussmaul reflex is usually persists in the first 3-5 months of life, but sometimes it can "work" longer.

The last of the main oral automatisms is Babkin's hand-mouth reflex. Its essence is as follows: moderate pressure on the baby’s palm with the fingertips of an adult causes the child’s mouth to open and his head to move forward towards the examiner. Like the search automatism of Kussmaul, the Babkin reflex is especially well expressed before feeding the baby - i.e. when he absolutely does not mind, in the words of Winnie the Pooh, "a little refreshment." Babkin's automatism is one of the oldest survival mechanisms inherent in a newborn person: at such an early age, the baby's hands are equipped with only one of the countless possible functions - to help the whole body seek food. Usually this reflex is well expressed until the age of two months, then it begins to fade relatively quickly. The weakening or asymmetry of this reflex in newborns, as well as its persistence in children older than 2-3 months of life, may indicate a possible pathology of his nervous system - this means that the baby should certainly be shown to an experienced pediatric neurologist. However, practically all unconditioned reflexes inherent in young children have such kind of "signal" functions - and that is why we considered it necessary to write this note for parents.

The next group of unconditioned reflexes in newborns and infants These are the so-called spinal motor automatisms. They are no less diverse than oral ones, and, perhaps, no less important for the survival of the baby in the external environment.

Spinal motor automatisms include protective reflex of the newborn. Try to put the baby on his stomach - and he will immediately "automatically" turn his head to the side. The biological meaning of this reflex is understandable without much explanation - it allows the baby to breathe even in such an uncomfortable position as the prone position. The reflex is usually present already in the first hours of life.

Bauer's crawling reflex- another spinal automatism present in a child from the first day of life. Being laid out on his stomach and feeling the palms of an adult attached to his soles, the baby will try to push off from them, as from a support. And move forward. Some newborns tend to carry out crawling movements without support - this is the so-called spontaneous reflex crawling. Normally, both the Bauer reflex and spontaneous crawling can exist up to 4 months of life, after which they fade away.

Support and automatic walking reflexes are also programmed motor acts controlled by the spinal cord. If you give the body of a newborn a vertical position and ensure that the soles of his feet come into contact with a horizontal hard surface, then the baby will straighten his legs and will "stand" (with support, of course - the inability to stand on his own, called physiological astasia-abasia, persists in children up to the age of 8- 12 months). If the “standing” newborn in this way is tilted forward somewhat, shifting the center of gravity of the body, then the baby immediately begins to “step over” with his legs - this is automatic walking. During its implementation, many children cross their legs at the level of the lower thirds of the legs - this should not be frightened: a slightly increased tone of the thigh adductor muscles in the first 1.5 months of life is quite physiological.

Grasping reflex and Robinson reflex- automatisms, the biological essence of which is to maintain an inseparable connection with the mother (in the most direct sense of the term). The good development of this reflex in primates allows the cubs to hold tightly to the mother's fur while the female is moving. Having inherited these automatisms from his evolutionary predecessors, a newborn person unconsciously squeezes the fingers of the palms if something is put into them. Sometimes such a grip is so strong that a baby who grabs the offered fingers of an adult can be lifted into the air (Robinson's reflex). The grasping reflex is considered physiological up to 4 months of age - then it disappears, and it is replaced by an arbitrary, completely conscious grasping of objects with hands.

Reflex Galant expressed in the bending of the back of the newborn in response to tactile irritation of his skin in the so-called paravertebral region - i.e. retreating 1-1.5 cm from the long axis of the spine. At the same time, the baby arches its back, forming an arc open towards the stimulus. This reflex usually lasts up to 3-4 months of life.

Much more unpleasant for a child is the assessment of another, somewhat similar to the Galant reflex, spinal automatism - Perez reflex. Checking this reflex, the doctor with a slight pressure runs the pad of his finger over the skin directly above the spinous processes of the baby's spine. Usually, in response to such irritation, the child unbends the torso, bends the arms and legs, raises its head and ... cries. Given the sharply negative emotional reaction of the baby, the doctor usually checks this reflex, which, unfortunately, is quite informative for assessing the nervous system of the child, last.

Moro reflex- the last of the spinal automatisms considered in this note - can be caused in a baby of the first months of life in different ways: by clapping the palms on the surface on which the child lies, produced simultaneously at a distance of 15 cm to the right and left of his head; sudden passive extension of the legs of a lying child; lifting the lower half of his torso by straightened legs. The reaction of the baby to these irritations proceeds in two phases: first, the child sharply takes the arms to the sides, simultaneously opening his fists, then, as it were, covers himself with his hands.

Children of the first year of life also have the so-called supra-segmental postural automatisms. The latter are subdivided into myelencephalic (controlled by the medulla oblongata) and mesencephalic (controlled by midbrain centers). However, it seems that such details are unlikely to be of interest to our readers, therefore we will immediately proceed to the description of suprasegmental reflexes - acts, the timely appearance and extinction of which is extremely important for the subsequent mastery of such fundamental motor skills as sitting, standing, crawling and walking. So,

The symmetrical cervical tonic reflex consists in bending the arms and extending the legs of the baby with passive flexion of his head (gently bringing the chin to the chest). The reflex, the name of which differs from the above by just one letter (asymmetric cervical tonic) is checked and looks completely different: if you turn the head of the baby lying on his back to the side (so that the child’s chin is at shoulder level), then a small the person will straighten the arm and leg towards which his face is turned, and bend the opposite arm and leg.

Normally, the muscle tone in a baby lying on his back differs significantly from the tone observed in the prone position. The reason for this is another suprasegmental postural automatism - the labyrinth tonic reflex. It is he who "makes" the flexor muscles "work" as much as possible when the baby lies on his stomach and "trains" the extensor muscles when their owner lies on his back.

Both the neck reflex and the labyrinth reflex are present in children already in the neonatal period, and usually fade away by the beginning of the third month of life. However, in preterm infants, these myelencephalic reflexes may persist somewhat longer. However, in the second half of life, these automatisms must certainly be reduced - otherwise the baby will have a delay in the development of motor skills.

As the reflexes controlled by the medulla oblongata fade away, the baby begins to show mesencephalic automatisms - the so-called chain symmetrical reflexes. The main effect of these unconditioned reflex acts, which are no longer controlled by the medulla oblongata, but by the midbrain, is the straightening of the torso with changes in the position of the head in space and an adequate setting of the arms, legs, and pelvis.

The cervical rectifying reaction is the subsequent rotation of the torso in the direction where the baby's head had previously turned. The functioning of this automatism helps the child to learn the motor skill that pleases parents so much - turning from back to side. At the age of 6-8 months, this simple automatism is replaced by another - the straightening reflex of the body. After turning the head to the side, the baby, following the commands of his midbrain, turns the shoulder girdle, torso, and then the pelvis in the same direction. Such rotation of the body around the longitudinal axis is an absolute condition for mastering turns from the back to the stomach and from the stomach to the back, the skills of self-sitting, standing up, etc. With each passing month, the rectifying reactions of the baby become more complicated, changing into complex voluntary motor acts.

Mesencephalic suprasegmental automatisms include both the protective reaction of the hands and the Landau reflex. The first is manifested in various movements of the handles (pulling forward, breeding, etc.) in response to a change in the position of the child's body in space. The second is easy to check by giving the child a "swimmer position" - lift the baby into the air so that his face looks down, and he will immediately raise his head, and then straighten (or even arch) his back, and also straighten his legs and arms.

Talk about unconditioned reflexes of newborns and infants you can go on for a long time - but, it seems, that the above information is quite enough for it to become clear to parents: the program of motor development of the baby of the first year of life laid down in the genes is quite rigid and conservative. That is why regular checking of reflexes and assessment of the dynamics of their development is very important in the medical observation of a child. Often, it is problems with the functioning of unconditional reflex acts that can be the very first visible symptoms of a serious pathology in the baby's central nervous system - and therefore, carefully monitor how your doctor checks the child's reflexes. And don't be afraid to ask your doctor questions if you have any concerns or concerns.

With the bone form of congenital clubfoot, the deformity of the foot is also obvious from the first day of life, but no manual attempts to bring the foot out and give it the correct position have no effect.

From this it is clear that the treatment of congenital clubfoot and neurogenic clubfoot differ in many ways. Orthopedists are involved in the treatment of bone forms of clubfoot.

In conclusion, I would like to emphasize that motor disorders in newborns are very common.

Unconditioned reflexes of newborns

A doctor examining a newborn pays attention to his unconditioned reflexes. By examining them, the doctor receives important information about the activity of the central nervous system and can assess whether this is the norm or a deviation from the norm.

It can be considered the golden rule of neurology that a healthy child at birth should have a complete set of physiological reflexes, which disappear by 3-4 months. Pathology is their absence during the neonatal period, as well as a delay in their reverse development. It is unacceptable to stimulate the reflexes of the newborn, especially the automatic walking reflex.

Let's talk about the main unconditioned reflexes of newborns.

Search reflex

Stroking in the area of ​​the corner of the mouth causes the newborn to lower the lips, lick the mouth and turn the head in the direction from which the stroke is performed. Pressing on the middle of the upper lip causes a reflex lifting of the upper lip up and extension of the head. Touching the middle of the lower lip causes the lip to drop, the mouth opens, and the baby's head produces a flexion motion.

The search reflex testifies to the harmonious work of the deep structures of the child's brain. It is impeccably evoked in all newborns and should disappear completely by the age of three months. If this does not happen, then it is required to exclude the pathology of the brain.

proboscis reflex

It is caused by a light tapping of the child's upper lip with a finger - in response, the lips fold in the form of a proboscis.

Normally, the proboscis reflex is detected in all healthy newborns, and in all it gradually fades away by the age of three months.

By analogy with the search reflex, its persistence in children older than three months of age is a sign of a possible pathology of the brain.

Sucking reflex

The sucking reflex is present in all healthy newborns and is a reflection of the child's maturity. Strict coordination of the sucking mechanism is made up of the interaction of five pairs of cranial nerves.

After feeding, this reflex weakens to a large extent, and after half an hour or an hour it begins to revive again.

With brain damage, the sucking reflex decreases or completely disappears. The sucking reflex is reduced or even disappears if any of the cranial nerves involved in the act of sucking is damaged. . Babkin palmar-oral reflex

This funny reflex is called like this: you need to lightly press your thumb on the palm of the child, and in response the baby turns his head and opens his mouth. After two months, this reflex decreases, and by three it disappears completely.

The palmar-mouth reflex is usually well expressed and constant in the norm. It decreases with some damage to the nervous system, especially with a birth injury of the cervical spinal cord.

grasp reflex

In response to a touch on the palm, the fingers are bent and the object is grasped into a fist.

Before feeding and during meals, the grasping reflex is much more pronounced. Normally, this reflex is well evoked in all newborns.

A decrease in the grasping reflex is most often noted on the affected side of the cervical spinal cord.

Robinson reflex

Sometimes, when this reflex is evoked, the child grasps an object or the doctor's finger so tightly that such a clinging child can be lifted up by the finger. Thus, it turns out that a newborn, outwardly seeming to be a completely helpless creature, can develop in his hands such a “muscular strength” that keeps his body in limbo.

Normally, the Robinson reflex in all newborns should be considered mandatory. By 3-4 months of life, on the basis of this unconditioned reflex, a purposeful grasping of a toy is formed, and a good expression of this reflex further contributes to a more rapid development of fine manual skill.

lower grasp reflex

This reflex is evoked by lightly pressing the fingertips on the front of the sole of the newborn, in response to which the child bends the toes. In healthy children, this reflex persists up to 12-14 months of life.

The inability to evoke this reflex occurs when the spinal cord is damaged at the lumbar level.

Moro's grasp reflex

This reflex is called like this: if you suddenly clap with both hands on both sides near the lying child, then he spreads his arms half-bent at the elbows and spreads his fingers, and then the movement of the hands in the opposite direction follows.

Normally, the Moro reflex lasts up to 3-4 months. In all healthy newborns, the Moro reflex is evoked quite well and is always the same in both hands. With flaccid paresis of the arm, the reflex decreases or is completely absent on the side of the lesion, which indicates that the spinal cord in the cervical region was injured during childbirth.

Perez reflex

To elicit this reflex, the doctor places the child face down on his palm. Then, with slight pressure, he runs his finger along the spine of the child from the bottom up from the coccyx to the neck. In response to this, the spine bends, the arms and legs are extended, the head rises. Checking this reflex gives the doctor information about the functioning of the spinal cord throughout its entire length. Often this is unpleasant for the child, and he reacts by crying. Normally, the Perez reflex is well expressed during the first month of a newborn's life, gradually weakens and completely disappears by the end of the third month.

In newborns with a birth injury of the cervical spinal cord, there is no lifting of the head, that is, the Perez reflex turns out to be “headless”.

Support reflex

The support reflex is very important for assessing the state of the central nervous system of the newborn. Normally, the reflex looks like this: if you take a newborn under the armpits, then he reflexively bends his legs at the hip and knee joints. At the same time, if he is placed against a support, he unbends his legs and firmly rests his entire foot on the surface of the table and so “stands” for up to 10 seconds.

Normally, the support reflex is constant, well expressed and gradually disappears by 4-5 weeks of age. With an injury to the nervous system, the child can lean on his toes, sometimes even with legs crossed, which indicates a lesion of the motor (pyramidal) pathway that runs from the cerebral cortex to the spinal cord.

Automatic walking reflex, or stepping reflex

When resting on the feet while slightly tilting the body forward, the child makes step movements. This reflex is normally well evoked in all newborns and disappears by 2 months of life. Evaluation of the automatic walking reflex is very important for the doctor, as it helps to identify the location of the lesion of the nervous system and its degree.

Alarming signs are the absence of an automatic walking reflex or walking on tiptoe with legs crossed.

Bauer crawling reflex

This reflex is evoked as follows: a hand is placed on the feet of a newborn, laid on his stomach, in response to which the child begins to perform crawling movements. This reflex is normally evoked in all newborns and lasts up to 4 months, and then fades away. Evaluation of the reflex is of great diagnostic value for the physician.

defensive reflex

The essence of the reflex lies in the fact that the newborn, laid on his stomach, quickly turns his head to the side and tries to raise it, as if providing himself with the opportunity to breathe. This reflex is expressed from the first day of life in all healthy newborns without exception. The decrease or disappearance of this reflex can be either with a particularly severe lesion of the upper cervical segments of the spinal cord, or with a pathology of the brain.

Evaluation of the protective reflex will help the doctor timely identify the pathology of the nervous system in the newborn.

leg withdrawal reflex

This reflex is called as follows: if each sole of the child is carefully pricked with a needle in turn, then the leg is bent in all joints.

The reflex must be called equally on both sides. The absence of a reflex indicates damage to the lower parts of the child's spinal cord.

cervico-tonic reflexes

In addition to these reflexes, the doctor evaluates another group of reflexes - these are the so-called neck-tonic or posotonic reflexes, which provide fixation and position of the body at rest and during movement.

These reflexes normally disappear in the first 2-3 months. A delay in the regression of tonic reflexes (over 4 months) indicates damage to the central nervous system of the newborn. The remaining tonic reflexes impede the further development of the child's movements, the formation of fine motor skills.

So, as the unconditioned and cervico-tonic reflexes fade, the child begins to hold his head, sit, stand, walk, and carry out other voluntary movements.

Damage to the nervous system in newborns

Damage to the nervous system in newborns can occur both in utero (prenatally) and during childbirth (intranatally). If harmful factors acted on a child at the embryonic stage of intrauterine development, severe, often incompatible with life defects occur. Damaging influences after 8 weeks of pregnancy can no longer cause gross deformities, but sometimes they manifest themselves as small deviations in the formation of the child - the stigmas of disembryogenesis.

If the damaging effect was exerted on the child after 28 weeks of intrauterine development, then the child will not have any defects, but some disease may occur in a normally formed child. It is very difficult to isolate the impact of a harmful factor separately in each of these periods. Therefore, more often they talk about the impact of a harmful factor in general in the perinatal period. And the pathology of the nervous system of this period is called perinatal damage to the central nervous system.

Various acute or chronic diseases of the mother, work in hazardous chemical industries or work associated with various radiation, as well as bad habits of parents - smoking, alcoholism, drug addiction - can have an adverse effect on the child.

A child growing in the womb can be adversely affected by severe toxicosis of pregnancy, the pathology of the child's place - the placenta, the penetration of infection into the uterus. Childbirth is a very important event for a child. Particularly great tests fall on the baby if the birth occurs prematurely (prematurity) or rapidly, if birth weakness occurs, the fetal bladder bursts early and water flows out when the baby is very large and he is helped to be born with special techniques, forceps or a vacuum extractor.

The main causes of damage to the central nervous system (CNS) are most often hypoxia, oxygen starvation of various nature and intracranial birth trauma, less often intrauterine infections, hemolytic disease of the newborn, malformations of the brain and spinal cord, hereditary metabolic disorders, chromosomal pathology.

Hypoxia ranks first among the causes of damage to the central nervous system, in such cases, doctors talk about hypoxic-ischemic damage to the central nervous system in newborns.

Hypoxia of the fetus and newborn is a complex pathological process in which the access of oxygen to the child's body decreases or completely stops (asphyxia). Asphyxia can be single or repeated, of varying duration, as a result of which carbon dioxide and other incompletely oxidized metabolic products accumulate in the body, primarily damaging the central nervous system.

With short-term hypoxia in the nervous system of the fetus and newborn, only small disturbances of cerebral circulation occur with the development of functional, reversible disorders. Prolonged and repeated hypoxic conditions can lead to severe disorders of cerebral circulation and even to the death of nerve cells.

Such damage to the nervous system of the newborn is confirmed not only clinically, but also with the help of Doppler ultrasound of cerebral blood flow (USDG), ultrasound of the brain - neurosonography (NSG), computed tomography and nuclear magnetic resonance (NMR).

In second place among the causes of CNS damage in the fetus and newborn is birth trauma. The true meaning, the meaning of birth trauma is damage to a newborn child caused by mechanical action directly on the fetus during childbirth.

Among the variety of birth injuries during the birth of a baby, the child's neck experiences the greatest load, resulting in various injuries of the cervical spine, especially the intervertebral joints and the junction of the first cervical vertebra and the occipital bone (atlanto-occipital articulation).

There may be shifts (dislocations), subluxations and dislocations in the joints. This disrupts blood flow in the important arteries that supply blood to the spinal cord and brain.

The functioning of the brain largely depends on the state of cerebral blood supply.

Often the root cause of such injuries is the weakness of labor in a woman. In such cases, forcedly applied rhodostimulation changes the mechanism of passage of the fetus through the birth canal. With such stimulated childbirth, the child is born not gradually, adapting to the birth canal, but quickly, which creates conditions for displacement of the vertebrae, sprains and ruptures of ligaments, dislocations, and cerebral blood flow is disturbed.

Traumatic injuries of the central nervous system during childbirth most often occur when the size of the child does not correspond to the size of the mother's pelvis, with an incorrect position of the fetus, during childbirth in breech presentation, when premature, underweight babies are born and, conversely, children with large body weight, large sizes, as in In these cases, various manual obstetrical techniques are used.

Discussing the causes of traumatic lesions of the central nervous system, it is necessary to dwell separately on childbirth using obstetric forceps. The fact is that even with the immaculate application of the forceps head, intense traction behind the head follows, especially when trying to help the birth of the shoulders and torso. In this case, all the force with which the head is pulled is transmitted to the body through the neck. For the neck, such a huge load is unusually large, which is why when removing the baby with forceps, along with the pathology of the brain, damage to the cervical region of the spinal cord occurs. Particular attention should be paid to the issue of injuries to the child that occurs during caesarean section. Why is this happening? Indeed, it is not difficult to understand the traumatization of a child as a result of its passage through the birth canal. Why does a caesarean section, designed to bypass these paths and minimize the possibility of birth trauma, end in birth trauma? Where do such injuries occur during caesarean section? The fact is that the transverse incision during caesarean section in the lower segment of the uterus should theoretically correspond to the largest diameter of the head and shoulders. However, the circumference obtained with such an incision is 24-26 cm, while the circumference of the head of an average child is 34-35 cm. Therefore, removing the head and especially the shoulders of the child by pulling on the head with an insufficient incision of the uterus inevitably leads to injury of the cervical spine. That is why the most common cause of birth injuries is a combination of hypoxia and damage to the cervical spine and the spinal cord located in it.

In such cases, they speak of hypoxic-traumatic damage to the central nervous system in newborns. With a birth injury, cerebrovascular accidents often occur, up to hemorrhages. More often these are small intracerebral hemorrhages in the cavity of the ventricles of the brain or intracranial hemorrhages between the meninges (epidural, subdural, subarachnoid). In these situations, the doctor diagnoses hypoxic-hemorrhagic lesions of the central nervous system in newborns.

When a baby is born with CNS damage, the condition can be severe. This is an acute period of the disease (up to 1 month), followed by an early recovery period (up to 4 months) and then a late recovery period.

Important for the appointment of the most effective treatment of CNS pathology in newborns is the definition of the leading complex of signs of the disease - the neurological syndrome. Consider the main syndromes of CNS pathology.

The main syndromes of CNS pathology

Hypertension-hydrocephalic syndrome

When examining a sick baby, an expansion of the ventricular system of the brain is determined, detected by ultrasound of the brain, and an increase in intracranial pressure is recorded (given by echo-encephalography). Outwardly, in severe cases with this syndrome, there is a disproportionate increase in the size of the cerebral part of the skull, sometimes asymmetry of the head in the case of a unilateral pathological process, divergence of cranial sutures (more than 5 mm), expansion and strengthening of the venous pattern on the scalp, thinning of the skin at the temples.

In hypertensive-hydrocephalic syndrome, either hydrocephalus may predominate, manifested by the expansion of the ventricular system of the brain, or hypertension syndrome with increased intracranial pressure. With the predominance of increased intracranial pressure, the child is restless, easily excitable, irritable, often screams loudly, sleep is sensitive, the child often wakes up. With the predominance of hydrocephalic syndrome, children are inactive, lethargy and drowsiness are noted, and sometimes developmental delay. Often, with an increase in intracranial pressure, children goggle, Gref's symptom periodically appears (a white strip between the pupil and the upper eyelid), and in severe cases, the “setting sun” symptom may be noted, when the iris of the eye, like the setting sun, is half immersed under the lower eyelid; sometimes convergent strabismus appears, the baby often throws his head back. Muscle tone can be either low or high, especially in the muscles of the legs, which is manifested by the fact that when supported, he stands on tiptoe, and when he tries to walk, he crosses his legs.

The progression of the hydrocephalic syndrome is manifested by an increase in muscle tone, especially in the legs, while the support reflexes, automatic walking and crawling are reduced. In cases of severe progressive hydrocephalus, seizures may occur.

Movement Disorder Syndrome

The syndrome of movement disorders is diagnosed in most children with perinatal pathology of the central nervous system. Movement disorders are associated with a violation of the nervous regulation of muscles in combination with an increase or decrease in muscle tone. It all depends on the degree (severity) and level of damage to the nervous system.

When making a diagnosis, the doctor must solve several very important questions, the main of which is: what is it - a pathology of the brain or a pathology of the spinal cord? This is of fundamental importance, since the approach to the treatment of these conditions is different.

Secondly, the assessment of muscle tone in various muscle groups is very important. The doctor uses special techniques to detect a decrease or increase in muscle tone in order to choose the right treatment.

Violations of increased tone in different groups lead to a delay in the emergence of new motor skills in a child.

With an increase in muscle tone in the hands, the development of grasping ability of the hands is delayed. This is manifested by the fact that the child takes the toy late and grabs it with the whole hand, fine finger movements are formed slowly and require additional training sessions with the child.

With an increase in muscle tone in the lower extremities, the child later gets up on his legs, while leaning mainly on the forefoot, as if “standing on tiptoe”, in severe cases, the lower extremities cross at the level of the shins, which prevents the formation of walking. In most children, with time and treatment, it is possible to achieve a decrease in muscle tone in the legs, and the child begins to walk well. As a memory of increased muscle tone, a high arch of the foot can remain, which makes it difficult to choose shoes. Syndrome of vegetative-visceral dysfunctions

This syndrome manifests itself as follows: marbling of the skin due to blood vessels, violation of thermoregulation with a tendency to an unreasonable decrease or increase in body temperature, gastrointestinal disorders - regurgitation, less often vomiting, a tendency to constipation or unstable stools, insufficient weight gain. All these symptoms are most often combined with hypertensive-hydrocephalic syndrome and are associated with impaired blood supply to the posterior parts of the brain, in which all the main centers of the autonomic nervous system are located, which provide guidance for the most important life-supporting systems - cardiovascular, digestive, thermoregulatory, etc.

convulsive syndrome

The tendency to convulsive reactions during the neonatal period and in the first months of a child's life is due to the immaturity of the brain. Seizures occur only in cases of spread or development of a disease process in the cerebral cortex and have many different causes that the doctor must identify. This often requires an instrumental study of the brain (EEG), its blood circulation (Dopplerography) and anatomical structures (ultrasound of the brain, computed tomography, NMR, NSG), biochemical studies. Convulsions in a child can manifest themselves in different ways: they can be generalized, capturing the whole body, and localized - only in a certain muscle group. Seizures are also different in nature: they can be tonic, when the child stretches out and freezes for a short time in a certain position, as well as clonic, in which the limbs twitch, and sometimes the entire body, so that the child may be injured during convulsions. .

There are many variants of manifestations of seizures, which are revealed by a neuropathologist according to the story and description of the child's behavior by attentive parents. The correct diagnosis, that is, determining the cause of the child's seizures, is extremely important, since the timely appointment of effective treatment depends on this.

It is necessary to know and understand that convulsions in a child during the neonatal period, if serious attention is not paid to them in time, can become the beginning of epilepsy in the future.

Symptoms to Seek to a Pediatric Neurologist

Summing up all that has been said, we briefly list the main deviations in the state of health of children with which it is necessary to contact a pediatric neurologist:

If the child sluggishly sucks the breast, takes breaks, gets tired at the same time. There is choking, leakage of milk through the nose; if the child has a weak cry, and the voice has a nasal tone; if the newborn often spits up, does not gain enough weight; if the child is inactive, lethargic or, on the contrary, too restless and this anxiety increases even with minor changes in the environment; if the child has a trembling of the chin, as well as the upper or lower extremities, especially when crying; if the child often shudders for no reason, falls asleep with difficulty, while sleep is superficial, short in time; if the child constantly throws back his head, lying on his side; if too fast or, conversely, slow growth of head circumference is noted; if the child's motor activity is reduced, if he is very lethargic, and the muscles are flabby (low muscle tone), or, conversely, the child is as if constrained in movements (high muscle tone), so that even swaddling is difficult; if one of the limbs (arm or leg) is less active in movements or is in an unusual position (clubfoot); if the child squints or goggles, a white stripe of sclera is periodically visible; if the baby constantly tries to turn his head in only one direction (torticollis); if the spread of the hips is limited, or, conversely, the child lies in the frog position with the hips separated by 180 degrees; if the child was born by caesarean section or in breech presentation, if obstetrical forceps were used during childbirth, if the infant was born prematurely or with a large weight, if umbilical cord entanglement was noted, if the child had convulsions in the maternity home.

Accurate diagnosis and timely and correctly prescribed treatment of the pathology of the nervous system are extremely important. Damage to the nervous system can be expressed to varying degrees: in some children from birth they are very pronounced, in others even severe disorders gradually decrease, but they do not completely disappear, and mild manifestations remain for many years - these are the so-called residual effects.

Late manifestations of birth trauma

There are also cases when at birth the child had minimal impairments, or no one noticed them at all, but after a while, sometimes years, under the influence of certain loads: physical, mental, emotional - these neurological disorders manifest themselves with varying degrees of severity. These are the so-called late, or delayed, manifestations of birth trauma. Pediatric neurologists often deal with such patients in their daily practice.

What are the signs of these effects?

Most children with late manifestations show a pronounced decrease in muscle tone. Such children are credited with "innate flexibility", which is often used in sports, gymnastics, and even encouraged. However, to the disappointment of many, it should be said that extraordinary flexibility is not the norm, but, unfortunately, a pathology. These children easily fold their legs into the “frog” position, easily do the splits. Often such children are gladly accepted into the rhythmic or artistic gymnastics section, into choreographic circles. But most of them do not endure heavy loads and are eventually expelled. However, these activities are enough to form the pathology of the spine - scoliosis. It is not difficult to recognize such children: they often clearly show a protective tension of the cervico-occipital muscles, often there is a slight torticollis, the shoulder blades stick out like wings, the so-called “pterygoid shoulder blades”, they can stand at different levels, like the shoulders. In profile, it can be seen that the child has a sluggish posture, a stooped back.

By the age of 10-15, some children with signs of injury of the cervical spine in the neonatal period develop typical signs of early cervical osteochondrosis, the most characteristic symptom of which in children is headaches. The peculiarity of headaches in cervical osteochondrosis in children is that, despite their different intensity, the pains are localized in the cervical-occipital region. As they grow older, the pains often become more pronounced on one side and, starting in the occipital region, spread to the forehead and temples, sometimes they radiate to the eye or ear, intensify when turning the head, so that a short-term loss of consciousness may even occur.