S.
N TIME SPECIFIC CONTENT MATTER TEACHING AV EVALUATION
O OBJECTIVES LEARNING AIDS
ACTIVITY
1. 2min. Establish SELF IDENTIFICATION :
rapport with Good morning, I am pawanpreet student of Msc
the group (n) 1st year. Today we will discuss about Neonatal
reflexes.
2. 2min. Observe the Previous knowledge:
previous Students have little bit knowledge regarding Neonatal
knowledge reflexes.
3 3min. Introduce the Introduction: Lecture cum
topic to the A reflex action, differently known as a reflex, is an discussion.
group. involuntary and nearly instantaneous movement in
response to a stimulus.
Reflex is an involuntary or automatic, action that your
body does in response to something — without you even
having to think about it. You don't decide to kick your leg,
it just kicks. There are many types of reflexes and every
healthy person has them. In fact, we're born with most of
them. Reflexes protect your body from things that can
harm it.
Neonatal reflexes are inborn reflexes which are
present at birth and occur in a predictable fashion. A
normally developing newborn should respond to certain
stimuli with these reflexes, which eventually become
inhibited as the child matures.
4 2min. To define the Definition: Lecture cum What are the
discussion.
5 2min. To describe Purpose: Lecture cum What is the
the purpose of To observe the sign of abnormality. discussion purpose of
neonatal To determine the high risk status in the baby. neonatal
reflexes. To detect any deviation from the normal. reflexes.
To determine proper reflexes in the baby.
6. 10min. To explain the Types of reflexes in newborn : Lecture cum What are the
type of 1) The Rooting and sucking reflex: discussion. type of neonatal
neonatal When baby's cheek or lips are touched he will reflexes.
reflexes. turn towards the source of the stimulation -
mouth open and tongue out, seeking
nourishment. When milk touches his mouth, he
reflexively sucks and swallows. As his eyesight
improves and he learns what objects (bottle,
breast, cup etc) are bringing him nourishment
look like, rooting disappears and is replaced with
a smile, when you are responding to his needs.
Onset: 28weeks GA
Well-established: 32-34 weeks GA
Disappears: around 12 months
Rooting helps the baby become ready to suck.
When the roof of the baby's mouth is touched,
the baby will begin to suck. This reflex does not
begin until about the 32nd week of pregnancy
and is not fully developed until about 36 weeks.
Premature babies may have a weak or immature
sucking ability because of this. Babies also have a
hand-to-mouth reflex that goes with rooting and
sucking and may suck on fingers or hands.
2) Grasping reflex:
Touching baby's palm will make his fingers wrap
around the object and hold on tightly. This will
fade between two and three months - allowing
baby to grasp objects voluntarily.
Characteristics response:
Infant’s finger curl around examiner’s finger, toes
curl downward.
3) Swallowing:
Feed infant, swallowing usually follows sucking
and obtaining fluids.
Characteristics response:
Swallowing is usually coordinated with sucking
and usually occurs without gagging, coughing or
vomiting.
4) Extrusion :
Touch or depress tip of tongue. While the tongue
thrust or 'extrusion reflex' is present, if a baby's
lips are touched her tongue automatically moves
forward. Tongue thrust aids feeding from the
breast or bottle but not solid foods. This reflex
generally fades by around 3 or 4 months of age
but for some babies it will remain active for
longer. While this reflex is still active, if solid foods
are offered it appears like your baby is pushing
the food out of her mouth with her tongue. This
reflex is often mistaken as dislike of food.
Characteristics response:
Newborn forces tongue outward.
5) Glabellar reflex:
Tap over forehead, bridge of the nose or maxilla
of newborn whose eyes are open. continued
blinking with repeated taps is consistent with
extrapyramidal disorder.
Characteristics response:
Newborn blink for first four or five taps.
6) Tonic neck or fencing:
With infant falling asleep or sleeping, turn head
quickly to one side. complete response disappear
by 3-4 month
Characteristics response:
With infant facing left side, arms and legs on that
side extent; opposite arm and leg flex( turn head
to right and extremities assume opposite
postures).
7) Moro reflex:
The Moro reflex is often called a startle reflex
because it usually occurs when a baby is startled
by a loud sound or movement. In response to the
sound, the baby throws back his/her head,
extends out the arms and legs, cries, then pulls
the arms and legs back in. A baby's own cry can
startle him/her and begin this reflex. This reflex
lasts about five to six months.
Characteristics response:
Symmetric abduction and extension of arms are
seen, fingers fan out & form a C with thumb and
forefinger; slight tremor may be noted, arms are
abducted in embracing motion and return to
reflexion and the movement.
8) Stepping reflex or walking:
This reflex is also called the walking or dance
reflex because a baby appears to take steps or
dance when held upright with his/her feet
touching a solid surface. This reflex appears at
birth, lasts for 3-4 months, then reappears at 12-
24 month.
Characteristics response:
Infant will simulate walking alternating flexion
and extension of feet ; term infants walk on the
soles of their feet and preterm infants walk on
their toes.
9) Crawling :
Place newborn abdomen. Newborn makes
crawling movements with arms and legs.
Responses disappear at the 6 weeks of the age.
10) Deep tendon:
Use finger instead of percussion hammer to elicit
patellar or knee jerk; reflex newborn must be
relaxed. Reflex jerk is present; even with newborn
relaxed, non-selective overall reaction may
occurs.
11) Startle :
Perform sharp hand clap; best elicit if newborn is
24 to 36 hours old. Arms abduct with flexion of
elbows, hands stay clenched. Response disappear
by 4 month of age. Response is elicit more rapidly
in preterm infants.
12) Babinski reflex
When the sole of the foot is firmly stroked, the
big toe bends back toward the top of the foot and
the other toes fan out. This is a normal reflex up
to about 2 years of age. The toes hyper extended
with dorsiflexion of big toe recorded as a positive
sign. Absence requires neurologic evaluation,
should disappear after 1 year of age.
13) Trunk incuration or gallant:
Place the infant prone on the flat surface, run
finger down back about 4-5 cm lateral to supine,
first on one side and then down other. Trunk is
flexed and pelvis is swung toward stimulated side.
Response disappears by the fourth week of the
life. Absence suggests general depression of the
nervous system.
14) Magnet :
Place infant in the supine position, partially flex
both lower extremities and apply pressure to the
soles of feet. Both lower limbs should extend
against examiner’s pressure. Absence suggest
damage to spinal cord or malformation.
15) Righting reflex:
With baby lying on his back, allow him to grasp
your thumbs in each hand while you hold on to
his hands, gently pull him into the sitting position
and watch as he tries to hold his head up right.
With his head accounting for a third or more of
his body weight his neck muscles can't yet
support the weight, but he'll give it a good try.
9. 4 min. To summarize SUMMARIZATION:
the topic. So today have discussed about antenatal
examination.
Definition of neonatal reflexes.
Purpose of neonatal reflexes.
Reflexes of neonatal reflexes.
10. 4 min. To recapitalize Recapitalizations:
the topic. What are the neonatal reflexes?
What is the purpose of neonatal reflexes?
What are the reflexes of neonatal reflexes?
11. 3 min.
Bibliography:
.Myles. Text book of midwife, Edition 8 th
.published by
Elsevier, New delhi,2009.
. Dutta DC.Text book of obstetrics, Edition 6th.published
by New central book agency Kolkata, 2009.
. Jacob Annnama, a comprehensive text book of midwife,
2nd edition, Jaypee, New delhi, 2008.
M.H.R D.A.V INSTITUTE OF NURSING JALANDHAR
CLINICAL TEACHING
TOPIC: ANTENATAL EXAMINATION
Submitted to: submitted by:
Respected pawan preet
Miss.ROSELINE mam msc(n)1st yr.
MsC(n)OBG rolls no.4
Lecturer Submitted on: 2.7.2013
SELF IDENTITIFICATION DATA
Name: Pawanpreet
Class: M.Sc (N) 1st Year
Subject: Obstetric & Gynecological Nursing
Venue: Chawla maternity Home
Topic: Antenatal examination
Time: 1 hour
Av aids : Chart, handouts
General objective: At the end of teaching the students will be understand about Antenatal examination.
Specific Objectives: At the end of teaching the mothers will be able to:
1. Define neonatal reflexes..
2. describe the purpose of neonatal reflexes.
3. explain the type of neonatal reflexes..
M.H.R D.A.V INSTITUTE OF NURSING JALANDHAR
CLINICAL PROCEDURE
TOPIC: NEONATAL REFLEXES
Submitted to: submitted by:
Respected pawan preet
Miss.chetna mam msc(n)1st yr.
MsC(n)chn roll no.4
Lecturer Submitted on: 25.7.2013
