Primitive Reflexes in Babies: List, Ages They Disappear and Retained Reflexes
A simple guide to primitive reflexes: Moro, rooting, grasp, ATNR, STNR and more, when each fades, what retained reflexes mean and what the evidence says.
Newborns can do some surprising things: they turn towards a touch on the cheek, grip your finger tightly and fling their arms out when startled. These automatic movements are called primitive reflexes. They are an important sign of a healthy nervous system, and so is the way they gradually disappear.
What are primitive reflexes?
Primitive reflexes are automatic, involuntary movement patterns that babies are born with. They come from the brainstem and help newborns feed, protect themselves and start to move. As the higher parts of the brain mature over the first months, these reflexes fade, or integrate, and voluntary, controlled movement takes over.
Doctors and therapists check reflexes because both their presence at birth and their fading on time tell us how the nervous system is developing.
Primitive reflexes chart
| Reflex | How it's triggered and what happens | Usually fades by | Why it matters |
|---|---|---|---|
| Rooting | Stroke the cheek or corner of the mouth; baby turns towards it with mouth open | About 4 months | Finding the breast or bottle |
| Sucking | Touch the roof of the mouth; baby sucks automatically | Becomes voluntary by about 4 months | Feeding |
| Moro (startle) | Sudden loss of head support or a loud noise; arms fling out, then come back in, often with crying | About 4–6 months | Early protective response |
| Palmar grasp | Press a finger into the palm; fingers close tightly | About 4–6 months | Must fade before a baby can let go of objects voluntarily |
| Asymmetrical tonic neck reflex (ATNR) | Turn the head to one side; the arm on that side straightens and the other bends ('fencing' pose) | About 4–6 months | Must fade for hands to come together at midline and for rolling |
| Stepping | Hold baby upright with feet on a surface; legs make stepping movements | About 2 months | Early leg movement pattern |
| Spinal Galant | Stroke along one side of the spine; hips bend towards that side | About 3–9 months | Early trunk movement |
| Tonic labyrinthine reflex (TLR) | Tilting the head forward or back changes muscle tone in the whole body | Fades in the first months, with full head control developing over the first years | Must reduce for head control, sitting and standing |
| Symmetrical tonic neck reflex (STNR) | Head bends forward: arms bend, legs straighten; head back: arms straighten, legs bend | Appears about 6–9 months, fades about 9–12 months | Linked with getting onto hands and knees before crawling |
| Plantar grasp | Press the sole of the foot; toes curl | About 9–12 months | Must fade before standing and walking |
| Babinski | Stroke the outer sole; big toe lifts and toes fan out | About 12–24 months | Normal in infants; checked in neurological exams |
Ages are approximate and vary between sources and children. Your child's doctor checks these during routine exams.
- 2 months
- Stepping reflex
- 4 months
- Rooting
- Sucking becomes voluntary
- 4–6 months
- Moro
- Palmar grasp
- ATNR
- 9–12 months
- STNR
- Plantar grasp
- 1–2 years
- Babinski
Why primitive reflexes need to fade
Each reflex has to step back so that a new, voluntary skill can appear:
- When the palmar grasp fades, babies can open their hands and let go of toys on purpose.
- When the ATNR fades, babies can bring both hands together in the middle, look at what they’re holding, and roll over.
- When the Moro reflex fades, babies develop more mature protective reactions, such as putting out their hands to catch themselves.
At the same time, postural reactions, like righting and balance reactions, develop. These help a baby hold their head up, sit, crawl and eventually walk.
When to talk to your doctor
-
Usually typical
- Reflexes present at birth
- Same on both sides
- Fading around the usual ages
- Baby reaching new milestones
Keep up routine checks
-
Ask your doctor
- Reflex missing at birth
- Much stronger on one side
- Still strong well past the usual age
- Very stiff or very floppy muscles
- Missing milestones
Get an assessment
A doctor may refer you to a pediatric neurologist, physiotherapist or occupational therapist.
A reflex that persists well beyond the expected age, especially along with stiffness, floppiness or delayed milestones, can be an early sign that the brain’s motor pathways are developing differently, for example in cerebral palsy. Early assessment means early support. Read more about early intervention and OT for infants and toddlers.
“Retained primitive reflexes” in older children
You may read online that school-age children with ADHD, dyslexia, anxiety or coordination problems have “retained primitive reflexes”, and that special exercise programs can integrate them.
How occupational therapy helps
For babies and young children whose reflexes or movement are developing differently, the occupational therapist focuses on function and participation:
- Positioning and handling to support posture and comfortable movement
- Tummy time and floor play to build head, neck and trunk control
- Play at midline, such as bringing toys to the centre and two-handed play, to support hand use
- Feeding support when sucking, rooting or oral-motor skills are a challenge
- Coaching parents to build practice into daily routines
For older children, the OT works on the skills that are hard, such as handwriting, bilateral coordination, balance or self-care, using approaches with good evidence.
Summary
Primitive reflexes are a normal, important part of early development, and their gradual disappearance makes room for voluntary movement. Doctors check them routinely. A reflex that is missing, uneven or persists too long deserves assessment. Claims about retained reflexes in older children are popular online, but the evidence is still limited, so focus on assessment and proven support for the skills your child finds hard.
Related guides: Vestibular activities for babies.
References
- Futagi Y, Toribe Y, Suzuki Y. The grasp reflex and Moro reflex in infants: hierarchy of primitive reflex responses. International Journal of Pediatrics. 2012;2012:191562.
- McPhillips M, Hepper PG, Mulhern G. Effects of replicating primary-reflex movements on specific reading difficulties in children: a randomised, double-blind, controlled trial. The Lancet. 2000;355(9203):537–541.
- Case-Smith J, O’Brien JC. Occupational Therapy for Children and Adolescents. Elsevier.
- Centers for Disease Control and Prevention. CDC’s developmental milestones.
Frequently asked questions
What are primitive reflexes?
When does the Moro reflex go away?
What does it mean if primitive reflexes are retained?
Does reflex integration therapy work?
How do doctors test primitive reflexes?
Written by
Payal Mehta, OT
Payal Mehta is a practising occupational therapist and co-founder of Occupational Therapy OT. She writes on pediatrics, sensory integration, and mental-health practice.
All articles by Payal →This article is for general education and is not a substitute for individualized assessment or treatment by a licensed occupational therapist. Always seek the guidance of a qualified professional for specific concerns.
