What is the Moro Reflex?

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC May 25, 2021

What is the Moro Reflex?

The Moro reflex is one of many infant primitive reflexes - an involuntary movement pattern that we are all born with. Put simply, the Moro reflex is the “startle reflex.” Have you ever seen an infant suddenly startle at a loud noise or sudden movement? That’s the Moro reflex at work!

An article published in 2020 described the Moro reflex as “an involuntary protective motor response against abrupt disruption of body balance or extremely sudden stimulation.” All primitive reflexes are designed for protection and higher level gross motor and cognitive development. The Moro reflex specifically induces a physical response as well as an auditory response - the infant will typically cry during this startle response. This is meant to alert the adult that the infant is in “danger” or needs assistance.

The Moro reflex is triggered by sudden stimuli, such as a loud noise, movement such as being picked up, or even a sudden movement that the infant produces themselves.

This startle response typically only lasts for a few seconds. You’ll see movement in the arms and the legs, as well as a startled look on baby’s face. Because this is a “protective” response, stress chemicals are released. Think of the adrenaline rush associated with “fight or flight” - it’s the same concept.

The Moro reflex is developed in utero. It should be fully developed at birth (however, it has been noted that the Moro reflex may be weaker in premature infants than in full-term infants). Because primitive reflexes are the foundation for higher-level motor and cognitive development, they should integrate (go away) at a certain developmental age. The Moro reflex should be integrated by six months of age/after birth. This reflex is also related to a baby’s development of head control!

How does the Moro reflex integrate?

Although there is no one scientific method to ensure full primitive reflex integration, there are some things to take into consideration when discussing the integration of the Moro reflex.

Baby at play

Let’s talk about sensory integration. By providing an infant with different types of sensory stimulation, new neural pathways will be developed in the brain, thus stimulating new movement and cognitive development. An article on sensory integration discussed that the engagement in sensorimotor activities promoted adaptive behaviors via neuroplastic changes. Simply put, by experiencing different types of sensory activities, our brains can change and thus promote new behaviors!

So what types of sensory activities should you provide to your newborn infant? Keep it simple!

  • Natural movement is always a fantastic option - instead of carrying your newborn in a carrier or stroller, use a wrap to carry your newborn on your body in order to provide more natural movement.
  • Rocking activities are great for newborns and young babies. Specifically, rocking in your arms while lying on their back, side, and stomach. This activates the vestibular system (our sense of movement) and may even elicit the Moro reflex response - that’s ok! It’s a natural response. But keep in mind that your baby likely does not have head control yet, so be sure to support their head/neck and rock slowly.
  • Tummy time. We’ve all heard it over and over again - tummy time is a must! A systematic review from 2020 identified that tummy time was positively associated with gross motor and total development. But how do you start tummy time with a newborn? Simply laying your newborn on your chest, on their tummy, is a great place to start. Then incorporating tummy time into everyday, waking play will begin to establish a routine and improve tolerance in the long run.
  • A variety of sights, sounds, smells, and tactile experiences. The more variety and the more frequent, the better!

Because every newborn is different and every experience is different, there’s no one way to guarantee that the Moro reflex will be successfully integrated by six months of age. However, you can feel more confident that your baby is getting the sensory experiences necessary for potential primitive reflex integration by using the above strategies.

What factors can contribute to an unintegrated Moro reflex?

study looking at the persistence of primitive reflexes and associated problems in children identified these potential factors for unintegrated primitive reflexes, including the Moro:

  • Stress during pregnancy
  • Substance abuse during pregnancy
  • Caesarean section birth
  • Brain damage during labor
  • Premature and low birth weight
  • Significant illness during the first year of life
  • Insufficient stimulation and tummy positioning
  • Lack of free movement time on the floor
  • Stressful environment
  • Not enough nourishment/insufficient weight gain

Additionally, if a child has successfully integrated their primitive reflexes, a sudden or chronic bout of trauma, stress or injury can re-activate these reflexes.

Swaddling baby

While there is no guarantee for reflex integration, there are contributing factors to consider if your child has an unintegrated Moro reflex.

Quick note: you may have heard talk about swaddling and the Moro reflex. However, there has been no research to prove a correlation between swaddling and an unintegrated Moro reflex.

What an unintegrated Moro reflex looks like

Because the Moro reflex elicits a physical reaction, it also includes a chemical reaction - stress hormones are released when the Moro reflex is activated, specifically adrenaline and cortisol. When the Moro reflex is unintegrated, these chemicals are being released more often, resulting in hypersensitivity, adverse reactions to small problems, focus, and concentration, and overall anxiety.

Additional symptoms related to an unintegrated Moro reflex in older children are:

  • Mood swings/sudden changes in behavior
  • Impulsivity
  • Visual challenges
  • Learning difficulties
  • Depression
  • ADHD
  • Autism
  • Emotional and social immaturity
  • Coordination and balance challenges
  • Motion sickness
  • Allergies and decreased immune function
  • Poor tolerance to change
  • Dyslexia and/or Dyscalculia

One Way to Assess Retained Moro Reflex


What can I do if my child has an unintegrated Moro reflex?

If your child exhibits any of the above symptoms/challenges, the first step will be to talk with your pediatrician. Discuss your concerns - if your pediatrician is familiar with primitive reflex integration, they may already have a plan of action ready. If your pediatrician is unfamiliar with primitive reflex integration, feel free to share what you've learned! If you ever feel uncomfortable or your concerns are being pushed to the side, don’t be afraid to seek a new pediatrician.

 

Many Occupational Therapists (OT) are trained in primitive reflex integration techniques. Seek one out! Talk with friends and family members to see if they know anyone specific. Use Facebook groups and Instagram to find someone who has training. Physical Therapists (PT), cranio-sacral therapists, and chiropractors may also have knowledge of primitive reflex integration. It can take some time to locate the right professional, so don’t give up!

Meanwhile, there are some different exercises and play activities that you can incorporate into your child’s daily routine that can help promote the integration of the Moro reflex.

For babies, decreasing the amount of waking time spent in containers is the best way to integrate the Moro reflex. When baby is awake, provide natural movement activities and as much tummy time as possible.

If your child is young, under three years old, focus on developmental movements. Try engaging them in more tummy time activities:

  • Playing in front of the mirror.
  • Looking at favorite books.
  • Laying on tummy on a therapy ball - support them at their hips/legs and roll them forward, so they land on their arms. You can place toys to grab or container toys to engage with in this position.
  • Lay on your stomach across from your child in tummy time! This promotes engagement and can be very motivating.
  • Try different animal crawls: worm crawl, snake crawl, etc. Be creative!
  • Play ball in tummy time - roll the ball back and forth.

If your child is older, you can still focus on the same developmental movements and incorporate tummy time into daily tasks.

  • Complete homework - handwriting, reading, etc. - laying on stomach.
  • Complete activities on a therapy ball, laying on stomach and “walking” out on hands.

If your child is struggling with some of the signs / symptoms associated with an unintegrated Moro reflex, try some of these strategies:

  • Visual challenges:
    • More ball games to promote visual tracking skills. Instead of throwing and catching, try something simpler such as rolling a tennis ball back and forth across the table.
    • Reading with a highlighter strip or a piece of paper under the line that is being read. This helps the eyes focus on the line and decreases distracting visual input.
  • Anxiety:
    • Try calming activities such as deep pressure and heavy work (proprioceptive input) - weighted blanket, massage, movements that work the muscles such as pushing/pulling, animal walks, etc.
    • Visual schedules - this can help the child understand time and space and know when certain things will be happening.
    • Noise-cancelling headphones - if your child is sensitive to sound, this can cause anxiety with certain situations. Try noise-cancelling headphones to decrease the auditory input.
    • Therapeutic Listening Programs
  • Coordination and balance challenges as well as motion sickness:
    • Incorporate more movement into the day.
    • Try obstacle courses, playing on playground equipment, jumping and crashing, balance games, etc.
  • Allergies and decreased immune function:
    • Talk to a naturopathic doctor about allergy and sensitivity testing.
    • Look into incorporating more whole, organic foods into the diet.
    • Talk to a nutritionist about ways to boost immune function.
  • Learning difficulties, Dyslexia, and Dyscalculia:
    • Talk with your child’s teacher about strategies in the classroom and accommodations that can be provided.
  • Social and emotional challenges:
    • Practice! When your child is calm, practice strategies for different social and emotionally challenging situations.
    • Try different programs such as How Does Your Engine Run? and The Zones of Regulation.

One last note

As you continue on your path through primitive reflex integration, keep in mind that your child is unique, and there's nothing wrong with them! Even if they have an unintegrated Moro reflex and seem to be struggling more than other children, your job is simply to help guide them along the way and provide as much support as possible.

You and your child are doing the best you can with what you have, so keep researching and keep trying new things until you find what works. Even then, keep searching because what works now might not work forever especially as your child grows and develops through different seasons of life!

 Be sure to check out our Primitive Reflex Integration Training on Harkla.co!

Resources

Prefer to listen to your information? Make sure to check out our podcast episode on The Moro Reflex!

 Be sure to check out our Primitive Reflex Integration Training on Harkla.co!

 

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/L, AC and Jessica Hill, COTA/L both Certified Occupational Therapy Assistants (COTA). They have been working with children for over 6 years in outpatient settings. Rachel and Jessica specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Rachel and Jessica are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Rachel and Jessica, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.


Leave a comment

Comments will be approved before showing up.


Also in Special Needs

What is interoception?
What is interoception?

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC September 17, 2021

We all know about the five main senses: sight, smell, taste, sound, and touch. Many people also know about two other very important hidden senses: proprioception and vestibular. Did you know there’s a third hidden sense- interoception? 

Interoception refers to the body and brain’s ability to understand and process internal information. Read more to learn the signs of interoception dysfuntion, the relationship between interoception and emotions, and strategies for improving interoception.

Read More
What is the Spinal Galant Reflex?
What is the Spinal Galant Reflex?

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC September 01, 2021

The Spinal Galant Reflex is one of many infant primitive reflexes - an involuntary movement pattern that we are all born with. Learn all about this primitive reflex, what happens when it's not integrated, and what you can do to help.
Read More
What is the Symmetric Tonic Neck Reflex?
What is the Symmetric Tonic Neck Reflex?

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC August 20, 2021

The Symmetric Tonic Neck Reflex (STNR) is one of many infant primitive reflexes - an involuntary movement pattern that we are all born with. Learn all about this primitive reflex, what happens when it's not integrated, and what you can do to help.
Read More