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Babinski Sign in Babies: Learn What Is Normal

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Even newborn babies display a range of automatic reflexes that protect them from dangers in their new environment. The Babinski or plantar reflex is one such example. Join Flo for an in-depth explanation.

What is a Babinski reflex?

A healthy newborn is able to demonstrate a number of reflex actions that protect them from dangers in their new environment and prepare them for the developmental challenges that await them in the months ahead.

Among them, the sucking and rooting reflexes help an infant to find food, the tonic neck and grasping reflexes prepare the baby to reach for and hold objects, and the stepping and Babinski reflexes prepare the infant for walking and protect it from falling.

The Babinski reflex, also called the plantar reflex, is commonly tested soon after birth and during routine wellness checkups. It provides an important assessment of normal development and may offer an early indication to parents and healthcare practitioners of developmental problems. The Babinski reflex is relatively easy to test at home and with little training, so you may even want to conduct this assessment yourself!

When the Babinski test is administered by a medical professional, the sharp point at the tip of the handle to a reflex hammer is used to stroke the outer side of the sole of the foot from top to heel. In an adult or older infant, the big toe will move down and the remaining toes will also flex in the same direction and bunch together.

However, in a healthy baby who is under 12 months of age or in an adult with damage to the brain or spinal cord, the big toe will move up and the other toes will extend and spread out. Read on for our comprehensive guidelines for the Babinski reflex — how it's tested and what normal and abnormal findings look like.

When does a plantar reflex appear and go away?

The Babinski sign is common in newborns and typically disappears by 4 months. Some older babies will still display the reflex at 24 months, but beyond this age it is usually associated with developmental problems.

How is a Babinski test conducted?

The Babinski test requires a relatively sharp object to stroke the sole of the infant’s foot from toes to heel. In a clinical setting, this typically consists of the sharp tip that is found at the end of the handle to a reflex hammer — such equipment is ubiquitous and in common usage by pediatricians and support staff. More recently, concerns about infection control have discouraged the use of reflex hammers for this purpose; single-use testing kits are available as an alternative.

Considering the discomfort of the plantar reflex, it’s common to warn an adult patient beforehand of the experience to come. Unfortunately, this is not possible in the case of the newborn or young infant! Nevertheless, it pays to settle the baby and put it at ease before beginning the test. If parents or carers are attending with the child, they can be enlisted in this purpose; after explaining what the procedure involves, they can calm the baby and distract them from discomfort if necessary.

It’s common for parents or carers to be unsettled by the Babinski test — after all, their precious little one is being scratched with a stick! However, it’s worth bearing in mind that testing for this reflex is an important part of a comprehensive wellness check. Once your pediatrician is able to demonstrate the full range of normal reflexes in your baby, it gives positive indications of healthy neurological development.

Testing for the plantar reflex can begin with only a fingernail being used to scratch across the surface of the sole, at first gently and then more firmly. The advantage of this graded approach is that it often allows a normal plantar reflex to be stimulated without the baby becoming upset or resistant to further examination. Once a gentle scratch has been attempted, one can proceed to using a sharper implement.

One begins at the heel of the foot and strokes up the outside border of the sole towards the toes. Even with a sharper object, the motion should be relatively gentle — there should be no digging into the skin of the foot.

When is a Babinski sign normal and abnormal?

The science around the Babinski sign and what it means is not completely understood, even nowadays. It appears that every part of the skin has the potential to reflexively react to a dangerous or harmful stimulation by withdrawing from the cause. It’s easy to imagine this reflex if you ever remember standing on something sharp while barefoot — you’ll recall that your foot (and probably your whole leg!) immediately pulled away from the floor to protect your skin from further damage.

In the Babinski sign, the big toe moves up while the remaining toes extend and spread out in response to the sole of the foot being scratched. This reaction is considered normal in a newborn baby, but usually disappears by 12 months. Although some healthy babies still display the Babinski sign at 24 months, beyond this age it is typically an indication of developmental problems associated with the brain or spinal cord.

The monitoring of the reflexes of newborns and young infants is an important step in checking for developmental problems. By ensuring that all reflexes — Babinski and others — are normal, your pediatrician or family doctor is in the best position to judge your little one’s developmental progress. And if any abnormalities are found, early detection means that you can be advised of the best options that are available for your child’s ongoing care.

https://www.ncbi.nlm.nih.gov/books/NBK397/

https://www.healthline.com/health/babinski-sign#normal-sign

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