Respiratory Reflex: Types And When They Are Checked

When a baby arrives we cannot help but think how small and defenseless it is. We look at it and we know that it depends for everything on us. However, that fragility and defenselessness that we see in our baby, it is not. When a baby is born, it does so with a series of coping mechanisms . These will give you the necessary protection and help you to approach the first moments of your life, for the first time without depending on your mothers.

It can be said that babies are born with a survival instinct . Let’s start by knowing what these mechanisms called reflexes are.

Respiratory reflex: What is a reflex?

The innate, automatic and involuntary responses that a baby presents to an external stimulus are what are called reflexes . Babies as soon as they are born are capable of responding to stimuli of all kinds without the need for learning.

For nine months, the baby has received food, warmth, protection, etc., from its mother. However, at the time of birth , the baby is alone before a new , stressful situation , with smells, sounds and lights that cause a series of reactions or reflections.

These reflexes are not learned , just as prey within minutes of being born are capable of running. Predators, including man, are capable of manifesting the reflexes necessary to stay alive, until their mother takes care of them.

Respiratory reflex: how do reflexes develop?

The baby’s reflexes depend on the midbrain, one of the parts that make up the brain. Its location allows to maintain fluid communication with the main structures of the central nervous system. Located in the brain stem, it is the structure that joins the brain with the cerebellum , the midbrain communicates the diencephalon of the brain with the varolium bridge which in turn joins the cerebellum.

The importance of the midbrain is vital, especially in the first moments of the baby’s independent life. The midbrain is in charge of receiving the baby’s sensory stimuli and in turn provoking the baby’s reaction or reflection to that stimulus. It has the important mission of regulating the baby’s sleep and consciousness.

If a baby lacks reflexes or they manifest in an irregular or abnormal way, we must be alert, these manifestations indicate serious problems , possibly related to the central nervous system.

Respiratory reflex What is it?

As the months of gestation go by, the different organs of the baby begin to form, some will finish maturing after the part, while others, such as the respiratory system , must be fully formed and mature to begin to function with total precision.

The baby has been kept in an aqueous medium throughout the pregnancy and at the time of delivery, the neonate must change oxygenation through the umbilical cord to breathing in a different medium . To make this change successfully, the baby must have good neuronal maturation, since through an involuntary reflex called the respiratory reflex, the midbrain will control the movement of inhaling and exhaling , causing the lungs to fill with for the first time. oxygen.

When the baby is born by natural childbirth, it will eliminate all the pulmonary and amniotic fluid that is in the lungs, for this the birth canal will be helped, thanks to the pressure that it exerts on the baby’s chest. With clean lungs, it will take just 30 seconds for the respiratory reflex to act,  since the umbilical cord from which you have been breathing until now, is cut.

At the time of delivery, the baby will continue to breathe through the cord. When the cord is cut , the baby stops receiving oxygen, activating the respiratory reflex. It is then when the midbrain function is activated , which, as we have mentioned, will control the inspiration / expiration movements with which to receive its first breath of oxygen.

At that moment the air forcefully enters his small lungs , still attached, expanding them . It is the first time that the baby breathes by himself, from now on a chain of events, with the first breath the heart-pulmonary blood circulation begins, the heart rate increases, thus beginning his new life as an autonomous being.

Types of reflections

The reflections can be primary or secondary, the difference is as follows:

• Primary reflexes are the reflexes that babies are born with, they are innate and tend to disappear over time.
• Secondary reflexes appear within a few months of the baby’s life.

The primary reflexes. They are activated as soon as they are born, they are the most basic and primary reflexes of the human being and their main and first mission is to make all the vital systems of the baby work perfectly, it will protect by causing a reaction of the baby, to potentially dangerous stimuli, from the outside and it will help you relate to the new world you are facing.

Within the primary reflexes , we find:

Adaptive reflexes

They are the reflections that protect babies from possible dangers, such as closing their eyes to a powerful source of light or turning their body away from a source of heat.

Legacy reflexes

They are the genetically inherited reflexes of our ancestors, such as grabbing anything that touches their little hands, this is due to the instincts of the baby primates, who had to cling to the hair of their mothers both to feed themselves and to be transported.

The primary reflexes are:

• Respiratory reflex

It is the innate reflex that is activated when the umbilical cord is cut. At that moment, the baby inhales its first breath of oxygen, starting automatic respiration, as we have discussed previously.

• Search reflection

When caressing the baby’s cheek or the areas near his mouth, the baby will turn his head looking for the hand that caresses him, he will do so by opening his mouth. This reflex will help the baby to find its mother’s source of nourishment. The more you feel hungry, the more this searching reflex becomes more acute. The search reflex usually disappears by 3 months.

• Suction reflexes

Very closely linked to the search reflex, the sucking reflex activates the production of milk in the mother, when the baby finds the mother’s nipple it will suck, first the colostrum, a substance rich in nutrients and necessary for the proper development of the baby milk .

• Grip reflex

It is the reflex that helps the baby not to fall, that is, the newborn baby will try to catch any object that he can reach, if we put a finger in his hand, the newborn will catch it quickly, exerting pressure. This reflex does not disappear completely, since throughout our lives and in certain situations the pressure reflex arises.

• Tense neck reflex

It is an obvious reflex when the newborn baby is placed on his tummy. Faced with this situation, the child turns his head to one side, extending the arm and leg on that side while keeping the opposite arm and leg flexed.

• Moro reflex

It is the sensation of falling, it consists of catching the newborn and after keeping it supported on the palm of the hand, withdrawing it to let it loose for a short moment. At that moment the Moro reflex is activated, where the baby, when feeling fall, extends the arms, raises the legs, joins the soles of the feet and makes the head back.

Surely we have all dreamed that we fell off a cliff, plane, etc. That feeling of falling is so strong that it often wakes us up. In that situation, while we dream, the Moorish reflex is activated.

• Automatic gear reflex

This reflex is seen when the baby is held under the arms while his feet are on a hard surface. Immediately afterwards, the baby will try to take a step, as if he wanted to walk. It is a reflex and adaptation movement, since in the amniotic fluid, the baby through the kicking movement could change position or turn.

• Babinski reflex

It is the reflex that is appreciated when the newborn is touched the sole of the foot, this reflex remains during the first year of life. By touching the sole of the foot, the baby raises the big toe, stretching and opening the rest of the toes in a fan.

Galant’s reflection

It consists of placing the newborn face down, on the palm of the hand and with a pen or the finger, it is crossed both sides of the spinal column. The baby should react by curving the spine towards the side that has received the stimulus. This reflection will also disappear after the year of life.

• Abdominal reflex

It is similar to the previous one, in this case the baby is placed on his back and the stimuli are carried out on the sides of the navel. The baby will experience the same reaction, this time turning the body to the stimulated side.

When are reflections checked?

As we saw in  First days after the baby is born , the reflexes are part of the first recognition that is made to the newborn. At the time of birth, the baby must undergo a routine medical check-up , which will be repeated two more times, at five minutes and at ten minutes .

It is the so-called Apgar Test , where the doctor will score the newborn’s response to certain stimuli.

These stimuli will measure:

• The color of the skin
• Muscle tone
• Respiratory effort
• Heart rate
• The reflections

Each of the tests will be scored with a score between 0 and 2, 0 being the lowest score and 2 the highest. Then the average grade will be calculated and that will be the one that appears as the result of the first test.

In each repetition ( at 5 and 10 minutes), the same tests will be carried out again and will be scored from 0 to 2. The final result will be indicated by the last test. In this way , the state at birth and the baby’s reaction level after the first minutes of life will be assessed . The Apgar Test is very important since the baby’s vital situation is quickly known and it will be possible to act quickly, if necessary.

The scoring criteria can be seen in the following table:

The color of the skin: The color of the newborn’s skin will be observed, assessing its coloration depending on whether it is pale blue, rosy.

The score will be 0 if the skin color is pale blue, 1 if the skin color is pink on the body and bluish on the extremities, 2 when all of the baby’s skin is pink in its entirety.

• Muscle tone: You will have a series of tests that will measure and look at your limbs. It will measure the force that the baby exerts before a stimulus as well as the ease of flexion of the upper and lower extremities.

The score will be 0, when the muscle tone is weak, causing flabby and loose muscles, the score will be 1 if some muscle tension is shown and you will receive a score of 2 when the muscles are toned, with active movements in both arms and arms. legs.

• Respiratory effort: The respiratory rate will be measured if it is slow, normal or fast.

The score will be 0 if the baby is not breathing, with a short and slow breath, he will receive a score of 1 and finally if the baby is crying loudly, he will receive a score of 2.

• Heart rate: Your heart rate and beat rate will be measured using a stethoscope.

The score will be 0 if there are no heartbeats, when the heart rate is less than 100 beats / minute, the score will be 1 and if the heart rate is greater than 100 l / m, your score will be 2.

• Reflexes: How the baby reacts to uncomfortable stimuli such as cleaning the nostrils with a pediatric pear will be measured . In this case, the baby must react with coughing or sneezing.

The baby’s grimaces will also be evaluated in addition to their degree of irritability. The baby will suffer a slight prick, in this way the baby’s reaction to this stimulus is evaluated. The score will be 0 when there is neither a grimace nor irritability reaction. If the baby gestures or makes a face, he will receive a score of 1, while if the answer is gesturing, grimacing and crying, he will have the highest score, 2.

The reflections, when do they disappear?

Most of these newborn reflexes will disappear as the months go by and the nervous system matures . Once the baby takes control and is able to move his muscles voluntarily and not as a reflex and involuntary act, these reflexes disappear.

But there are other reflections that will accompany us throughout life , these are:

• Blink reflex : We involuntarily blink before certain stimuli as it is before a light stimulus.
• Cough Reflex : When the airway is obstructed, an involuntary cough-like movement occurs that will try to expel the obstruction.
• Sneeze reflex : Pollen, dust, etc. Any particle that irritates the nostrils will cause sneezing as an involuntary effect.
• Nausea reflex : It occurs when there is a negative stimulus in the throat, smell, etc.
• Yawning reflex: A reflex action necessary to oxygenate, additionally, the body.
• Swallowing reflex: A reflex action that occurs with the intake of liquids or solids.