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The Moro reaction: More than a reflex,a ritualized behavior of nonverbal communication
Institution:1. Innovative Neonatal and Infant Feeding Disorders Research Program, Center for Perinatal Research, The Research Institute at Nationwide Children''s Hospital, Columbus, OH;2. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH;3. Division of Pediatric Gastroenterology and Nutrition, Nationwide Children''s Hospital, Columbus, OH;4. Division of Pulmonary Medicine, Sleep Laboratory, Nationwide Children''s Hospital, Columbus, OH;5. Division of Neonatology, Nationwide Children''s Hospital, Columbus, OH;1. Department of Internal Medicine, Maimonides Medical Center, New York City 11219, USA;2. Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India;3. Department of Cardiology & Internal Medicine, Maimonides Medical Center, New York City 11219, USA
Abstract:ObjectiveTo propose a phylogenetic significance to the Moro reflex which remains unexplained since its publication in 1918 because both hands are free at the end of the gesture.MethodAmong the 75 videos of healthy term newborns we have filmed in a research project on antenatal education to parenthood, we describe a sequence that clearly showed the successive movements of the Moro reflex and we report the occurrence of this reflex in the videos that were recorded from Time 0 of birth defined as the moment that lies between the birth of the thorax and the pelvis of the infant.ResultsThe selected sequence showed the following succession of the newborn’s actions: quick extension-adduction of both arms, the orientation of the body, head and eyes towards a human person, and full extension-abduction of both arms with spreading of the fingers, crying and a distressed face. There were 13 Moro reflexes between 2 and 14 s from Time 0 of birth. We found a significant association between the occurrence of the Moro reflex and the placement of the newborn at birth in supine position on the mother’s abdomen (p = 0.002).DiscussionThe quick extension-adduction of both arms which started the sequence may be considered as a startle reflex controlled by the neural fear system and the arm extension-adduction which followed as a Moro reflex. The characteristics of all Moro reflexes were those of ritualization: amplitude, duration, stereotype of the gestures. This evolutionary process turns a physiological behavior, grasping in this case, to a non-verbal communicative behavior whose meaning is a request to be picked up in the arms. The gestures associated with the Moro reflex: crying and orientation of the body, head, and eyes towards a human person, are gestures of intention to communicate which support our hypothesis. The neural mechanism of the Moro reaction probably involves both the fear and the separation-distress systems.ConclusionThis paper proposes for the first time a phylogenetic significance to the Moro reflex: a ritualized behavior of nonverbal communication. Professionals should avoid stimulating the newborns’ fear system by unnecessarily triggering Moro reflexes. Antenatal education should teach parents to respond to the Moro reflexes of their newborn infant by picking her up in their arms with mother talk.
Keywords:Human newborn  Moro reflex  Ritualization  Nonverbal communication  Active defense reaction  Parental education
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