Newborn Reflexes Assessment Form
Patient information
Patient’s name:
Date of birth: Sex:
Weight (kg): Height (cm):
Each reflex should be observed and documented during the assessment. Mark “Yes” for present or
“No” for absent in the corresponding column. Note any additional observations or concerns
regarding the reflex response.
Reflex Description Present Comments
Babinski reflex When the sole of the foot is
stroked firmly, the big toe moves
upward or toward the top of the
foot.
Yes
No
Extrusion reflex When the baby’s tongue is
touched, they will push it out. Yes
No
Moro reflex If the baby's head moves
suddenly or if they're startled by a
loud noise, they'll extend their
limbs and neck before quickly
bringing their arms together, often
crying.
Yes
No
Palmar grasp reflex The baby will grasp an object
placed in their hand. Yes
No
Plantar grasp reflex The baby will curl their toes
around an object placed at the
base of their toes.
Yes
No
Rooting reflex When the baby’s cheek or mouth
is touched, they will turn their
head toward the stimulus.
Yes
No
Stepping reflex The baby will make walking
movements when held upright
with their feet touching a flat
surface.
Yes
No
Sucking reflex The baby will suck when
something touches the roof of
their mouth.
Yes
No
