My Baby's Primitive Reflexes Are Not Integrating
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published AAP, NIH, CDC guidelines
Last reviewed:
Your baby's physical development is unique, and concerns about primitive reflexes are not integrating, here is what you need to know.
The short answer
Primitive reflexes are automatic movements present at birth that should gradually integrate (disappear) during the first year as your baby develops voluntary movement control. If reflexes persist beyond their expected timeframe, it may indicate neurological immaturity or developmental concerns. Your pediatrician checks reflexes at well visits.
Key takeaways
- Primitive reflexes are automatic movements present at birth that should gradually integrate (disappear) during the first year as your baby develops voluntary movement control. If reflexes persist beyond their expected timeframe, it may indicate neurological immaturity or developmental concerns. Your pediatrician checks reflexes at well visits.
- Usually normal when: Your baby is under 4 months and reflexes are strong and present.
- Call your doctor if: Your baby's reflexes are getting stronger rather than fading.
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP, NIH, CDC guidelines, primitive reflexes are automatic movements present at birth that should gradually integrate (disappear) during the first year as your baby develops voluntary movement control. If reflexes persist beyond their expected timeframe, it may indicate neurological immaturity or developmental concerns. Your pediatrician checks reflexes at well visits. At 0-3 months, all primitive reflexes should be present and strong at this age. The Moro (startle), rooting, sucking, palmar grasp, and ATNR reflexes are normal and important. Their presence shows healthy neurological function. It is generally considered normal when your baby is under 4 months and reflexes are strong and present. However, you should contact your pediatrician promptly if your baby's reflexes are getting stronger rather than fading.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
All primitive reflexes should be present and strong at this age. The Moro (startle), rooting, sucking, palmar grasp, and ATNR reflexes are normal and important. Their presence shows healthy neurological function.
3-6 months
Some reflexes begin to integrate. The Moro reflex should fade by 4-6 months, and the palmar grasp should weaken as voluntary grasping develops. If all reflexes remain very strong with no change, mention it to your pediatrician.
6-9 months
Most primitive reflexes should be integrating or integrated by now. The ATNR should be fading, the Moro should be gone, and voluntary movement should be replacing reflexive patterns. Persistent strong reflexes at this age warrant evaluation.
9-12 months
Primitive reflexes should be largely integrated. Persistence of reflexes like the ATNR or palmar grasp at this age can interfere with voluntary movement development and should be evaluated. Physical therapy can help with reflex integration.
What to Tell Your Pediatrician
- Describe when you first noticed primitive reflexes are not integrating and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a specific reflex is still strong beyond its expected integration age.
- Mention if reflexes seem to be interfering with voluntary movement development.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your baby is under 4 months and reflexes are strong and present.
- Reflexes are gradually weakening as voluntary movement develops.
- Your baby shows good voluntary movement alongside fading reflexes.
- A specific reflex is still strong beyond its expected integration age.
- Reflexes seem to be interfering with voluntary movement development.
- Multiple reflexes persist beyond 6 months.
- Your baby's reflexes are getting stronger rather than fading.
- Your baby is losing voluntary movements while reflexes persist.
What You Can Do at Home
- Keep track of when you notice primitive reflexes are not integrating — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your baby is under 4 months and reflexes are strong and present — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Provide plenty of supervised floor time and tummy time to support your baby's physical development.
- While monitoring at home, seek immediate care if your baby's reflexes are getting stronger rather than fading.
Related Conditions
My Baby Still Has a Strong Grasp Reflex
The palmar grasp reflex (automatic grasping when something touches the palm) should gradually integrate between 4-6 months as voluntary grasping develops. If the reflex persists strongly beyond 6 months, it can interfere with voluntary hand use and should be evaluated.
My Baby Still Has the Fencing Reflex (Persistent ATNR)
The asymmetric tonic neck reflex (ATNR, also called the fencing reflex) causes your baby to extend the arm on the side they are looking toward. It should integrate between 4-6 months. If the ATNR persists strongly beyond 6 months, it can interfere with bringing hands to midline, bilateral hand use, and rolling. Evaluation is recommended.
My Baby Still Has a Persistent Foot Grasp Reflex
The plantar grasp reflex (toes curling when the sole is touched) normally integrates between 9-12 months, around the time a baby begins standing. If this reflex persists, it may affect weight bearing and walking development because the toes curl under instead of spreading flat on the floor. Evaluation is recommended if the reflex persists past 12 months.
Related Resources
Milestone Checklists by Age
Track your baby's developmental milestones from birth to 5 years with age-specific checklists.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is primitive reflexes are not integrating normal?
When should I call the doctor about primitive reflexes are not integrating?
When is primitive reflexes are not integrating normal?
What causes primitive reflexes are not integrating?
What should I mention to my pediatrician about primitive reflexes are not integrating?
Is primitive reflexes are not integrating normal at 0-3 months?
Is primitive reflexes are not integrating normal at 3-6 months?
Should I go to the ER for primitive reflexes are not integrating?
Does primitive reflexes are not integrating go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss My Baby's Primitive Reflexes Are Not Integrating.
Things to mention
- Describe when you first noticed primitive reflexes are not integrating and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a specific reflex is still strong beyond its expected integration age.
- Mention if reflexes seem to be interfering with voluntary movement development.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- A specific reflex is still strong beyond its expected integration age.
- Reflexes seem to be interfering with voluntary movement development.
- Multiple reflexes persist beyond 6 months.
Urgent signs to report immediately
- Your baby's reflexes are getting stronger rather than fading.
- Your baby is losing voluntary movements while reflexes persist.
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
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Related Resources
Bottom line
Most cases of primitive reflexes are not integrating are normal. Talk to your pediatrician if your baby's reflexes are getting stronger rather than fading.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Physical Concerns
My Baby Still Has a Strong Grasp Reflex
The palmar grasp reflex (automatic grasping when something touches the palm) should gradually integrate between 4-6 months as voluntary grasping develops. If the reflex persists strongly beyond 6 months, it can interfere with voluntary hand use and should be evaluated.
My Baby Still Has the Fencing Reflex (Persistent ATNR)
The asymmetric tonic neck reflex (ATNR, also called the fencing reflex) causes your baby to extend the arm on the side they are looking toward. It should integrate between 4-6 months. If the ATNR persists strongly beyond 6 months, it can interfere with bringing hands to midline, bilateral hand use, and rolling. Evaluation is recommended.
My Baby Still Has a Persistent Foot Grasp Reflex
The plantar grasp reflex (toes curling when the sole is touched) normally integrates between 9-12 months, around the time a baby begins standing. If this reflex persists, it may affect weight bearing and walking development because the toes curl under instead of spreading flat on the floor. Evaluation is recommended if the reflex persists past 12 months.
Should I Use Adjusted Age for My Preemie's Milestones?
Yes — for premature babies, developmental milestones should be assessed using adjusted (corrected) age, not chronological age, until at least 2 years of age. Adjusted age is calculated by subtracting the number of weeks your baby was born early from their actual age. For example, a 6-month-old born 2 months early would have an adjusted age of 4 months, and should be assessed against 4-month milestones. Most pediatricians use adjusted age for developmental assessment through age 2-3, and for growth charts through age 2.
Baby-Proofing a Small Apartment
Baby-proofing a small apartment is absolutely possible and focuses on the same key safety principles as any home: securing furniture to walls, covering outlets, locking cabinets with hazardous materials, and ensuring safe sleep spaces. Small spaces actually have an advantage - there is less area to monitor. Focus on eliminating the most dangerous hazards first: falls, poisoning, choking, and burns.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.