Newborn Developmental Senses and Reflexes – OT / NBCOT® Exam Study Guide

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Study Guide


  • Senses such as sound begin to develop before birth.
  • Many of these senses are not matured yet.


  • Fully developed in newborns.
  • Moms may feel their babies kick or respond to loud noises.
  • Babies often get a hearing test when they are born in the hospital.
  • Babies prefer higher-pitched tones such as mom’s compared to lower-pitched tones such as dads.


  • Newborn babies cannot see very well.
  • Eyes are not well-coordinated.
  • May be cross eyed.
  • Babies can only focus up close, about 8-10 inches.
  • Parents should get up close to their baby when interacting with them to bond.
  • Takes about 2 to 3 years for a baby to develop their 20/20 vision.
  • Babies can better distinguish contrast (such as black and white) compared to colors.


  • Babies are believed to have a strong sense of smell, such as for their mother.
  • Studies have shown babies to be able to distinguish between breastmilk and formula.
  • Seems that babies can recognize the smell of their familiar caregivers.


  • Babies prefer sweet compared to sour or bitter.
  • Babies prefer breastmilk over formula.
  • Babies cannot taste salty flavors.


  • Babies loved to be cuddled, held, swaddled, and comforted by touch.
  • Swaddling is considered safe for SIDS because babies can be put on their back and they are not able to roll over.


  • Babies respond to rocking motions.
  • Can be calmed by them.
  • Newborns may enjoy car rides.


  • Thinking about a baby’s senses helps you to understand their skills.


  • Newborns have their rooting and sucking reflexes to help grow.
  • Learn to coordinate the suck-swallow breathing pattern.
  • Sucking strength is not strong.
  • Can drink exclusively breastmilk or formula.
  • Should not be fed water as it can cause an electrolyte imbalance.
  • May nurse every 2-3 hours.
  • Newborns need help with burping the air out.

Bowel and Bladder

  • Incontinent and pee or poop in their diapers.
  • Total assist from caregivers.


  • Crying
  • Cry or not cry.
  • Don’t intentionally start to smile yet.


  • Need full support while being held.
  • On their backs, they may stay there and move their arms and legs with uncoordinated movements.
  • When propped up to sit or for burping, newborns tend to kick into extensor tone and straighten out.
  • Newborns can begin belly time, but won’t be able to really lift their neck up or use their arms to push from the surface.
  • Movement for newborns are primarily driven by their reflex patterns, which are present at birth.

Newborn Reflex Patterns

Reflexes present at birth

  • Feeding
    • Rooting – the head turns when side of mouth is touched.
    • Sucking – sucking occurs when lips are touched by nipple or finger.
  • Arms and legs
    • Palmar and plantar grasp – fingers and toes flex when touched.
    • Stepping – alternating steps when supported upright with some weight on the feet.
    • Moro Reflex – when the baby is tipped back and their arms extend, they abduct out and then flex afterward with adduction.
    • Placing of arms and legs – hand and legs flex and then extend when they are placed on a tabletop.
    • Tonic Labryinthine – when the baby is on their back and their head tilts back, it causes them to stiffen up and arch backwards.
  • These reflexes generally fade beginning at 2 to 3 months.