What Is the Rooting Reflex?

Newborn babies cannot do much for themselves and thus rely on their caregivers in the first few months of their lives. One thing they can do well is eat. Newborn babies have a set of innate reflexes that help support their nutrition and growth in the early stages of their lives. One of these mechanisms is known as the ‘rooting reflex’.¹

What is the rooting reflex? 

The rooting reflex is a primitive reflex seen in babies from up to 4-6 months old. It is essential for babies to have this as it helps them find a food source (i.e. a breast or bottle) and to initiate feeding. The reflex can serve as an early cue for hunger when the skin around their mouth is stimulated.² 

What happens next can be seen as an automatic muscle response, where a baby will open their mouth and turn their head towards the side of the mouth or cheek that is stimulated, opening their mouths with their tongue thrusting. Once the food source is found, the baby will instinctively latch onto it and consume the milk or formula provided by the caregiver.^2,3 

Whilst physical stimulation (i.e. touching the baby's face) is the most well-known stimulus for the reflex, it is not the only one. For example, both hunger and the smell of milk will also trigger the rooting reflex. All of these stimulators will prompt instinctual rooting for a breast or bottle. Some babies may exhibit the rooting reflex when they seek to suck on a pacifier or their thumb for comfort, rather than for feeding. Understanding your baby's cues and needs is essential in responding appropriately to the reflex.² 

It is important to distinguish the rooting reflex from the sucking reflex, another primitive reflex that occurs when the roof of a baby's mouth is touched. The sucking reflex is responsible for the coordination of breath with swallowing whilst feeding, allowing milk to enter the stomach instead of the lungs. It can be felt when inserting a finger into a baby’s mouth. Both reflexes work together to ensure adequate and safe feeding in newborns.^1,3

The rooting reflex duration and development 

As a baby develops, the rooting reflex gradually disappears. It is most prominent during the first few months of life but becomes less pronounced as the baby grows. This fading of the reflex is a sign that a baby’s nervous system is maturing. As such, the rooting reflex will gradually be replaced by more deliberate and controlled movements over time.^1,2 This includes infants moving in response to voices or noise and, eventually, them gaining the voluntary control necessary to initiate feeding and explore their surroundings independently. This shift from reflexive behaviour to intentional actions is an important milestone in the baby's nervous system and social development.^1,2 

Why the rooting reflex matters

The rooting reflex holds significant clinical importance in several ways. Firstly, it serves as a valuable tool for monitoring developmental milestones in infants, as it gives insight into the maturation of a baby’s nervous system and their social development.¹ 

Healthcare professionals often use the rooting reflex to assess the neurological health of newborns.¹ An absent rooting reflex can be a sign of feeding difficulties or problems, and you should speak to your healthcare provider if you notice any changes in your baby’s behaviour.^1,3

When to seek medical help 

Knowing when to seek medical help with a baby's rooting reflex is crucial for ensuring the well-being of the newborn. The primary cause is if a newborn completely lacks a rooting reflex.³ This can sometimes manifest on one side of the face, and in more worrisome cases, on both sides, which may be indicative of an underlying issue with the baby's nervous system. 

An absent rooting reflex should not be taken lightly, as it could point to neurological problems requiring immediate medical attention.² Further points of concern when the rooting reflex is missing are causes such as physical illnesses like jaundice or lethargy.⁴

Any change in the rooting reflex can be an early sign of various health issues and is cause for medical attention. Similarly, babies showing the rooting reflex past 4-6 months of age may also be experiencing issues with their nervous system, such as cerebral palsy and autism.⁵ It is important to know that these time periods are rough estimates and that every baby is different.

Various factors can influence the rooting reflex in babies. These factors include their age, hunger level, and overall physical condition. Additionally, a baby's alertness and responsiveness to external stimuli can affect the strength of their rooting reflex. However, you should consult a healthcare professional if you have any concerns about your baby's rooting reflex.^2,5

FAQ's

When does the rooting reflex occur?

The rooting reflex is normally present from birth to 4-6 months of age.⁵

What is the purpose of the rooting reflex?

The reflex helps to initiate feeding in the first few months of life, it can also serve as an indication of whether a baby is hungry.^2,5 

What does the rooting reflex look like?

Stroking the side of a baby's mouth or cheek will make the baby turn to the side of stimulation and ‘look for’ a food source (i.e. bottle or nipple).^1,5

Is the rooting reflex the same as the sucking and swallowing reflexes?

The rooting reflex is related to but distinct from the sucking and swallowing reflexes. The rooting reflex involves the baby's automatic turning of the head and opening of the mouth in response to a touch on the cheek, helping them find a nipple. The sucking reflex is the rhythmic, automatic sucking motion the baby makes once they've latched onto the nipple, while the swallowing reflex occurs when the baby swallows the milk during feeding. These reflexes work together to facilitate breastfeeding.^2,3

What happens as the rooting reflex disappears?

The gradual disappearance of the rooting reflex reflects a baby's growing motor skills. As the rooting reflex disappears, babies transition to more mature feeding patterns and can begin to self-regulate their feeding.²

Can the rooting reflex be tested for in newborns?

Yes, the rooting reflex can be tested in newborns as a part of the routine neonatal examination. To test the rooting reflex, a gentle touch or stroke is applied to the baby's cheek. If the baby turns their head toward the side that was touched and opens their mouth, this reflex is considered present and normal.⁵

What should parents or guardians know about the rooting reflex?

Parents and caregivers should be aware that the rooting reflex is an instinctual response in newborns. It gradually diminishes as the baby develops voluntary movements and head control.⁵

How can parents encourage or stimulate the rooting reflex during breastfeeding?

To encourage or stimulate the rooting reflex during breastfeeding, parents can start by ensuring a comfortable and quiet environment for feeding. Gently stroke the baby's cheek with a clean finger or the nipple itself, allowing the baby to feel the soft touch. When the baby turns their head and opens their mouth toward the stimulation, gently guide them to the breast, making sure they achieve a deep latch for effective feeding.^1,2 

What is the relationship between the rooting reflex and a baby's development?

As the rooting reflex fades, it allows the baby to transition from automatic, instinctual behaviours to more intentional and purposeful movements, which are critical for their overall growth and development.⁵

When should I be worried about my baby's rooting reflex?

You should be concerned about your baby's rooting reflex if it persists beyond the typical age of 4-6 months, as this may indicate a delay in nervous system development. You should also seek medical advice if your baby loses the reflex on one or both sides.^4,5

Is it normal for babies to have variations in the rooting reflex's strength or duration?

Yes, it's normal for babies to exhibit some variability in the strength and duration of their rooting reflex. Some babies may have a more pronounced reflex than others, and the duration may also vary.⁵ 

What factors can affect the rooting reflex in babies?

Various factors can influence the rooting reflex in babies. These factors include their age, hunger level, alertness, responsiveness, and overall physical condition.⁵ 

Summary

The rooting reflex plays an essential role in the early development and well-being of babies. This reflex, which is characterised by a baby's automatic turning of the head and mouth towards a stimulus, is important in facilitating feeding from a breast or bottle and ensures that babies receive adequate nutrition in their early lives. Furthermore, it serves as a crucial indicator for evaluating a baby’s health and neurological development. The presence or absence of the rooting reflex helps healthcare professionals monitor developmental milestones. In essence, it is vital for a baby's healthy feeding and provides valuable insights into their early stages of life.