Neonatal Facial Movements in the First Minutes of Life-Eye Opening and Tongue Thrust: An Observational Study

Abstract

Infants born by caesarean section (CS) near or at term were observed to display spontaneous facial movements in their first minutes. We hypothesized that those are reproducible. Up to now, nothing was known about the significance, frequency, and determinants of such facial activity. Repetitive eye opening (EO) and tongue thrust (TT) actions were documented during 1 to 5 minutes, 5 to 10 minutes, and 1 to 15 minutes in 102 infants. In addition, 32 infants were recorded on video from minute 2 to minute 10. Infant- and maternal- influencing factors were noted and videos analyzed using Interact (Version 7.1, Mangold International, Arnstorf, Germany). According to our results, 99 of 102 newborns (gestational age, 33 to 42 weeks) performed EO or TT during the first 15 minutes. Preterm and infants with lower Apgar scores and infants born under general anesthesia showed less EO. Infants of smoking mothers, newborns admitted to special care, and infants with lower umbilical artery pH had significantly fewer TT episodes. Within a "normal" population of newborns of > 37 weeks at delivery (n = 57), 97% showed EO and 95% showed TT. In the filmed 32 newborns, infants began EO at 2:40 and TT at 2:34 minutes of life on average. Crying had no influence, but suctioning/intervention reduced EO frequency. In conclusion, EO and TT are occurring regularly during neonatal adaptation. TT seems to be an inborn automatic behavior; numerous occurrences of EO argue for neurological well-being. Both facial actions may initiate maternal-infant attachment.

Preterm infants’ orally directed behaviors and behavioral state responses to the integrated H-HOPE intervention

“…Day 14 findings are likely related to infant characteristics for those infants remaining in the hospital. Improved behavioral organization immediately prior to feeding has the potential to facilitate complete oral feeding (Erlandsson et al, 2007; Hentschel et al, 2007; Matthiesen et al, 2001; Ransjo-Arvidson et al, 2001; Widstrom et al, 1987). However, there are there are no other feeding readiness interventions that address changes in orally directed behaviors and behavioral state.…”

“…Repeated episodes of swiping at mouth are considered a less organized behavior whereas a sustained hand to mouth is more difficult to achieve and is considered a more organized behavior (Bell et al, 2012). In full-term infants, high frequency of orally directed behaviors is associated with successful latch and sustained breastfeeding (Erlandsson, Dsilna, Fagerberg, & Christensson, 2007; Hentschel, Ruff, Juette, von Gontard, & Gortner, 2007; Ransjo-Arvidson et al, 2001). …”

‘Off everyone's radar’: Australian women's experiences of medically necessary elective caesarean section

“…Early human research by Stern (1977), Oliver and Oliver (1978) and others led to the advocation of uninterrupted face-to-face contact between mother and baby following delivery to 'cement' the attachment between them. In later work, German researchers Hentschel et al (2007) hypothesised that it is innate in human newborns to actively try and engage their mother almost immediately following birth.…”

Imprinting, latchment and displacement: a mini review of early instinctual behaviour in newborn infants influencing breastfeeding success

“…Sequential spontaneous behaviour of wide eye opening followed by the seeking mouth gaping and the tongue moving downwards and forwards, usually in the first fifteen minutes of life, signals the mother, who has evolved as an active participant in the latching process, of the nearing readiness to feed 20, 21.…”

“…It has been observed that newborn babies proceed to open their eyes widely after birth 20 occurring about 5–20 minutes after an initial blinking phase. Following this, the mouth opens and the tongue descends and protrudes.…”