STARTLES

A startle is a sudden jerky of the body, more typical of the upper body. All infants startle and there is a startle reflex called the moro reflex (which a doctor or neurodevelopmental psychologist would elicit to check on your baby’s reflexes. The concern is when your baby startles often and especially if they startle without a loud noise or body position change. Startles are a frequent sign and about 60% of infants going through abstinence have frequent startles (or are easily startled or on exam could have an exaggerated Moro reflex). This is a sign of impact on the central nervous system and there are interventions that can help your baby. Note that startles can cause your baby to be irritable/cry more and to impact sleep causing them to wake up. So, helping your baby if they do startle and reducing startles is important.

NOTE: The Following Videos found in this kit under the Parenting Tips from Specialists will provide more information and/or demonstration that might be useful for some of the interventions recommended here.

NAS: Early Interventions

The SOOTHE Technique

NAS Babies & Movement

NAS Babies & Muscle Tone

Touch and Infant Massage

Assistive Rocking and Weighted Devices

STRATEGIES BY DISCIPLINE

NEURODEVELOPMENT

  • Avoid fast movements or position changes for the baby.

  • Handle the baby gently and give the baby intention movements; place your hand on their chest every time before you pick them up.

  • Infant massage will help the central nervous and motor system to mature.

  • Make sure the baby is well supported when picking them up and holding them.

  • Swaddle your baby during handling (diaper changes, feeding etc.) to reduce startles. Make sure to use safe swaddling instructions offered by the manufacturer AND do not swaddle arms in if the baby can roll over.

  • Avoid loud sounds in the baby’s environment (dogs barking, yelling, media etc.).

MEDICAL

  • Determine the root cause of the startle with the help of your baby’s doctor.

  • Let your baby’s doctor know about the startles so they can do a thorough examination (for other potential disorders).

NURSING

  • Tell your Baby’s doctor about the startles.

  • Infant massage on arms and legs is helpful for reducing startles.

  • Chest to chest contact is very beneficial with infants who have startles.

OCCUPATIONAL THERAPY

  • Infant massage is very beneficial especially with baby yoga as part of the routine.

  • Certain positions are more helpful to reduce startles: tummy time, swaddling.

SPEECH PATHOLOGY

  • Reduce the amount of noise in the environment.

  • Be very aware of startles during FEEDs – as this can result in coughing or choking or poor coordination of the suck/swallow/breathe pattern necessary for safe and productive eating.

  • Infant massage with a focus on the mouth to strengthen the oral motor area (mouth

  • muscles) and to help keep the baby calm is very important.

    • Infant massage around the mouth will encourage a more coordinated suck (suck/swallow/breathe) and reduce startles and prevent coughing and choking.