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

Juliane Hentschel; Ruth Ruff; Frauke Juette; Alexander von Gontard; Ludwig Gortner

doi:10.1055/s-2007-992178

American Journal of Perinatology, Table of Contents

Am J Perinatol 2007; 24(10): 611-618
DOI: 10.1055/s-2007-992178

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

Juliane Hentschel¹ , Ruth Ruff¹ , Frauke Juette¹ , Alexander von Gontard² , Ludwig Gortner¹

¹Saarland University Children's Hospital, General Pediatrics and Neonatology, Homburg/Saar, Germany
²Saarland University Hospital, Department of Child and Adolescent Psychiatry and Psychotherapy, Homburg/Saar, Germany

Abstract

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.

KEYWORDS

Neonatal facial expression - caesarean section - Apgar - maternal-infant bonding - eye opening - tongue thrust

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References

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Juliane B Hentschel
M.D. F.A.A.P.

Department of Pediatrics and Neonatology, Saarland University Children's Hospital

D-66421 Homburg/Saar, Germany