The Landau reflex is a postural reflex in infants where, when held face-down in the air, the baby lifts their head and extends their back and legs to form a gentle arch against gravity. It typically develops by 4 to 5 months of age and is one of several reflexes pediatricians check to assess whether a baby’s motor development is on track.
How the Landau Reflex Works
When a clinician or parent holds a baby horizontally in the air with a hand supporting the chest and belly (prone suspension), a baby with a fully developed Landau reflex will do three things: lift the head above the plane of the trunk, straighten the spine, and extend the legs. The overall posture looks like the baby is doing a mini Superman pose, actively working against gravity rather than flopping over the supporting hand.
The reflex also has an interesting built-in “switch.” If you gently push the baby’s head down into a flexed position, the legs will drop into flexion too. Release the head, and both the head and legs spring back into extension. This linked response between the head and lower body shows that the brain is coordinating posture across the full length of the spine.
Importantly, no healthy infant hangs completely limp during this test. Electromyographic recordings of neck muscles confirm that even babies who haven’t fully developed the reflex still show some active muscle engagement when held in this position.
When It Appears and Disappears
Research filming infants during horizontal suspension found that full trunk extension and head elevation (face vertical) were present in about 45 percent of babies at four months and in 90 percent of babies between five and ten months. The response stayed remarkably consistent once established. Fewer than 10 percent of infants showed any regression in their postural response from one monthly exam to the next.
Kicking activity during the test was observed in 80 percent of infants older than four months, which is a normal part of the response. The Landau reflex gradually integrates (fades) as the child develops more mature, voluntary postural control, typically between 12 and 24 months of age.
Why Clinicians Check It
The Landau reflex serves as a quick, reliable window into how well a baby’s motor system is maturing. Because it requires coordination between the head, trunk, and legs, its absence can flag problems that might not yet be obvious in other ways.
Absence of the response in infants older than three months is associated with motor weakness seen in conditions like cerebral palsy, motor neuron disease, and intellectual disability. A baby who cannot extend against gravity during prone suspension may have low muscle tone (hypotonia) or neurological issues that warrant further evaluation. The reflex is not a diagnosis on its own, but it is one piece of a broader developmental assessment.
What Happens If It Doesn’t Integrate
On the flip side, a reflex that persists well beyond its expected window can also signal trouble. When primitive and postural reflexes fail to integrate on schedule, they can interfere with the development of more advanced motor skills. Children with retained reflexes may show poor balance, clumsiness, and difficulty with activities like running, cycling, throwing, and catching. They may avoid games that involve physical movement altogether.
Research on healthy preschool children has found that even in the absence of a diagnosed condition, retained primitive reflexes are linked to broader difficulties. These can include challenges with psychomotor development and, once children reach school age, potential academic and behavioral difficulties. The underlying issue is that reflexes meant to serve as building blocks for early movement end up competing with the voluntary motor control a child needs as they grow.
Landau Reflex vs. Parachute Reflex
The Landau reflex is sometimes confused with other postural reflexes, especially the parachute reflex, since both involve holding the baby in the air. The differences are straightforward:
- Landau reflex: Baby is held face-down horizontally. The response is extending the head, back, and legs. Develops around 4 to 5 months.
- Parachute reflex: Baby is turned face-down toward a surface, as if falling. The response is throwing the arms out to “catch” themselves. Develops later, around 8 to 9 months, and is the last postural reflex to appear.
Before the parachute reflex develops, a baby tipped toward a surface will actually pull the arms back toward the body and away from the mat, which is essentially the opposite of the protective response. The parachute reflex is considered a prerequisite for safe independent walking, while the Landau reflex reflects an earlier stage of postural control focused on trunk and head stability.
What to Expect During Testing
If your baby’s pediatrician checks the Landau reflex, the process takes only a few seconds. The clinician will support your baby’s torso with one hand while observing whether the head lifts, the back straightens, and the legs extend. They may gently flex the baby’s head to see if the legs drop in response. The whole thing looks simple, but the coordination it reveals is a meaningful marker of neurological health. It is typically checked alongside other developmental milestones at well-baby visits between 4 and 10 months of age.