A simple clinical test for differentiating physiological from pathological head lag in full-term newborn infants

This prospective study was designed to assess the value of a simple clinical test, a 'feeding test', on the outcome of head lag among term neonates. Of 5718 infants who were examined before their morning meal, 67 had moderate to severe head lag in the absence of predisposing risk factors for head lag. Fifteen minutes following feeding, 62 infants (92%) showed an improvement in or disappearance of head lag with concomitant rise in serum glucose. All of these infants had normal psychomotor development on follow up. In 4 infants in whom no improvement occurred after feeding, an underlying pathological cause for head lag was subsequently diagnosed. Conclusion Use of the feeding test as a screening procedure in apparently healthy newborns with head lag may rule out pathological conditions in over 90% of the cases.