It may be troubling seeing your baby clenching their fists practically all of the time, even though you want them to hold on to toys or your fingers.
Usually, babies under six months hold their fists clenched most of the time. However, if a baby aged more than six months does so, it might be a cause for concern and necessitate medical care.
Read on to know more about the causes of clenched fists in infants, when you can expect your baby to unclench their fists to hold other objects, and why some newborns don’t clench their fists.
Why Do Babies Clench Their Fists?
The palmar grasp reflex is the reason behind clenched fists in fetuses and babies younger than six months. This primitive reflex is a normal part of a baby’s development and disappears after the age of six months as the baby’s brain matures (1).
Some anecdotal beliefs state that clenched fists indicate stress or hunger in babies. However, this is a normal reflex that may have been required for survival in the evolutionary past. You may look for other signs to understand stress or hunger in babies.
Spastic cerebral palsy or brain damage may cause the persistence of palmar grasp reflex beyond the age of six months. Brain damage may indicate shaken baby syndrome. Consult a pediatrician for necessary evaluation. Early identification and interventions could improve the quality of life and may prevent severe dysfunctions (2).
Why Do Babies Clench Fists While Feeding?
It is not just while feeding, but while sleeping, playing, or any other time that an infant under six months of age may clench their fists due to the primitive grasp reflex.
Clenched fists are normal until six months of age, and it may not be a useful method to understand your baby’s hunger. You may look for other feeding cues, including (3):
- Lip licking
- Keeping hands in the mouth
- Arm and leg movements
- Sucking sounds
- Looking towards you
Why Do Some Babies Not Clench Their Fists?
Clenched fists in babies are seen from the fetal stage to six months after birth. The palmar grasp reflex usually appears from the 16th week of gestation.
The following reasons may cause babies not to clench their fists.
- Amniotic band syndrome: Absence of clenched fists in fetal life may indicate amniotic band syndrome. This is a rare condition where strands or bands of amniotic sac wrap the fetus’ fingers, toes, or any other part of the body. The severity of amniotic band syndrome depends on the affected location and the tightness of the wrap. Milder wraps can be surgically removed after birth without causing any physical damage. However, tighter wraps may permanently damage the fingers (4).
- Peripheral nerve injuries: Weak palmar grasp reflex or unclenched fists before the age of six months could occur due to injuries of the peripheral nerve roots, plexus, and spinal cord (2). Babies who have peripheral nerve damage due to complications in labor may develop unclenched fists.
- Floppy babies: In this condition, the muscle tone of the baby is lost due to congenital reasons. These babies feel limp in arms, like a rag doll.
Appropriate prenatal care and cesarean sections may help reduce the risk of peripheral neuropathy. You may discuss with your obstetrician to choose the right method of delivery to avoid birth injuries.
When Should Babies Unclench Their Fists?
The baby will gradually begin grasping, holding, and releasing objects with their tiny fingers as the reflex fades. Babies do this on their own as their little brain matures. Unclenching of fists indicates a maturation of higher motor centers of the brain and development of voluntary motor functions (5) (2).
What if a three-month old baby doesn’t unclench their fist even momentarily?
Then you should approach your pediatrician. Persistence fist clenching without even a transient opening may point to some serious condition like spasticity.
Frequently Asked Questions
1. Do closed fists always mean the baby is hungry?
No. If your baby has a clenched fist, it does not necessarily have to mean that they are hungry. It might just be a developmental reflex. However, to be sure, you may check for other signs of hunger as well.
2. When should I be worried about clenched fists?
If your baby has their fists clenched all the time tightly and does not unclench them easily, it might indicate an underlying neurological problem. However, it is advised to consult with the doctor regarding the same for a confirmed diagnosis.
3. Why do babies clench their fists when sleeping?
Babies usually clench their fists while sleeping as a result of the primitive grasp reflex and not due to any developmental disorder.
4. What is clenched fist syndrome?
Clenched fist syndrome is when a person keeps one or both hands tightly clenched. It can be seen in various age groups. This is considered a psychological disorder since there won’t be any somatic pathologies causing the condition. However, it can be associated with swelling and stiffness. These symptoms can be due to continuous clenching of the hands. Doctors may look for all possible causes of clenched fists and evaluate the mental health to establish the diagnosis (6).
Often, babies open up their fists a little later than expected. You need not worry as it is normal. Going through developmental milestones later than others is not something that should bother you, as it takes time for some babies to cope with the changes they notice within themselves. If your baby’s clenched fists remain the same beyond six months of age, you should consult the baby’s pediatrician. It may indicate an issue that needs to be given immediate attention and starting treatment as early as possible can be beneficial.
- The palmar grasp reflex causes the fetuses and babies under six months to keep their fists clenched most of the time.
- Unclenching of fists indicates proper neuromotor development enabling babies to hold and grasp objects.
- The persistence of clenched fists beyond six months could indicate an underlying neurological issue. Talk to your pediatrician if your baby keeps its fists clenched or doesn’t try to grasp objects or items even after six months.
2. Aabha A. Anekar and Bruno Bordoni; Palmar Grasp Reflex;StatPearls Publishing (2020)
3. Caring for Your Baby; Health Information Translations
4. Amniotic Band Syndrome; UCSF Benioff Children’s Hospital
5. Newborn Reflexes; Stanford Children’s Health
6. The clenched fist syndrome: case report of a clinical rarity of special interest for psychiatrists and hand surgeons; BMC Psychiatry