Journals / Yalova Üniversitesi Spor Bilimleri Dergisi / 2026 / Cilt: 5 Sayı: 2

The Mammalian Diving Reflex (MDR) in Infants and Children: Physiological Foundations, Developmental Characteristics, and a Meta-Analytic Synthesis Draft

Bebeklerde Ve Çocuklarda Memeli Dalış Refleksi (MDR): Fizyolojik Temeller, Gelişimsel Özellikler Ve Meta-Analiz

Erengül Özbuğutu(YALOVA ÜNİVERSİTESİ REKREASYON BÖLÜMÜ)0009-0006-7796-6139
Nigar Küçükkubaş(YALOVA UNIVERSITY, FACULTY OF SPORTS SCIENCE, DEPARTMENT OF RECREATION, RECREATION PR.)0000-0003-0886-8923
Pages
283–300
Publication Date
2026-10-23
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The findings indicate that MDR responses attenuate with increasing age and that response magnitude is sensitive to protocol duration, type of stimulus, frequency of exposure, and individual differences in autonomic regulation.

📌 3 Key Takeaways

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Objective & Hypothesis:The aim of this study is to systematically synthesize cardiopulmonary and autonomic response patterns associated with the mammalian diving reflex (MDR) in infants and children, and to evaluate its physiological foundations, developmental characteristics, and clinical/applied implications within a meta-analytic framework.
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Key Findings & Data:The study was designed as a systematic review and meta-analytic synthesis in accordance with PRISMA 2020 guidelines.
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Conclusion & Impact:The findings indicate that MDR responses attenuate with increasing age and that response magnitude is sensitive to protocol duration, type of stimulus, frequency of exposure, and individual differences in autonomic regulation.
🔬Design:Review & Systematic Survey
📍Scope:2020 Verileri
⚙️Variables:dalış refleksi · .kalp hızı · .bradikardi

Abstract

The aim of this study is to systematically synthesize cardiopulmonary and autonomic response patterns associated with the mammalian diving reflex (MDR) in infants and children, and to evaluate its physiological foundations, developmental characteristics, and clinical/applied implications within a meta-analytic framework. The study was designed as a systematic review and meta-analytic synthesis in accordance with PRISMA 2020 guidelines. Studies published between 1980 and 2025 were identified through searches of PubMed, Web of Science, Scopus, and Google Scholar databases. Included studies comprised experimental or prospective observational research examining the effects of MDR—elicited through facial immersion, cold stimulation, or trigeminal activation—on heart rate and other cardiorespiratory outcomes in infants and children aged 0–24 months. Due to limited access to raw data, quantitative synthesis was conducted at a descriptive and comparative level. Across the reviewed studies, MDR activation was consistently associated with significant bradycardic responses, particularly pronounced during the early months of life. Mean reductions in heart rate in infants were most commonly reported within the range of 15–25%, with some cases demonstrating decreases exceeding 50%. The findings indicate that MDR responses attenuate with increasing age and that response magnitude is sensitive to protocol duration, type of stimulus, frequency of exposure, and individual differences in autonomic regulation. Overall, the available evidence suggests that MDR represents a physiologically preserved and predictable short-term cardiorespiratory response during infancy; however, there is insufficient scientific support to interpret this reflex as a developmental gain, a learned skill, or a guarantee of safety in infant swimming or aquatic adaptation practices.

Özet

Bu çalışmanın amacı, memeli dalış refleksinin (MDR) bebekler ve çocuklarda kardiyorespiratuvar ve otonom yanıt örüntülerini sistematik bir yaklaşımla sentezlemek; refleksin fizyolojik temelleri, gelişimsel özellikleri ve klinik/uygulamalı boyutlarını meta-analitik bir çerçevede değerlendirmektir. Çalışma, PRISMA 2020 rehberine uygun olarak planlanan bir sistematik derleme ve meta-analitik sentez taslağıdır. PubMed, Web of Science, Scopus ve Google Scholar veri tabanlarında 1980–2025 yılları arasında yayımlanan 312 çalışma taranmıştır. Dahil edilen çalışmalar, 0–24 ay arası bebekler ve çocuklarda yüz daldırma, soğuk uyaran veya trigeminal uyarım yoluyla tetiklenen MDR’nin kalp hızı ve diğer kardiyorespiratuvar çıktılar üzerindeki etkilerini inceleyen deneysel veya prospektif gözlemsel araştırmalardan oluşmaktadır. Ham verilere erişimin sınırlı olması nedeniyle nicel sentez, tanımlayıcı ve karşılaştırmalı düzeyde gerçekleştirilmiştir. İncelenen çalışmalarda MDR sırasında, özellikle yaşamın ilk aylarında belirgin olmak üzere, kalp hızında anlamlı düzeyde azalma ile seyreden bradikardik yanıtlar rapor edilmiştir. Bebeklerde ortalama kalp hızı düşüşü çoğunlukla %15–25 aralığında bildirilmiş, bazı olgularda bu düşüşün %50’nin üzerine çıkabildiği gösterilmiştir. Bulgular, MDR yanıtının yaşla birlikte zayıfladığını ve yanıt şiddetinin uygulanan protokolün süresi, uyarım türü, maruziyet sıklığı ve bireysel otonom yanıt farklılıklarına duyarlı olduğunu ortaya koymaktadır. Sonuç olarak mevcut kanıtlar, MDR’nin bebeklik döneminde fizyolojik olarak korunmuş ve kısa süreli koşullarda öngörülebilir bir kardiyorespiratuvar yanıt örüntüsü olduğunu göstermektedir; ancak refleksin bebek yüzme veya suya adaptasyon uygulamalarında gelişimsel bir kazanım, öğrenilmiş bir beceri ya da güvenlik garantisi olarak yorumlanmasını destekleyen yeterli bilimsel kanıt bulunmamaktadır.

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Cite This Article

Özbuğutu, E., Küçükkubaş, N. (2026). The Mammalian Diving Reflex (MDR) in Infants and Children: Physiological Foundations, Developmental Characteristics, and a Meta-Analytic Synthesis Draft. Yalova Üniversitesi Spor Bilimleri Dergisi, Cilt: 5 Sayı: 2, 283–300. https://ajindex.com/articles/1626780

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References (20)

  1. Allen, L. G., Howard, G., Smith, J. B., McCubbin, J. A., & Weaver, R. L. (1979). Infant heart rate response to trigeminal airstream stimulation: Determination of normal and deviant values. Pediatric Research, 13(3), 184–187.
  2. Brown, W. U., Jr., Ostheimer, G. W., Bell, G. C., & Datta, S. S. (1976). Newborn response to oxygen blown over the face [Letter to the editor]. Anesthesiology, 44(6), 535–536. https://doi.org/10.1097/00000542-197606000-00013
  3. Costa, M. J., Barbosa, T. M., Ramos, A., & Marinho, D. A. (2016). Effects of a swimming program on infants’ heart rate response. The Journal of Sports Medicine and Physical Fitness, 56(4), 352–358.
  4. Feige, S., Peter, S., Weickmann, J., Michaelis, A., Gebauer, R. A., Weidenbach, M., Dähnert, I., Münch, D., Poschart, M., Wüstenfeld, J., & Paech, C. (2025). Physiologic response to distance diving in healthy children and young adults. Frontiers in Sports and Active Living, 7, 1515674. https://doi.org/10.3389/fspor.2025.1515674
  5. Godek, D., & Freeman, A. M. (2022, September 26). Physiology, diving reflex. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538245/
  6. Goksör, E., Rosengren, L., & Wennergren, G. (2002). Bradycardic response during submersion in infant swimming. Acta Paediatrica, 91(3), 307–312.
  7. Hamilton, J., Moodie, D., & Levy, J. (1979). The use of the diving reflex to terminate supraventricular tachycardia in a 2-week-old infant. American Heart Journal, 97(3), 371–374. https://doi.org/10.1016/0002-8703(79)90439-3
  8. Lundström, A., Karlsson, M., Rydberg, A., & Wiklund, U. (2025). Assessment of arrhythmias and heart rate response in healthy adolescents performing face immersion and body submersion in ice-cold water. Physiological Reports, 13(13), e70430. https://doi.org/10.14814/phy2.70430
  9. Matturri, L., Ottaviani, G., & Lavezzi, A. M. (2005). Sudden infant death triggered by dive reflex. Journal of Clinical Pathology, 58(1), 77–80. https://doi.org/10.1136/jcp.2004.020867
  10. Panneton, W. M. (2013). The mammalian diving response: An enigmatic reflex to preserve life? Physiology, 28(5), 284–297.
  11. Panneton, W. M., & Gan, Q. (2020). The mammalian diving response: Evidence for a brainstem reflex. Respiratory Physiology & Neurobiology, 273, Article 103332.
  12. Pedroso, F. S., Riesgo, R. S., Gatiboni, T., & Rotta, N. T. (2012). The diving reflex in healthy infants in the first year of life. Journal of Child Neurology, 27(2), 168–171. https://doi.org/10.1177/0883073811415269
  13. Ramet, J., Praud, J. P., D’Allest, A. M., Dehan, M., & Gaultier, C. (1990). Trigeminal airstream stimulation: Maturation-related cardiac and respiratory responses during REM sleep in human infants. Chest, 98(1), 92–96.
  14. Rixen, M., Weickmann, J., Gebauer, R. A., Weidenbach, M., Markel, F., Michaelis, A., Dähnert, I., Wüstenfeld, J., Münch, D., Poschart, M., Sieber, A., Schagatay, E., & Paech, C. (2024). First real-life data on the diving response in healthy children. Pediatric Cardiology, 45, 314–322. https://doi.org/10.1007/s00246-023-03370-z
  15. Santos, C., Burnay, C., Button, C., & Cordovil, R. (2023). Effects of exposure to formal aquatic activities on babies younger than 36 months: A systematic review. International Journal of Environmental Research and Public Health, 20(8), 5610. https://doi.org/10.3390/ijerph20085610
  16. Singh, G. P., Chowdhury, T., Bindu, B., & Schaller, B. (2016). Sudden infant death syndrome – Role of trigeminocardiac reflex: A review. Frontiers in Neurology, 7, Article 221. https://doi.org/10.3389/fneur.2016.00221
  17. Tuladhar, R., Harding, R., Adamson, T. M., & Horne, R. S. (2005a). Heart rate responses to non-arousing trigeminal stimulation in infants: Effects of sleep position, sleep state and postnatal age. Early Human Development, 81(8), 673–681.
  18. Tuladhar, R., Harding, R., Adamson, T. M., & Horne, R. S. (2005b). Comparison of postnatal development of heart rate responses to trigeminal stimulation in sleeping preterm and term infants. Journal of Sleep Research, 14(1), 29–36. https://doi.org/10.1111/j.1365-2869.2004.00434.x
  19. Vincenzi, F. F. (2019). Sudden unexpected death and the mammalian dive response: Catastrophic failure of a complex tightly coupled system. Frontiers in Physiology, 10, Article 97. https://doi.org/10.3389/fphys.2019.00097
  20. Yoshinaga, M., Kamimura, J., Fukushige, T., Kusubae, R., Shimago, A., Nishi, J., Kono, Y., Nomura, Y., & Miyata, K. (1999). Face immersion in cold water induces prolongation of the QT interval and T-wave changes in children with nonfamilial long QT syndrome. The American Journal of Cardiology, 83(10), 1494–1497.