A quick tour
History of knowledge on yawning
Popular knowledge and beliefs
Yawning circumstances
Echokinetic yawning
Parakinesia brachialis oscitans
Fetal yawning
Clinical cases
Website's actuality
The author: Dr Walusinski.
Thematic search
Research by word

with the help of

Website's letter subscription
Yawning and literaure
Yawning by painters
Moebius syndrome and yawning
Content and Contagion in Yawning Sarnecki
Fetal Yawning
Development of Normal Fetal Movements
The first 25 weeks of Gestation
Piontelli A
 Departement of maternal/fetal medicine
Clinica Mangigalli
University of Milan Italy
The emergence of fetal behaviour
de Vries JI, Visser GH, Prechtl HF
Early hum Dev
Fetal mouth movements during behavioural states 1F and 2F
van Woerden EE, van Geijin HP, Caron FJ et al.
Europ J Obstet Gynecol Reprod Biol
Classification and quantitative aspects of fetal movements during the second half of normal pregnancy
Roodenburg PJ, Wladimiroff JW, van Es A
Early Hum Develop
Fetal yawning
Sepulveda W, Mangiamarchi M
Ultrasound Obstet Gynecol
A fetal yawn
Egerman RS, Emerson DS
N Engl J Med
Color Doppler imaging of fetal yawning
Masuzaki H, Masuzaki M
Ultrasound Obstet Gynecol
Fetal yawning activity in normal and high-risk fetuses: a preliminary observation
Petrikovsky BM, Kaplan GP, Holsten N
Ultrasound Obstet Gynecol
Yawning and behavioral states in premature infants
Giganti F, Hayes MJ, Akilesh MR et al.
Development Psychobiol
The potential of four dimensional (4D) ultrasonography in the assessment of fetal awarenes
Kurjak A, Stanojevic M, Azumendi G et al.
J Perint Med
Fetal yawning assessed by 3D and 4D sonography
Walusinski O, Kurjak A, Andonotopo W, Azumendi G
The Ultrasound Review of Obstetrics & Gynecology
Mise à jour le
24 mai 2009
Fetal Yawning
O. Walusinski
On one hand, fetal neurobehavioral patterns have been considered indicators of nervous system development. On the other hand, the capacity of four-dimensional sonography to evaluate complex facial expressions allows recognition of common behaviors with which one can appreciate the prenatal functionnal development of the central nervous system. Using yawning as an example, we review this interpretation on the basis of knowledge derived from phylogeny and ontogeny.
As a flip-flop switch, the reciprocal interactions between sleep- and wake-promoting brain regions allow the emergence of distinct states of arousal. By its ontogenical links with REM sleep, yawning appears as a behavior which causes an arousal reinforcement through the powerful stretch and the neuromuscular connections induced. Yawning indicates a harmonious progress in the development of both the brainstem and the peripheral neuromuscular function, testifying to the induction of an ultradian rhythm of vigilance. The lack of fetal yawn, frequently associated with lack of swallowing, associated or not with retrognathia, may be a key to predict a brainstem's dysfunction after birth.

this text becomes a chapter of the book :
 The Mystery of Yawning in Physiology and Disease
Frontiers of Neurology and Neuroscience tome 28
Karger, Basel 2010
Fetal Yawning
Development of Normal Fetal Movements
The first 25 weeks of Gestation
Piontelli A
 Departement of maternal/fetal medicine
Clinica Mangigalli
University of Milan Italy
 Edited by: Kerry Thoirs
ISBN 978-953-307-947-9
Hard cover, 346 pages
Publisher: InTech
Publication date: February 2012
Fetal Yawning
Olivier Walusinski
Chapter 18
Pages 325-332
Medical sonography is a medical imaging modality used across many medical disciplines. Its use is growing, probably due to its relative low cost and easy accessibility. There are now many high quality ultrasound imaging systems available that are easily transportable, making it a diagnostic tool amenable for bedside and office scanning. This book includes applications of sonography that can be used across a number of medical disciplines including radiology, thoracic medicine, urology, rheumatology, obstetrics and fetal medicine and neurology. The book revisits established applications in medical sonography such as biliary, testicular and breast sonography and sonography in early pregnancy, and also outlines some interesting new and advanced applications of sonography.
General movements are part of the spontaneous movement repertoire and are present from early fetal life. Prior to the seventies, self-perception by the mothers was the only testimony of this fetal motor activity. The advent of ultrasound technology in the 1970s enabled live, unobtrusive observations of fetal behaviors in humans, vastly increasing our knowledge of many others more subtle motor activity (swallowing, respiratory movements, smiling, hiccup) and thus of the human fetal development. Our understanding of the orderly and sequential fetal behavioral's development increased substantly, leading to a greater appreciation of the embryologic and developmental anatomy. The introduction of four-dimensional ultrasound (4D-US) has led to very important conclusions concerning fetal behavior milestones (Kurjak and Azumendi, 2007). The development of oral sensorimotor function and swallowing (essential for the survival) from the fetal period through early infancy assess normal or abnormal neurobehavioral development. While the appreciation of theses functions takes a long time, another daily behavior will can be detected: yawning (Yan et al., 2006). Curiously, little data has been published for 25 years and since the following was written : "yawning is a universally well known, but poorly understood"(Sepulveda and Mangiamarchi, 1995) or "a rudimentary reflex, appears to have at best an obscure purpose, if any"(Egerman and Emerson, 1996). Although remarkably little interest has been paid to yawning in research, even though it is an everyday phenomenon, we will discuss the meaning of this behavior and how its characterization can enhance neuro-behavioral understanding.
fetal yawning 13 weeks
fetal yawning 12 weeks pregnant (see the video) Dr Walusinski ©
A popular belief states that yawning is a response to elevated CO2 or depressed O2 levels in the blood. Provine and Tate (1987) found no support for this hypothesis. Fetal yawning in amniotic fluid (like a fish's yawn in water) also speak data against any association between oxygenation capacity and yawning.
With the significant advances in the image quality, and resolution of ultrasound, and now 3D and 4D technology, the practice of ultrasound examination during pregnancy steps forward from anatomical examination to functional evaluation. Recognition of fetal yawning helps to verify the harmonious progress of brainstem maturation, and on the other hand, to appreciate the neural underpinnings of sleep and arousal systems. An abnormality of yawn's occurrence fosters an intensive research of anemic fetuses (frequency amplified) or brainstem dysfunction with or without mandibular hypoplasia (frequency sparse or null) (Prechtl, 1990). We hope and expect that upcoming researchs complete the datas currently available.
Abadie V, Morisseau-Durand M. Brainstem dysfunction: a possible neuroembryological pathogenesis of isolated Pierre Robin sequence. Eur J Ped. 2002;161(5):275-280.
American Thoracic Society. Idiopathic congenital central hypoventilation syndrome: diagnosis and management. Am J Respir Crit Care Med 1999;160:368-373.
Almli CR, Ball RH, Wheeler ME. Human fetal and neonatal movements patterns: gender differences ans fetal-to-neonatal continuity. Dev Psychhobiol. 2001;38(4):252-273.
Argiolas A, Melis MR. The neuropharmacology of yawning. Eur J Pharmacol. 1998;343(1):1-16.
Baenninger R. On yawning and its functions. Psychonomic Bul Rev. 1997;4(2):198-207.
Blumberg MS, Luca DE. A developmental and component analysis of active sleep. Develop Psychobiol. 1996;29(1):1-22.
Briscoe J, Wilkinson DG. Establishing neuronal circuitry: hox genes make the connection. Genes Dev. 2004;18(14):1643-1648.
Cattaneo L, Chierici E, Bianchi B et al. The localization of facial moto impairment in sporadic Möbius syndrom. Neurology. 2006;66(12):1907-1912.
Davis FC, Frank MG, Heller HC. Ontogeny of Sleep and Circadian Rhythms. In. Regulation of Sleep and Circadian Rhythms. Turek, Fred. W. and Zee, Phyllis C. eds. Marcel Dekker Inc. New York, 1999. p19-79
de Vries JI, Visser GH, Prechtl HF. The emergence of fetal behaviour. Early hum Dev. 1982;7(4):301-322 and 1985;12(2):99-120.
Dobzhansky T. Nothing in biology makes sense except in the light of evolution. The American Biology Teacher. 1973;35:125-129.
Egerman RS, Emerson DS. Images in clinical medicine. A fetal yawn. N Engl J Med. 1996;335(20):1497.
Ezure K, Tanaka I. Convergence of central respiratory and locomotor rhythms onto single neurons of the lateral reticular nucleus. Exp Brain Res. 1997;113(2):230-242.
Giganti F, Hayes MJ, Akilesh MR et al. Yawning and behavioral states in premature infants. Development Psychobiol. 2002;41(3):289-293.
Graham A. The development and evolution of the pharyngeal arches. J Anat. 2001;199(Pt 1-2):133-141.
Hata T, Kanemshi K, Akiyama M et al. Real-time 3-D sonographic observation of fetal facial expression. J Obstet Gynecol Res 2005;31(4):337-340.
Jacob J, Guthrie S. Facial visceromotor neurons display specific rhombomere origin and axon pathfinding behavior in the chick. J Neurosci. 2000;20(20):7664-7671.
Joseph R. Fetal Brain Behavior and Cognitive Development. Developmental Rev. 2000;20(1):81-98
Kinney HC, Brody BA, Kloman As etal. Sequence of central nervous system myelination in human infancy. J Neuropathol Exp Neurol. 1988;47(3):217-234
Kobayashi T, Good C, Mamiya K, et al. Development of REM sleep drive and clinicals implications. J Appl Physiol. 2004;96(2):735-746.
Köntges G, Lumsden A. Rhombencephalic neural crest segmentation is preserved throughout craniofacial ontogeny. Development. 1996;122(10):3229-3242.
Kumar R, Macey PM, Woo MA, et al. Diffusion tensor imaging demonstrates brainstem and cerebellar abnormalities in congenital central hypoventilation syndrome. Pediatr Res. 2008;64(3):275-280.
Kurjak A, Stanojevic M, Azumendi G et al. The potential of four dimensional (4D) ultrasonography in the assessment of fetal awareness. J Perinat Med. 2005;33(1):46-53.
Kurjak A, Azumendi G. The fetus in three dimensions. Imaging, Embryology and fetoscopy. Informa healthcare. London 2007. 520p.
Marder E, Rehm KJ. Development of central pattern generating circuits. Curr Opin Neurobiol. 2005;15(1):86-93.
Masuzaki H, Masuzaki M. Color Doppler imaging of fetal yawning. Ultrasound Obstet Gynecol. 1996;8(5):355-356.
Matsumato M, Yanagihara T et al. Antenatal three-dimensional sonographic features of Pierre Robin Syndrome. Case report. Gynecol Obstet Invest. 2001;51(2):141-142.
May M, Schaitkin B, Shapiro A: Facial nerve disorders in newborns and children. In The Facial Nerve. Thieme Medical Publishers 2000; 2nd edition:339-365.
Pace-Schott EF, Hobson A. The neurobiology of sleep: genetics, cellular physiology and subcortcal networks. Nature Rev Neurosci. 2002;3(8):591-605.
Petrikovsky BM, Kaplan GP, Holsten N. Fetal yawning activity in normal and high-risk fetuses: a preliminary observation. Ultrasound Obstet Gynecol. 1999;13:127-130.
Prechtl HFR. Qualitative changes of spontaneous movements in fetus and preterm infant are a marker of neurological dysfunction. Early Hum Development. 1990;23(3):151-158.
Provine RR, Tate BC, Geldmacher LL. Yawning: No effect of 3-5% C02. 100% 02, and exercise. Behav Neural Biol. 1987;48(3):382-393.
Robinson SR, Blumberg MS, Lane MS et al. Spontaneous motor activity in fetal and infant rats is organized into discrete multilimb boots. Behav Neurosci. 2000;114(2):328-336.
Roodenburg PJ, Wladimiroff JW, van Es A et al. Classification and quantitative aspects of fetal movements during the second half of normal pregnancy. Early Hum Develop. 1991;25(1):19-35.
Rose RJ. Prenatal programming of behavior: a twin study perspective. Neurosci Biobehav Rev. 2005;29(2):321-327.
Santagati F, Rijli F. Cranial neural crest and the building of the vertebrate head. Nature Rev Neurosci. 2003;4(10):806-818
Saper CB, Chou TC, Scammell TE. The sleep switch: hypothalamic control of sleep and wakefulness. Trends Neurosci. 2001;24(12):726-31.
Sarnat HB. Watershed infarcts in the fetal and neonatal brainstem: an aetiology of central hypoventilation, dysphagia, micrognatia. Europ J Ped Neurol. 2004;8(2):71-87.
Sepulveda W, Mangiamarchi M. Fetal yawning. Ultrasound Obstet Gynecol. 1995;5:(1):57-59.
Siegel JM. Sleep phylogeny : clues to the evolution and function of sleep. In Luppi PH ed. Sleep : circuits and functions. Boca Raton CRC Press. 2005;9:163-176.
Valatx JL. The ontogeny and physiology confirms the dual nature of sleep states. Arch Ital Biol. 2004;142(4):569-580.
van Woerden EE, van Geijin HP, Caron FJ et al. Fetal mouth movements during behavioural states 1F and 2F. Europ J Obstet Gynecol Reprod Biol. 1988;29(2):97-105.
Volpe P, Gentile M. Three dimensional diagnosis of Goldenhar syndrome. Ultrasound Obstet Gyncol. 2004;24(7):798-800.
von Haeckel E. Anthropogenie oder, Entwickelungs-geschichte des menschen, Keimes und stammesgeschichte. Leipzig : W. Engelmann ed. 1877: 770p.
Walusinski O, Deputte B. The phylogeny, ethology and nosogeny of yawning. Rev Neurol (Paris). 2004;160(11):1011-1021.
Walusinski O. Yawning: from birth to senescence Psychol Neuropsychiatr Vieil. 2006;4(1):39-46.
Wan H, Xu Y, Ikegami M, et al. Foxa2 is required for transition to air breathing at birth. Proc Natl Acad Sci U S A. 2004;101(40):14449-14454.
Wragg LE, Smith JA, Borden CS. Myoneural maturation and function of the fetal rat tongue at the time of secondary plate closure. Arch Oral Biol. 1972;17(4):673-682.
Yachnis AT. Cerebellar and Brainstem Development: An Overview in Relation to Joubert Syndrome. J Child Neurol. 1999;14(9):570-573.
Yan F, Dai SY, Akther N, Kuno A, Yanagihara T, Hata T. Four-dimensional sonographic assessment of fetal facial expression early in the third trimester. Int J Gynaecol Obstet. 2006;94(2):108-113.
Yigiter AB, Kavak ZN. Normal standards of fetal behavior assessed by four-dimensional sonography. J Matern Fetal Neonatal Med. 2006;19(11):707-721.
How is a yawn triggered?
Neurophysiology of yawning
The curious phenomenon of contagious yawning
Echokinetic yawning, theory of mind, and empathy
Video of a typical Yawn
Flavio Aloe Yawning
Daquin G, J Micallef, O Blin Yawning
Smith EO Yawning: an evolutionary perspective
Why do people yawn ? 
Neural basis of drug induced yawning Cooper SJ, Dourish CT