Breast crawl

What is the breast crawl?

Healthy babies usually crawl up the mother’s tummy and latch onto the breast if they are placed skin-to-skin with the mother right after birth. This is the breast crawl. It has many benefits, including helping to settle the baby after the stress of birth and increasing breastfeeding success. As the baby crawls toward the breast, it stays warm against the mother’s skin, picks up healthy bacteria, and is reassured by the mother’s familiar voice, heartbeat, and smells. The baby’s feet push on the uterus, helping it to contract. Once at the breast, the baby massages the breast as it sucks. This increases the release of a hormone in the mother that encourages bonding and the release of milk.

A) Describing the breast crawl

Healthy, unmedicated babies born at full term by vaginal birth generally can crawl up the mother’s tummy (abdomen) and latch themselves onto the breast if they are placed skin-to-skin with the mother immediately after birth (Righard 1990; Varendi 1994). This is called the breast crawl. They learn the skills needed to accomplish this well before their due date (Widström 2019).

B) Importance of the breast crawl

As the baby moves to the breast, the baby is:

  • Kept warm by the mother’s body.
  • Reassured by the mother’s familiar voice and heartbeat.
  • Guided to the areola by its darker appearance and unique smell.
  • Attracted by the smell of colostrum and the breast (Hym 2020).
  • Able to breastfeed when ready.

1) Reducing the baby’s stress

Babies have traditionally been placed at the breast right after birth, but many babies do not respond to this. Birth is stressful for the baby, who leaves a warm, quiet, dark environment and suddenly enters a very different one. The baby’s heart and lungs must undergo a major change, as the baby can no longer rely on the placenta for oxygen and nutrients. Indeed, nearly every system is affected as the baby is born.

This causes stress. The baby is not hungry in this state and needs time to adjust and settle down.

2) The baby guides the process

The breast crawl allows the baby to move toward the breast using reflexes and external cues. The timing of all movement is determined by the baby.

3) Other benefits

The breast crawl:

  • Allows the baby to acquire healthy bacteria from the mother’s skin.
  • Increases breastfeeding success (Girish 2013).
  • Decreases the risk of nipple pain (Yin 2021).
  • Reduces the amount of newborn weight loss (Girish 2013).
  • Reduces the mother’s perception of pain during the repair of an episiotomy, a cut sometimes made at the opening of the vagina to ease delivery (Fernandes 2017).

C) The breast crawl process

1) Preparing for the breast crawl

Immediately after birth, the naked baby is placed tummy-down on the mother’s naked tummy (skin-to-skin). This creates the right environment for the breast crawl. If the room is cool, the baby’s back can be wiped dry while the baby is on the mother’s tummy. A pillow can be placed under the mother’s head so she can watch her baby.

2) The stages of the breast crawl

One study describes nine stages of activity that babies showed immediately after birth (Widström 2011):

  1. The birth cry
  2. A short period of relaxation
  3. An awakening phase
  4. An active phase with limb movement
  5. Rooting (searching) activity and looking at the mother's face
  6. A crawling phase with soliciting sounds
  7. A familiarization phase with licking of the areola
  8. A sucking phase
  9. A sleeping phase

As the baby crawls toward the breast, the baby’s feet push on the uterus, helping it to contract. Once at the breast, the baby’s hands massage the breast as the baby sucks, releasing the oxytocin hormone in the mother (Henderson 2011; Matthiesen 2001).

D) Reasons for a baby not being able to do the breast crawl

The baby’s ability to crawl up the mother’s body, reach the nipple, and latch on without help is decreased by various factors including:

References

Fernandes VR. Effectiveness of breast crawl on the intensity of episiotomy pain and behavioral response among women during episiotomy suturing. Muller J Med Sci Res 2017;8:24-30
 
Girish M, Mujawar N, Gotmare P, et al. Impact and feasibility of breast crawl in a tertiary care hospital. J Perinatol. 2013 Apr;33(4):288-91
 
Heidarzadeh M, Hakimi S, Habibelahi A, et al. Comparison of Breast Crawl Between Infants Delivered by Vaginal Delivery and Cesarean Section.
Breastfeed Med. 2016 May 12
 
Henderson A. Understanding the breast crawl: implications for nursing practice. Nurs Womens Health. 2011 Aug-Sep;15(4):296-307

Hym C, Forma V, Anderson DI, et al. Newborn crawling and rooting in response to maternal breast odor. Dev Sci. 2020 Nov 10:e13061

Matthiesen AS, Ransjo-Arvidson AB, Nissen E, et al. Postpartum maternal oxytocin release by newborns: effects of infant hand massage and sucking. Birth 2001; 28: 13–9
 
Nissen E, Widström AM, Lilja G, et al. Effects of routinely given pethidine during labour on infants' developing breastfeeding behaviour. Effects of dose-delivery time interval and various concentrations of pethidine/norpethidine in cord plasma. Acta Paediatr. 1997 Feb;86(2):201-8
 
Righard L, Alade MO. Effect of delivery room routines on success of first breast-feed. Lancet 1990 Nov 3;336(8723):1105-7
 
Varendi H, Porter RH, Winberg J. Does the newborn baby find the nipple by smell? Lancet. 1994 Oct 8;344(8928):989-90
 
Widström AM, Brimdyr K, Svensson K, et al. A plausible pathway of imprinted behaviors: Skin-to-skin actions of the newborn immediately after birth follow the order of fetal development and intrauterine training of movements. Med Hypotheses. 2019 Oct 14;134:109432
 
Widström AM, Lilja G, Aaltomaa-Michalias P, et al. Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation. Acta Paediatr. 2011 Jan;100(1):79-85

Yin C, Su X, Liang Q, et al. Effect of Baby-Led Self-Attachment Breastfeeding Technique in the Postpartum Period on Breastfeeding Rates: A Randomized Study. Breastfeed Med. 2021 Apr 27