The breast crawl pattern: a somatic perspective
Babies move and organize their movement in response to their environment. Quoting developmental psychologist Esther Thelen:
“Movement arises from a confluence of processes and constraints in the organism and environment. Every movement is unique; every solution is fluid and flexible.”[1]
We’ll apply this perspective on movement development to the breast crawl[2] pattern, one of our earliest movement responses to our new environment after birth. We’re interested in enriching the understanding and appreciation of the breast crawl, and thus encouraging its practice. To this end, we’ve gathered recent research and as somatic movement educators, we’ve also applied a somatic lens to this potent early movement pattern.
The breast crawl is an inheritance of our mammalian lineage[3], and expresses a primal urge and the ability to seek nourishment and bonding. It is a complex full-body sensory and motor response sequence that is available to emerge in the early hours (and weeks and months) of a baby’s life. Through the breast crawl, a baby communicates and participates in satisfying their innate drive for support and connection. This movement pattern reveals an underlying fluid whole-body rhythm, carried along by the rhythmically condensing and expanding gut tube, and led by the baby’s mouthing and rooting.
Value of the Breast Crawl at Birth
When the environment is such that the pattern is supported to emerge in the immediate aftermath of birth, the breast crawl offers continuity and transition between the intrauterine environment, the birth process itself, and the new extrauterine environment. The baby is laid on top of/above the uterus that has been their home until now. Resting here, the baby can orient and yield to the vibration and sound of the caregiver’s heartbeat and voice, now experienced from the outside. When allowed to follow their own timing, most babies will begin to crawl toward the breast within 30-40 minutes after birth. This process is guided primarily by smell: the scent of amniotic fluid and early breast secretions are similar, and the baby’s familiarity with amniotic fluid helps them orient to and seek the scent of the breast. By not cleaning the amniotic fluid from the baby's hands (per a recommended protocol), the baby’s nose and mouth may also orient to their own hand. When the baby's hand is grasping the nipple, this hand-to-mouth (or mouth to hand) connection helps their mouth find the breast, and at the same time, stimulates the breast.
The breast crawl gives the baby the opportunity to exercise and experience their early movement capabilities, and to express and motor out their birth experience. It allows parents/caregivers (and others present) to witness and appreciate that this baby (like all babies) has agency, power, and self-direction even at such a young age. It’s an early opportunity to trust a baby’s competence and follow their timing.
Supporting a baby to experience the breast crawl has clear value in the immediate moments after birth leading up to the first feeding: it promotes good latching and subsequent feeding, supports bonding and attachment between the baby and their birthing person, and provides a first experience of breast/feeding as a whole body, full-person, baby-led action. The breast crawl protocol can be modified for cesarean births (for example, by placing the baby further up, above the abdominal area), for non-birthing caregivers, and other situations.
Facilitating a baby to breast crawl for the first feeding also benefits the birthing person and the dyadic system as a whole. The baby’s leg movements — pushing, stepping, scooting and crawling — massage the internal organs, in particular the uterus. This can help to stimulate the contractions that birth the placenta and reduce the risk of hemorrhage. The breast crawl, with its skin-to-skin contact, the stimulation of the baby’s hand massaging the nipple, and the baby’s mouth suckling the breast, leads to neuroendocrine responses (oxytocin and gastrointestinal hormones) in both the baby and the birthing person. These responses have been shown to positively influence milk flow, the mood and mental wellness of the birthing person, and promote absorption in the digestive tract for both baby and birthing person. The birthing person and their baby can be seen as mutual caregivers[4] (even a single psychobiological organism), supporting each other as they recover from a momentous transition and adapt to their new relationship.
Somatic Movement and Psychophysical Perspectives on the Breast Crawl
The breast crawl movement, guided by the sense of smell, is a manifestation of the chemotaxis utilized by single-celled and multicellular organisms: slime molds seeking sustenance, sperm cells navigating the vaginal canal and uterine tubes, embryonic stem cells migrating to their eventual destination, and our immune cells traveling to where they’re needed.
Through the lens of Body-Mind Centering®, the fullness and ongoing presence of the prevertebrate patterns[5] are expressed in the inchworm quality and rhythm of the breast crawl pattern. At birth, a baby’s way of taking in nourishment transitions from their umbilical cord to their mouth, in resonance with the prevertebrate transition from the navel radiation pattern to mouthing and analing, and its gut-tube orientation.
The condensing and expanding rhythm that underlies the breast crawl movements relates to and resonates with other oscillatory rhythms: the uterine contractions and the baby’s cycling between physiological flexion and physiological extension[6] during birth; ongoing physiological rhythms such as the heart, peristaltic and craniosacral rhythms; and rhythms that are particular to Body-Mind Centering® including the simultaneous condensing and expanding rhythm (SCEY), the autonomic rhythm, and the pulsating fluid rhythm (PFR).
As a whole body pattern supported and initiated by nosing/mouthing/rooting/bobbing reflexes and responses, the breast crawl helps to engage and tone the gut (digestive) tube along its length and as a whole. Many primitive reflexes and righting reactions[7] are stimulated into action, including but not limited to: tonic labyrinthine reflex, palmar grasp, flexor withdrawal and extensor thrust of the upper and lower limbs, stepping reflexes, sucking/swallowing, hand-to-mouth, Babkin, analing, the symmetrical neck and lumbar reflexes, and the body on head (BOH) righting reaction. In the breast crawl, these individual reflexes and reactions are stimulated into expression through a participatory, integrated engagement with the environment, rather than as isolated, single stimulus and response feedback loops. This critical postnatal period calls upon and challenges the multisensory, motoric and perceptual capacity of a whole being adapting to and trying to survive in a dramatically new environment. When we support a baby as they meet this moment, they can fully experience their own competence as well as their interdependence.
In the breast crawl, getting to the breast via scent is the imperative, not getting to the birthing person per se (as ‘other’). The baby is responding to its environment, which is living, moving, responding, and nourishing -- now on the outside as it was when the baby was inside.
The breast crawl also offers a new baby early, germinal experiences of space and the relational cycle of yield/push/reach/pull (another Body-Mind Centering® concept). After actively participating in their birth as they travel head-first through the birth canal (if born vaginally and not breech), the baby locomotes through space via the breast crawl. A baby's senses are developed enough at birth to orient to their “near-reach space”[8] in the new atmosphere of air: to nearby voices and sounds, to the contrast of the areola of the breast, and to the pattern of their caregiver’s face and close range eye-to-eye contact. And as the baby roots and bobs and turns their head to seek a breast, the (even minimal) lifting of their head is a movement into space with gravity as a support. The baby completes the reach and pull phases of the relational cycle as they latch to the breast with their mouth (considered our first limb from a Body-Mind Centering® perspective), opening wide and fully grasping, suckling and swallowing to satisfy their needs, and eventually yielding into satiety and rest.
Value of the Breast Crawl in the Weeks and Months after Birth
Early research into the human breast crawl response and its positive impact on breastfeeding competence emphasized the short duration and fragility of its critical period in the first hour(s) after birth. More recent research demonstrates that the stepping/crawling response that is part of the breast crawl may be visibly present from birth through the first few months. The crawling movement depends on the springiness and tone that develop in the later stages of pregnancy, as the baby is condensed into flexion. After birth, as the baby gains more weight — more fat than muscle in the early weeks — and arrives more fully into gravity, the breast crawl pattern subsides into the background. Even if a baby does not latch and feed in the ‘golden hour’ right after birth (due to difficulties, separation, etc.), they may still learn to breastfeed if the environment is set up for the instinctive behavior of the breast crawl to emerge. Environmental factors include the caregiver in a semi-reclining or side-lying position, skin-to-skin contact, and support for the baby to be in a calm, alert state.[9]
During the days and weeks following birth, while the pattern is still available, the breast crawl can be perceived as an ongoing way of allowing babies to process their experiences and express their capabilities. This is true whether or not a baby is breast (or chest) feeding. Moving in the prone position of the breast crawl, with the baby’s limbs actively meeting the resistance of the underneath surface, supports an engagement and release of tone that can promote settling and rest.
The undulating process of the breast crawl, supported by the motive potency of fluids, oscillates between activity and rest, flexion and extension, and the cycling of sensory and motor activity. The active, locomotive phase of the breast crawl is itself embedded within a series of stages moving through various levels of rest, alertness and activity. This process, when allowed to emerge, demonstrates an early capacity for self- and co-regulation, and expresses the baby's sense of agency and readiness to participate.
When given opportunities to breast crawl on the supine, reclining (or semi-reclining) body of a caregiver, a baby can actively yield and bond with gravity and the earth, and at the same time, with the “safe ground” of their caregiver. The prone position of the breast crawl — front-to-front and perhaps also skin-to-skin — facilitates the baby to express the embracing, flexion phase of the Moro reflex, helping to resolve and counter-balance the extension, startle phase of the Moro that they may have experienced during the birth process and in their early experiences. In this sense, the breast crawl might be appreciated as a variation of baby ball[10], which refers to holding a baby in a balled-up and contained way, with their spine in flexion and their limbs also flexed and gathered in toward the midline.
Comfort and familiarity with prone early on can serve as a bridge to tummy time (eventually not on a caregiver’s body), further assisting caregivers to perceive tummy time not as a place, but a process from which babies learn to move and negotiate gravity and their own bodies. This can help avoid what often gets interpreted as babies “hating” tummy time. Prone also supports a more restorative, parasympathetic state, which aids in bringing balance to the stimulation that can accompany an infant's experience of being on their backs or held upright.
A baby’s birth and immediate after-birth experiences help seed their internal and external microbiomes. Skin-to-skin contact, and the presence of microorganisms related to the vaginal canal, oral cavity and breast secretions all influence the baby’s developing microbiome, and as a result, their digestive and immune functions. This close contact also helps the baby become more familiar with and bond to the particular scents and ‘terrain’ of their caregiver(s).
What have been labeled stepping reflexes are functional at birth in the breast crawl - they are not only a foreshadowing of walking or more mature crawling patterns. The breast crawl can be perceived (and appreciated) as an early, ‘primitive’ and vital crawling stage.
In their first weeks, newborns undergo enormous physiological, homeorhetic[11] and structural changes as they arrive into and adapt to their new environment: breathing air, taking in food, negotiating gravity and regulating their body temperature. Examples of these changes include: the transition from fetal hemoglobin, which binds oxygen more strongly, to postnatal hemoglobin in the first six months; the alveolarization of the lungs continues after birth, and lung capacity doubles in the first four months; and the ossification of bones, including the ribs, which in turn increases the efficacy of the respiratory diaphragm. Providing a young baby with opportunities to rest, explore and actively breast crawl in a prone position facilitates increased stamina, respiratory capacity and structural robustness.
Becoming familiar with resting and moving in a prone position increases a baby’s experience with and ability to keep their airways open, and in this way helps minimize the risk of sudden infant death syndrome (SIDS). The prone position allows for more ventilation of the back of the lungs, where most of its tissue and breathing capacity is.
Most babies are born with asymmetrical preferences (tilts and rotations) in their resting head position, potentially influenced by their intrauterine position and birth process. The movements of lifting and turning their head while in prone engage and help balance a baby’s neck muscles and movement choices, and indirectly, also helps healthy growth of their facial and cranial bones.
Footnotes
1 Esther Thelen (U.S., 1941-2004) was a thought leader in the field of developmental psychology. In her research, she applied chaos theory to the process of babies learning to move and interact with the world. See Sources and links section below for quote citation.
2 The use of the term breast crawl in Western medical literature grew out of the work of researchers who studied and advocated for delivery practices that respect a baby’s innate neurobehavioral instincts and ability to find nourishment and attachment. Fields such as neuroscience, pediatrics, comparative mammalian biology, psychophysiology, trauma, and attachment theory have increasingly recognized and contributed to our understanding of our mammalian selves.
Notable researchers who have influenced Western birth practices include French obstetrician Michel Odent, who in the late 1970s highlighted the early competence of newborns, describing how their rooting reflex helps them seek and attach to the breast. Ann-Marie Widström, Kerstin Uvnäs-Moberg and their Swedish research team followed on Odent’s work and named the complex, competent behavior the breast crawl in a study published in 1987. Pediatrician Lennart Righard and midwife Margaret Alade, also Swedish, used the term infant self-attachment in their research and published videos (1990-95). In further research published in 2011, Ann-Marie Widström’s team described the “nine stages” of the breast crawl, which includes periods of rest, alertness and activity.
3 Like other mammals, humans produce milk to feed their young, have fur or hair, and are warm-blooded. (Specifically, mammals are homeothermic, meaning they maintain a stable internal temperature range, which is a high-energy strategy for thermoregulation.) All mammals at birth follow a mammalian feeding sequence, a set of behaviors that help the infant search for the nipple and begin to suckle.
“From species to species, the immediate postnatal behaviors of all mammalian newborns are remarkably similar. After a short period of recovery, the newborn of each species, guided by neurosensory cues, searches for and independently finds its mother’s teat, grasps it with its mouth, and initiates feeding.” (Smillie, p. 90)
4 The term mutual caregivers arose from research by G. C. Anderson into the mutual benefits of continuous “rooming-in” of a newborn with its birthing person after birth (a practice more prevalent in European countries than in the U.S.), and the risks associated with the parent and baby being separated.
5 The Basic Neurocellular Patterns (BNPs), as defined and developed within the Body-Mind Centering® somatic approach (developed by Bonnie Bainbridge Cohen), is a map of “potential patterns of movement inherent in the nervous system from both a phylogenetic (the evolutionary progression through the animal kingdom) and ontogenetic (the developmental progression of the human infant) perspective.” Within this map, prevertebrate patterns precede the vertebrate patterns, and refer to patterns observed in animals without a spine. The progression of prevertebrate patterns is: vibration, cellular breathing, sponging, pulsation, navel radiation, mouthing, and prespinal. (Quote is by Bonnie Bainbridge Cohen from the BNPs course notebook.)
6 Physiological flexion and physiological extension are described in Body-Mind Centering as whole body movement patterns - total body flexion and total body extension - that arise in the last trimester before birth. These patterns support a baby’s active participation in the birth process, and underlie balanced postural tone as they develop.
In developing the Body-Mind Centering work around primitive reflexes, Bonnie Bainbridge Cohen started with her training as an occupational therapist and the existing literature describing neurophysiological reflexes and expanded upon it. Notably, she applied the principle that every reflex has an opposite and modulating reflex. When there was not an already identified modulating reflex, it was added. Physiological flexion had been described and named in the traditional literature, and Bonnie may have learned of it during her study of infant development with the Bobaths. Bonnie later added physiological extension as the balancing pattern to physiological flexion.
7 Primitive reflexes are automatic movement responses that originate in the central nervous system and are exhibited by typically developing newborn infants in response to particular stimuli (and assuming that the infant is in a behavioral state which makes them available to respond to it). Righting reactions help us orient to uprightness and verticality in relationship to our vertical axis (head to tail) and gravity.
8 The term near-reach space comes from the study of Space in Laban/Bartenieff Movement Analysis and defines the size of the Kinesphere that is utilized in movement. Kinesphere can be delineated into zones of near-, mid- and far-reach space. We inhabit and experience space differently via different sense organs, and the sense of smell is considered to be most active in the near-reach space of the Kinesphere.
9 See Smillie (p. 92-94).
10 Baby ball was coined by Lenore Grubinger in 2000 and incorporated into Body-Mind Centering’s Infant Developmental Movement Education (IDME) program, which teaches observation and facilitation skills in working with babies (and their caregivers) from birth to walking. The baby ball supports an infant’s ability to orient to themselves and to their environment, helping them to find a sense of safety and comfort, and to co-regulate with the support of their caregiver.
For more on baby ball, see Babies Project’s Preparing for Caring project as well as Lenore Grubinger’s article on baby ball.
11 The term homeorhesis (from Greek roots meaning similar +flow) grew out of the concept of homeostasis and refers to homeostasis along a developmental trajectory, or flow. Homeorhesis acknowledges that development involves an organism (and its ecosystem) undergoing metamorphosis while continually facing the challenge of maintaining a dynamic equilibrium far more complex than homeostasis might imply.
Sources and links
Anderson, G.C. Risk in mother-infant separation postbirth, in Journal of Nursing Scholarship, 1989
Bergman, Nils. Breastfeeding and Perinatal Neuroscience, from Supporting Sucking Skills in Breastfeeding Infants, 3rd edition, 2017, edited by Catherine Watson Genna
Cohen, Bonnie Bainbridge, Lisa Nelson, and Nancy Stark Smith. 2012, 3rd edition. Sensing, feeling, and action: the experiential anatomy of Body-Mind Centering. Northampton, Ma: Contact Editions.
Klaus, Marshall H. and Kennell, John H., Care of the Parents, from Care of the High-Risk Neonate, 5th edition, 2001, edited by Klaus & Fanaroff
Nugent, J.K. Keefer, C.H., Minear, S., Johnson, L., Blanchard, Y. 2007, Understanding Newborn Behavior and Early Relationships: The Newborn Behavioral Observations (NBO) system Handbook. Baltimore, Maryland: Paul H. Brookes
Smillie, Christina M. How Infants Learn to Feed: A Neurobehavioral Model, from Supporting Sucking Skills in Breastfeeding Infants, 3rd edition, 2017, edited by Catherine Watson Genna
Thelen, Esther. Motor Development: A New Synthesis, February 1995, American Psychologist Tiwari V, Singh N, Purohit A, Shyam S. Role of breast crawl in maternal health and wellbeing.
Tiwari V, Singh N, Purohit A, Shyam S. Role of breast crawl in maternal health and wellbeing. Int J Med Res Rev 2015;3(6):540-546. doi: 10.17511/ijmrr.2015.i6.103
Includes a description of a breast crawl protocol
https://ijmrr.medresearch.in/index.php/ijmrr/article/view/277/540
Describes a Breast Crawl project in India
https://bpnimaharashtra.org/highlights/breast-crawl/
Breastfeeding in the first hours after birth
https://www.youtube.com/watch?v=uMcgJR8ESRc
This video shows early breastfeeding initiation through the journeys of 3 newborns. Early initiation of breastfeeding through the breast crawl
https://www.youtube.com/watch?v=b3oPb4WdycE
Includes a description of the “Nine stages of breast crawl”
https://en.wikipedia.org/wiki/Breast_crawl
About Us
Sarah Barnaby (US) and Satu Palokangas (FIN) are certified Body-Mind Centering® Teachers, Practitioners and Infant Developmental Movement Educators. In 2020 they received a 3-year grant from the Kone Foundation for their research and development of critical somatics, which explores the interconnections between cells, babies and community.
© 2022 Sarah Barnaby and Satu Palokangas
