Do newborns have a crawling reflex?

Newborn Crawling Reflex

Yes, newborns do have a crawling reflex, which is a complex pattern that can be modulated in response to higher-order stimuli rather than a simple stereotyped reflex under spinal control. 1

Evidence for the Crawling Reflex in Newborns

The crawling reflex in newborns has been documented as a primitive behavior that allows them to propel themselves toward their mother's breast when positioned skin-to-skin on her abdomen just after birth. Recent research has revealed that this reflex is more sophisticated than previously thought:

• Newborns can modulate their crawling in response to sensory stimuli processed at a supra-spinal level, including:

  • Visual stimuli
  • Olfactory stimuli
  • Auditory stimuli (including language) 1

• A 2023 study demonstrated that French newborns just a few hours after birth showed enhanced crawling patterns when exposed to their native language compared to an unfamiliar language, with:

  • More arm and leg steps
  • More and larger trunk rotations
  • Appropriate head and trunk rotation toward sound sources 1

Development and Characteristics of Primitive Reflexes

Primitive reflexes, including the crawling reflex, follow a developmental pattern:

• They are present from intrauterine life through early infancy
• Upper and lower extremity grasp reflexes are present in all premature infants from as early as 25 weeks gestational age 2
• Other reflexes like the Moro, asymmetric tonic neck reflex, and Galant develop between 25-30 weeks gestational age 2
• Lower extremity placing, positive support, and stepping reflexes develop later, sometimes not fully present even at term 2
• These reflexes become stronger, more complete, and more consistently elicited with increasing postconceptional age 2

Clinical Implications

The crawling reflex has important clinical implications:

• It facilitates early skin-to-skin contact between mother and newborn, supporting breastfeeding initiation 3
• Proper positioning during skin-to-skin care is essential to ensure safety while allowing natural reflexes to occur 3
• Healthcare providers should be aware of this reflex when positioning newborns for skin-to-skin care

Safety Considerations During Skin-to-Skin Care

When facilitating skin-to-skin care that may involve the crawling reflex, healthcare providers should ensure:

1. Infant's face can be seen
2. Infant's head is in "sniffing" position
3. Infant's nose and mouth are not covered
4. Infant's head is turned to one side
5. Infant's neck is straight, not bent
6. Infant's shoulders and chest face mother
7. Infant's legs are flexed
8. Infant's back is covered with blankets
9. Continuous monitoring during the delivery environment and regularly on the postpartum unit 3

Persistence of Primitive Reflexes

• Primitive reflexes should naturally become inhibited with central nervous system maturation by approximately 6 months of age 4
• Persistence of primitive reflexes beyond the expected timeframe may indicate neuromotor dysfunction 5
• Persistent primitive reflexes can affect later motor development, including walking gait patterns in children 4

Clinical Assessment

When evaluating primitive reflexes in newborns:

• Sequential assessment can be a useful method for evaluating extremely premature infants prior to term 2
• The pattern of primitive reflexes in premature infants at 40 weeks postconceptional age is similar to that of full-term newborns 2
• Evaluation of these reflexes can provide insights into neurological development and maturation

The crawling reflex represents an important developmental milestone that demonstrates the remarkable capabilities of the newborn brain and nervous system, showing that even at birth, infants possess complex motor patterns that respond to environmental stimuli.