The Importance of Crawling in Infants

Crawling is a controversial topic when discussing infant development.

Some believe crawling isn’t a necessary skill in infant development, and others argue otherwise.

As a pediatric occupational therapist, I have always believed crawling is an important developmental milestone that encourages acquisition of several other skills.

This post will be exploring the evidence in regards to support for crawling and the adverse. This article will also discuss the importance of crawling.

When an infant is born, there is a primitive reflex present called Bauer crawling. Primitive reflexes are important in establishing mature neural pathways for mature movements, safety, cognition and more. This crawling reflex is observed when a newborn is able to crawl up the caregiver’s chest with the goal of reaching the nutrient source. This reflex is also important in the development of coordination, vision, and higher level cognitive skills. An article by Nimble Kids states that this reflex lays the foundation for independent crawling skills, like crossing midline, using muscles in ways for crawling mobility, and others. This Bauer crawling reflex emerges around 28 weeks in utero and integrates around 6 weeks of age. This reflex then reappears as an infant is learning to crawl later in infancy which again shows that crawling is a biologically foundational skill. Since this primitive reflex is present, we can conclude that crawling is in our biology for sure!

So, why does the CDC omit this milestone in the most recent developmental milestone charts? Especially if this crawling pattern is present when a baby is born…

Based on an article by The Pumping Station, the CDC has omitted this milestone because “there is no empirical evidence to support the idea that 75% of children crawl.” Therefore, if 75% or less of children don’t crawl then the CDC omits this from the chart. This omission is based on occurrence, so does the decrease in occurrence reflect our encouragement of this skill in our babies? Or does the decrease in occurrence reflect the lack of education provided on the importance of crawling as a milestone?

In addition, an article by Psychology Today (2022), states on average 5-15% of infants do not crawl on their hands and knees prior to walking. Again, is this due to the lack of exposure to positions and/or education provided on the importance of this milestone? To state that a certain number of infants do not crawl, does not shed light on the importance of the milestone and it’s benefits.

So, what does the evidence say about the developmental consideration when an infant skips the crawling stage?

Based on my research, the crawling development of an infant is cultural. Some cultures carry their infants in an upright position until the age of 12 months and these infants may skip crawling due to limited exposure in crawling preparatory positions. In addition, in an article by Frontiers in Psychology states “that motor development is, at least partially, culturally constructed.”

However, there is evidence to support that increased prone positioning (i.e. tummy time) does promote prone-specific (i.e. rolling belly to back, crawling, etc) milestones. Therefore, if a baby enjoys tummy time then they will be more likely to assume a crawling position. I have seen this very clearly in my practice as a pediatric occupational therapist. Babies that do not enjoy tummy time, must be encouraged to enter crawling from sitting which is a bit more complex than assuming from their tummy.

So, is it bad if your baby skips crawling?

There are many articles based on subjective experience, like one where occupational therapist Brittany Ferri, states “everyone develops at a different rate and some children skip creeping/crawling and move right to pulling to stand and walking,”

And a quote from Sprout + Thrive states “If your baby skips crawling, he/she WILL probably be just fine, BUT we are here to make a case for not “skipping” this milestone and circling back to it if your baby did not, or only briefly crawled on hands and knees before walking.” From what I have found, there is no substantial evidenced to support that an infant that skips the crawling stage has any negative developmental considerations. However, there is evidence to support the benefits of crawling.

So, what are the benefits of crawling?

Some benefits of crawling, from my experience and schooling, include visual development and input, sensory input and integration, musculoskeletal development, and development of coordination, balance, motor planning, body awareness, and integration of primitive reflexes to encourage normal movement,

A developmental textbook edited by Petra & Klaus (2016) states “'motor skills are a vital part of healthy development… It has been known for a long time that motor development is critical for children's understanding of the physical and social world.”

The book goes on to state “at birth, we start with relatively poorly developed motor skills but soon gain eye and head control, learn to reach, grasp, sit, and eventually to crawl and walk on our own. The opportunities arising from each of these motor milestones are profound and open new and exciting possibilities for explorations, interactions, and learning.” This text supports the developmental motor progression which includes that of crawling in the overall development of the infant physically and socially. Although there is no substantial evidence to support that “skipping” crawling hinders an infant’s development, we do see many benefits of this movement stage.

Let’s look at the benefits further…

Muscle strength and coordination are huge parts in encouraging crawling in your baby. Not only does your baby need these skills to begin crawling, but the action of crawling continues to encourage these to develop. There are many ways to encourage strength and coordination BEFORE your baby crawls. Try encouraging your baby to prop on their tummy with their hands on the floor to provide upper body input and strength. You can also encourage your baby to weight bear on both hands and knees in a crawling position over your leg. This will encourage your baby to learn to hold themselves up in a crawling position therefore strengthening the muscles needed to get going! As far as coordination is concerned, try encouraging your baby to begin moving their hands and legs in an alternating pattern once they are stable on hands and knees. Once your baby takes off and begins to crawl, these skills will continue to develop and they will get faster and faster in crawling! Get ready to baby proof!

Visual development is also an important benefit to crawling. When our babies are born, they have very limited vision. They can only see 8-10 inches in front during the first few months but as their vision develops they can reach, grasp, and manipulate items more purposefully. They begin to roll over and view the world in a different way, then begin to sit and experience the world more upright. When our babies crawl, they experience the world in a new way by viewing the world belly down and moving forward. This helps baby develop skills like visual tracking, depth perception, and more. It’s stated in many articles that crawling supports reading skills in that this milestone supports usage of both sides of the brain and more complex visual development. The baby also has to track their hand placement with their eyes throughout the crawling patterns which further develops visual skills.

Crawling also encourages usage of both sides of the body. Using both sides of the body is so common… more common than you even know. How many hands do you use when you open a drink can? Drive your car? Type on your keyboard? Cut your items at dinner with a knife and fork? Using both sides of the body is inevitable if both limbs are intact and crawling encourages the usage of both of these sides. Using both sides of the body involves using both sides of the brain which is SO important in more complex contralateral skills, like skipping, jumping jacks, and others! Crawling is going to encourage our babies to coordinate both sides of the body which will translate to more improved body awareness and coordination of the body overall.

Additionally, integrating primitive reflexes is also a benefit of crawling. As stated above, the Bauer crawling reflex is present at birth and integrates throughout the first year. There are many other reflexes though and crawling is beneficial for integrating many of them. Crawling assists in integrating many reflexes, or using these reflexes in a mature and purposeful movement manner. Some of the reflexes integrated in crawling are the STNR, ATNR, Bauer crawling, and others. The STNR is present when your baby is on hands and knees and the head lifts resulting in the belly dropping. The ATNR is present when your baby turns their head and the opposite arm bends while on their back resulting in rolling which supports crawling skills in the future. Lastly, the Bauer crawling is when the baby alternates both sides of the body in attempts to move forward to desired area on their tummy. All of these reflexes facilitate crawling development and are integrated through the movements of mature crawling. With all of this in mind, in my opinion, crawling development should be a focus in purposeful play to encourage development of skills that are very clearly addressed through the development of crawling.

In conclusion, I, as a therapist and mom, believe we should encourage our little ones to crawl. This can be completed through play and positioning to acquire the skills for mature crawling. Want to support your baby’s mature crawling? Check out my course here!

Thanks for reading!

Brooke Boruff, OTR/L