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The first hour after birth is a critical time for infants and mothers. During this brief but powerful window, a healthy newborn possesses remarkable instinctive abilities that can help initiate breastfeeding and support lifelong health.

A new study by Drs Karin Cadwell, Anna Blair, Scovia Nalugo Mbalinda, and Kajsa Brimdyr, published in Early Human Development (2026), provides compelling evidence that newborns who succeed in crawling behavior during uninterrupted skin-to-skin contact are significantly more likely to breastfeed effectively following birth.

What makes the first hour so critical?

Immediately after birth, healthy newborns are biologically programmed to seek the breast. When placed skin-to-skin on their mother’s chest, babies progress through a series of instinctive behaviors known as The Nine Stages. These stages include the birth cry, relaxation, awakening, activity, crawling, rest, familiarization, self-attachment, and suckling. Research has shown that these behaviors emerge naturally when mother and baby remain together in immediate, continuous, and uninterrupted skin-to-skin contact.

The crawling stage occurs when a newborn uses crawling movements to move toward the breast. They are then able to locate the nipple, self-attach, and begin suckling without assistance.

While all nine stages can take up to an hour or longer, they represent one of the earliest demonstrations of infant competence and self-regulation.

What Did the New Study Find?

Cadwell and colleagues examined the relationship between newborn the specific stage of crawling behavior during the first hour after birth and breastfeeding effectiveness postpartum.

Their findings revealed that infants who successfully crawled during skin-to-skin contact were more likely to demonstrate effective breastfeeding after birth compared with infants who did not crawl.

Why Does Crawling Matter?

At first glance, a baby slowly inching across a parent’s chest may seem simple. However, this behavior reflects a sophisticated integration of neurological reflexes, sensory processing, motor development, and feeding readiness.

During the breast crawl, newborns are exposed to multiple sensory cues:

• The familiar scent of amniotic fluid and breast secretions
• The warmth of their mother’s skin
• The sound of their mother’s heartbeat and voice
• Tactile stimulation across the entire front of their body

These sensory experiences help activate innate feeding behaviors and prepare the infant for breastfeeding.

Researchers have suggested that allowing infants to self-attach may promote a deeper neurological learning experience than assisted latching alone. The process may help babies develop effective positioning, oral motor coordination, and feeding behaviors that support breastfeeding beyond the first feed.

The Importance of Uninterrupted Skin-to-Skin Contact

Routine procedures such as weighing, bathing, measurements, or unnecessary handling can interfere with the infant’s progression through the nine instinctive stages.

The World Health Organization recommends immediate and uninterrupted skin-to-skin contact after birth and encourages delaying non-urgent procedures until after the first breastfeeding is completed. Evidence shows that babies who experience skin-to-skin contact in the first hour are more likely to breastfeed successfully and exclusively in the weeks and months that follow.

Despite these recommendations, many newborns worldwide are still separated from their mothers shortly after birth, preventing completion of these biologically imperative behaviors. Research has found that fewer than half of newborns globally begin breastfeeding within the first hour of life.

A Shift in How We View Newborns

Perhaps the most profound implication of this research is what it teaches us about newborn capabilities.

For many years, maternity care practices focused primarily on what healthcare providers should do to and for babies. This study reminds us to consider what babies are biologically prepared to do for themselves when given the opportunity.

When healthcare systems protect this critical first hour after birth and allow these behaviors to unfold naturally, babies often show us exactly what they are capable of doing.

Implications for Maternity Care

The findings support several evidence-based maternity care practices:

• Immediate skin-to-skin contact after birth
• Continuous and uninterrupted contact until the first breastfeed
• Delaying routine procedures until after the first feeding
• Avoiding unnecessary assistance with latching unless clinically indicated
• Educating families about normal newborn feeding behaviors
• Supporting Baby-Friendly maternity care practices

By creating an environment that protects normal newborn behaviors, healthcare providers can help increase breastfeeding success and improve maternal-infant outcomes.

The Bottom Line

This new study by Cadwell, Blair, Mbalinda, and Brimdyr adds powerful evidence to what decades of skin-to-skin research have demonstrated: newborns are born ready to breastfeed.

When healthy infants are placed skin-to-skin immediately after birth and allowed to progress to the crawling—they are more likely to breastfeed effectively postpartum.

The message is simple but profound: sometimes the most effective intervention is not doing more, but protecting the time and space for biology to unfold as nature intended.

Donna Walls, RN, BSN, CLC, ANLC

Years ago, when my husband and I were in Italy visiting Trevi Fountain, I noticed a mom with a baby in her arms, nursing. To my utter surprise and joy I saw a man stand up and gesture to her to take his seat. Wow, it was so heartwarming! Would that happen here in the US? More likely she may have noticed glaring, snickering or maybe even unwelcome comments. How sad that our culture hasn’t learned to accept, or better yet welcome, nursing mothers.

On an even more disheartening note, there are laws protecting breastfeeding moms.  Wow, we need laws protecting a mom’s rights to feed her baby? Currently, all 50 states, the District of Columbia, Puerto Rico and the US Virgin Islands have laws allowing women to breastfeed in public or private locations. Public Indecency Exemptions (are you kidding me?!) exist in 31 states and Washington DC, Puerto Rico and the US Virgin Islands explicitly exempt breastfeeding from indecency laws. Whew! So nice of them the recognize that breastfeeding is not “indecent”!

Is it our Puritan history that considers the breasts as sexual, to be hidden? Strangely, women breastfed freely in early American times and frequently for up to two years of age. Indigenous cultures honor and respect breastfeeding as nourishing and nurturing the offspring, and consider it an honor to be able to breastfeed their babies.

Technology and science brought about changes in infant feeding in the eighteenth and nineteenth centuries. Formulas and breastmilk substitutes became available in the nineteenth century, originally developed to feed the orphans in institutions. By the late 1800s factories began processing infant formulas, with Abbott Labs increasing the manufacturing and marketing of formulas by the 1920s.The profession of Pediatrics was, in part, first developed for the overseeing of artificial infant feeding and the belief was that this new, scientific method lent itself to better nutritional control and provided mothers with more independence. More aggressive marketing to families and physicians was, to say the least, successful.

When World War II began more women were working outside of the home and the use of infant formula was rising with breastfeeding becoming viewed as inconvenient and “old fashioned”. As the changing perspective of formula feeding continued, there also came about an attitude that higher socioeconomic, more well-educated women were choosing not to breastfeed.

Another significant influence we saw in that era was the sexualization of breasts promoted in men’s magazines and in the media focusing on the sexual function of breasts and diminishing the function of lactation.

So here we are today. As a lactation care provider for 40 years I have seen an improvement in attitudes and support for breastfeeding over the last 10-20 years. But, we are not even close to the attitude I saw in Europe. There is, what seems like, unlimited money available for marketing and advertising formula feeding with little resources for promoting breastfeeding. How can we make breastfeeding the norm, the expected way to feed our newborns?

First, we need to see more breastfeeding–it needs to be normalized! There are beautiful works of art depicting breastfeeding; use them whenever you can. Then, talk about breastfeeding–let people know about the benefits to both mother and baby. For example, in breast cancer support circles, let people know that breastfeeding reduces the risk of breast cancer.

Formula feeding is often promoted as being convenient, so maybe we also need to talk about the difference between preparing bottles at night compared to the ease of nursing at night. Don’t be afraid to talk about the well-documented benefits of breastfeeding when infant-related conversations arise; talk about the reduced risk of infections, including ear and viral infections in newborns and infants. If discussing work schedules–let everyone know there are less missed workdays when babies are healthier. When talking about school–drop the research that shows that breastfed children can get an IQ boost from breastfeeding.

When you see a nursing mother, smile and make easy conversation–send the message that breastfeeding is normal and accepted. If you see a mom being harassed while breastfeeding, go to her and gently support her right to nurse. If moms are concerned about nursing in public let them know about clothing designed to discretely breastfeed or how to layer loose-fitting clothing that allows easy access to the breast. You might want to discuss how to use “cover ups”, but reassure them that they have every right to be breastfeed wherever and whenever their baby sends the “I’m hungry” message. Show your support by reminding them that they really do not need to hide or go to unacceptable places like bathrooms to nurture and nourish their baby!

We can take steps to normalize breastfeeding through educating the public and parents-to-be as well as supporting breastfeeding mothers and families, directly or indirectly. Making breastfeeding the norm will not happen quickly–but it can happen!

It was my son’s birthday yesterday. My baby turned 25. One quarter of a century. As often happens these days, it made me rather sentimental. But then I started thinking about the bond between mother and child. It is in this space where the poetic and the scientific meet, and that meeting space is fascinating to me.

The connection between a mother and her baby is often described as emotional, instinctive, and lifelong. Many mothers speak about “feeling” their child even when separated by distance or time. Increasingly, science suggests that maternal-infant bonding may also be deeply biological—extending far beyond pregnancy and birth.

One of the most fascinating discoveries in modern maternal health research is the phenomenon known as fetal microchimerism: the transfer of fetal cells into the mother’s body during pregnancy, where they may remain for decades. Research led by Dr. Maureen Gröer, Phd, Rn, FAAN,  has helped bring attention to the possibility that these cells may play important roles in healing, immune regulation, and the enduring biological relationship between mother and child.

What Is Fetal Microchimerism?

During pregnancy, cells travel back and forth across the placenta. Some maternal cells enter the baby’s body, and some fetal cells enter the mother’s circulation. These exchanged cells are called microchimeric cells because they originate from another individual yet continue living within the host body.

Researchers have discovered that fetal cells are not simply temporary passengers. Many of these cells are stem-cell-like, capable of adapting into different tissue types. Remarkably, they may persist in the mother’s body for decades after birth.

Scientists have identified fetal cells in maternal blood, bone marrow, thyroid tissue, liver, skin, and even the brain.

Maureen Gröer’s Research and a New Understanding of Motherhood

In her influential paper, Fetal Microchimerism and Women’s Health: A New Paradigm, Maureen Gröer and colleagues explored how fetal stem cells may contribute positively to maternal health rather than being harmful “foreign” cells as once believed.

Gröer’s work helped shift the conversation from fear of immune conflict toward the possibility of cooperation and healing. Her research suggests that fetal microchimeric cells may:

• Participate in tissue repair
• Support wound healing
• Influence immune system regulation
• Contribute to maternal adaptation after pregnancy
• Potentially assist in regeneration of damaged organs

This creates a profound image of pregnancy—not simply as a mother giving to her baby, but as a dynamic biological partnership in which mother and infant continue interacting at the cellular level long after birth.

Babies’ Cells May Help Mothers Heal

One of the most compelling findings in microchimerism research is that fetal cells appear capable of migrating to sites of injury in the mother’s body. Animal and human studies suggest these cells may act similarly to stem cells, responding to inflammation or tissue damage.

For example, fetal cells have been found in damaged maternal heart tissue, suggesting they may participate in repair processes after injury. Researchers are still investigating exactly how these cells function, but the possibility that babies may biologically contribute to maternal healing has captured both scientific and public imagination.

Gröer described these cells as potentially “reparative” and “regenerative,” opening new avenues for understanding women’s long-term health after pregnancy.

The Role of Breastfeeding in Cellular Connection

The biological relationship between mother and infant does not end at birth. Emerging research suggests breastfeeding may continue the exchange of living cells between mother and baby.

Human milk contains immune cells, stem cells, growth factors, cytokines, and other bioactive components. Maureen Gröer has also contributed to research examining the complex biological properties of human milk, including immune and growth-promoting substances.

Scientists now believe maternal cells from breast milk may pass through the infant’s intestinal lining and enter the infant’s tissues, a phenomenon called breastfeeding-related maternal microchimerism.

This means breastfeeding may not only nourish the infant nutritionally and emotionally, but also continue the cellular dialogue between mother and child.

Maternal-Infant Bonding Beyond Emotion

Maternal-infant bonding is often discussed in psychological terms—attachment, responsiveness, oxytocin release, eye contact, and touch. These remain critically important. But microchimerism research introduces an additional dimension: bonding may also exist at the cellular and immunological level.

The mother literally carries cells from her child within her body for years, perhaps for life. Likewise, maternal cells may remain in the child’s body into adulthood.

This discovery resonates deeply with many mothers who describe feeling permanently changed by pregnancy and parenting. While science cannot fully explain maternal intuition or emotional attachment, it increasingly supports the idea that pregnancy creates enduring biological integration between mother and baby.

A Lifelong Biological Legacy

The implications of fetal microchimerism are still being explored. Researchers continue studying whether these cells are always beneficial or whether they may sometimes contribute to autoimmune disease under certain circumstances. The field remains young and complex.

Nevertheless, the evidence strongly suggests that pregnancy leaves a lasting biological imprint on mothers.

For generations, mothers have said, “A piece of my child is always with me.” Modern science now suggests this may be literally true.

The work of Maureen Gröer and others reminds us that motherhood is not simply an experience of caregiving—it is a profound biological transformation. Through pregnancy, birth, skin-to-skin contact, and breastfeeding, mother and baby become connected in ways science is only beginning to understand.

References

• Maureen Gröer et al. Fetal Microchimerism and Women’s Health: A New Paradigm. Biological Research for Nursing, 2011.
• Molès JP et al. Breastfeeding-related maternal microchimerism. Nature Reviews Immunology, 2017.
• O’Donoghue K. Fetal microchimerism and maternal health during and after pregnancy. Obstetric Medicine, 2008.
• Kinder JM et al. Immunological implications of pregnancy-induced microchimerism. Nature Reviews

Continuing education doesn’t always have to happen in a conference hall. Sometimes, it happens on the open ocean.

The Center for Breastfeeding—part of the Healthy Children Project—offers a unique professional development opportunity each year: the Breastfeeding Symposium at Sea. This innovative conference combines high-quality lactation education with the unforgettable experience of cruising to beautiful destinations alongside colleagues and mentors in the field of maternal and infant health.

For lactation professionals, nurses, doulas, childbirth educators, and others who support breastfeeding families, the symposium offers a rare opportunity to deepen knowledge while building meaningful professional connections in an inspiring setting.

A Conference Unlike Any Other

The Breastfeeding Symposium at Sea blends rigorous clinical education with the relaxed atmosphere of a cruise. Attendees participate in educational sessions while traveling to stunning destinations, creating a learning experience that is both stimulating and restorative.

The upcoming 2026 symposium will take place September 21–28, 2026, sailing round-trip from Seattle to Alaska aboard the Anthem of the Seas. Participants spend the week attending classes, engaging in discussions with leading researchers and clinicians, and networking with colleagues while exploring the dramatic landscapes of Alaska.

The event is designed to be both intellectually engaging and enjoyable. In addition to conference sessions, attendees can take advantage of cruise amenities, excursions, and social gatherings with peers who share a passion for improving care for mothers and babies.

Continuing Education for Lactation Professionals

One of the key benefits of the symposium is the opportunity to earn continuing education credits in a collaborative and immersive environment.

Participants can enroll in multiple educational tracks and earn contact hours applicable for Registered Nurses (RNs), Certified Lactation Counselors (CLCs), and International Board Certified Lactation Consultants (IBCLCs). By attending all available sessions in the 2026 program, participants can earn up to 30 contact hours of professional education.

The curriculum reflects the latest developments in lactation science and clinical care, with sessions designed to support evidence-based practice and practical skills.

2026 Educational Tracks

The 2026 program includes six in-depth tracks led by internationally recognized experts in lactation and maternal-infant health.

Topics include:

Media Influences on Birth and Breastfeeding
Explores how cultural narratives and media portrayals shape expectations around birth and breastfeeding—and how professionals can help families navigate those messages.

Oxytocin, Pitocin, and Labor Medications
Examines the physiology of oxytocin, the effects of synthetic oxytocin during labor, and how these factors influence breastfeeding outcomes.

Communication and Ethics in Lactation: A Skills Lab
Focuses on strengthening counseling skills and ethical decision-making when supporting breastfeeding families.

Skin-to-Skin Contact: What Do We Know and Why Does It Matter?
A deep dive into the evidence behind immediate skin-to-skin contact and its physiological and psychological effects on mothers and newborns.

Latch: A New Approach to Old Problems
Provides practical strategies for assessing and improving latch, one of the most common clinical challenges in breastfeeding support.

Unique Findings in Human Lactation: Research Updates
Reviews emerging research in lactation science and its implications for clinical practice.

Each session is designed not only to present current research but also to translate evidence into practical tools clinicians can use with families.

Networking in a Unique Setting

Professional conferences often provide valuable learning opportunities, but the Breastfeeding Symposium at Sea adds something extra: time.

Because participants travel together for an entire week, there are countless opportunities for informal conversation, collaboration, and connection. Discussions begun in the classroom often continue over meals, during shore excursions, or while watching glaciers drift by.

These shared experiences help foster lasting professional relationships and strengthen the global network of clinicians and advocates working to improve breastfeeding support.

A Balance of Learning and Adventure

In addition to educational sessions, attendees have time to explore the breathtaking landscapes of Alaska. Ports of call may include glacier-filled fjords, coastal towns, and wilderness areas rich in wildlife and natural beauty.

The combination of continuing education and travel creates a conference experience that participants often describe as both energizing and restorative.

Cruise amenities—such as dining, entertainment, and recreation—allow attendees to unwind after sessions while continuing conversations with colleagues who share similar professional passions.

Why Conferences Like This Matter

Breastfeeding support is a rapidly evolving field. Research on lactation physiology, infant microbiomes, maternal mental health, and early newborn care continues to reshape best practices.

Events like the Breastfeeding Symposium at Sea play a critical role in translating emerging evidence into real-world clinical practice. They give healthcare professionals the opportunity to update their knowledge, refine their skills, and return home better equipped to support families.

At the same time, they remind participants that caring for caregivers matters too. Time spent learning in inspiring environments can renew passion for the work of improving maternal and infant health.

Setting Sail for Learning

For clinicians who want a continuing education experience that is both meaningful and memorable, the Breastfeeding Symposium at Sea offers something truly special.

It’s a chance to explore new ideas, connect with leaders in the field, and gain practical skills—while sailing through some of the most beautiful landscapes in the world.

And perhaps most importantly, it’s an opportunity to strengthen the global community dedicated to supporting breastfeeding families.