Written By Lindsay Smith
Toys and tools that contain your baby can be a big help. They can keep babies safe while you take a shower or cook on the stove. They can occupy a few minutes of time while you open the door for a package. They can even encourage the development of certain skills — if you have the right ones.
That’s the key when it comes to containers: choose the right ones and use them correctly. But how can you tell what’s what? We’re here to help.
First, we need to dig into why this is so important. There are a lot of containers marketed to parents and caregivers at the moment, and if you rely on the wrong ones, or even use the right ones incorrectly or for too long, your baby risks getting Container Baby Syndrome. This syndrome is defined as when a baby has not achieved developmental milestones or developmental milestones are delayed due to increased time in containers. Containers are any device that limits a child’s physical movement, and they include nursing pillows, cushions, infant seats, car seats, high chairs, jumpers, walkers, stand-in tables, and infant swings. Having the right information about these devices is key to using them the right way.
Second, we understand the use and intention of these containers. For some, they make your baby happy and you can get things done. You can safely cook, take a shower, pack older kids’ lunches, or talk to the repair person — all while making sure your baby is in a secure space and feeling content. For others, they serve a very important purpose, like the safety of a car seat, the feeding needs of a high chair, and the positioning help of a nursing pillow.
We get that the reality is that you need some of these devices, even the ones of convenience, but we want you to feel confident that you’re making the right choices. To get there, we’ve brought in Gillian Whelan, a PT, DPT, who has worked with children as a physical therapist for seven years. She’s seen many children facing multiple pediatric gross motor development issues and has done significant research on Container Baby Syndrome. When being approached by caregivers concerned about a child skipping or missing milestones, she has often found Container Baby Syndrome to be the culprit.
Here’s what she had to say about safe containers, how to avoid Container Baby Syndrome, and ways to guard against the developmental concerns that come from containers:
Hi, Gillian. Thanks for talking with us today about such an important topic. Let’s kick it off by talking about when it’s ok to use containers. When is it appropriate to place a newborn (0-3 months) or an infant (3-6 months) in a container?
Newborns and infants can be placed in containers as needed, including when a parent or caregiver is unable to hold them or when placing them on the floor is unsafe. Those unsafe times might include when a parent needs to shower, use the bathroom, or eat. We recommend that babies spend no longer than 15 minutes at a time in a container. Also, these containers should not be used during developmental playtime or while the baby is sleeping.
What containers are safe and appropriate for my newborn (0-3 months)?
Newborns have little to no head and neck control, so any container you place your baby in should offer adequate support for their head and neck. Car seats, carriers on your body, infant swings, and Boppy-style pillows are all appropriate containers for this age. It is important not to spend prolonged periods of time in any of these containers and try to be aware and monitor the baby’s head shape to avoid flat spots. One benefit of baby carriers and boppy pillows is that they can promote tolerance to future “tummy time” or prone play by allowing the baby to receive pressure or bear some weight through their tummies.
What about baby seats?
It’s important to be aware of hip, pelvis, and spine positioning when babies are placed in a baby seat. A lot of baby seats, like the Bumbo seat, put the baby in an unnatural position where the pelvis is tilted posteriorly. This does not encourage engagement of the trunk or weight-bearing through the extremities. It also does not provide high enough support for the back and neck, if a baby does not have adequate head and neck control.
I suggest instead using a Bobby-style pillow to encourage supportive sitting or placing your baby on the floor between your legs. This will push your baby to develop the appropriate strength, while still providing needed support.
What about standers?
In my experience, babies are often placed in standers, like an exercauser, too early. It is important to be aware of age-appropriate or developmentally appropriate use of containers, and this is often an issue with standers. A child needs adequate head control, neck control, and trunk strength before being placed in a stander. Generally, to do this, the child should be able to sit independently.
Also, like baby seats, standers tilt the pelvis and place the baby in an unnatural position. This then requires little to no use of trunk, hip, and thigh muscles, which means there is no weight bearing through the hip joint and no strengthening of the core or thigh muscles. Typical development of babies includes strengthening and use of proximal muscles first and then distal muscles. When in a stander, the feet are the only thing bearing weight or working, so generally it’s strengthening distal muscles before proximal muscles. Standers are also commonly used at the wrong height. If the seat is too high, and your baby has to extend their feet to reach the platform, they will bear weight only through their toes.
What about stand-in walkers and walk-assist push toys?
Walkers, like standers, are often used too early and not at the right height. Because babies in walkers tend to sit in a sling-style seat, there is little to no required use of their trunk and hip muscles, which does not allow for a natural gait pattern or typical development. These tend to place babies in an atypical posture, pushing forward on their toes.
Walk-assist push toys allow a baby to practice walking with support, which seems helpful. However, it is important not to encourage a baby to use a push toy if they are not developmentally ready to walk. Babies should be crawling and pulling to stand before encouraging walking. Again, following typical development of proximal strengthening, before distal strengthening, crawling helps develop the hip and trunk muscles needed for walking.
What negative effects have you seen with babies and children who are placed in containers too often and for too long?
Most commonly, I see decreased core strength and little tolerance for “tummy time,” which leads to delays in developmental milestones like crawling and walking. Containers tend to place a child in an unnatural or fully supported position where they are not offered opportunities to move or strengthen their trunk muscles appropriately.
When babies are placed in containers that place them in positions too developmentally advanced for their age, they tend to be unable to create motor plans independently to work through the transitions necessary to reach those positions. For instance, placing a baby in a chair before they are developmentally ready to sit can result in them finding the natural transition to sit extremely challenging, or frankly, they just won’t try it because they expect to be placed in sitting without any effort. The same thing happens when babies are placed in a standing device before they are developmentally ready to stand.
What container is an “absolutely not” for you?
Definitely jumpers! Jumping is a skill that typically occurs around 20 months of age. A six-month-old doesn’t need to jump. But also walkers that babies stand it. Why not let your baby learn to walk naturally and on their own time?
What is the one container you’d be okay with if your mother-in-law bought it for you?
An infant swing or rock-n-play. These containers can offer a convenient and safe spot for your baby when needed.
Though containers should be used with care, there are options! Check out our favorites here.
Lindsay Smith
