This is part 2 of a three part series of posts. Be sure to read Part 1 : Basics of Baby Holding Devices.
In Part 1, we defined Baby Holding Devices and established that most babies are spending a large percentage of their waking hours in infant positioners. So now it's time to answer the question you may be asking yourself, "What's wrong with that?" Warning that this is a long post, but if you hang with me I can guarantee you'll learn something you didn't know before today!
There isn't anything inherently terrible about Baby Holding Devices; their negative effects merely stem from overuse. There are two types of consequences of your baby spending too much time supported in a semi-reclined position:
- the physical impacts of maintaining this position
- what your baby is NOT doing when she's sitting in a Baby Holding Device
Let's look first at the physical impacts of the semi-reclined position. One of the most obvious negative impacts of infant positioners is flattening of the head. I know, I know, we all want to point our finger at the Back To Sleep recommendations and throw up our hands in helplessness about head flattening. Without a doubt, your baby should sleep on her back. But one of my hopes in writing this series is to educate parents and caregivers that the plethora of baby gear our newborns lounge in during the day is a huge contributing factor to head flattening that we CAN change.
Another potential impact of extensive time in a semi-reclined position is exacerbation of muscle asymmetries. Huh? Most babies are born with very subtle muscle imbalances from being all squished in the womb. One side of the neck might be a little tight or one side of the torso slightly curved. When you place your newborn in a semi-reclined position, gravity pulls her into that preferred "womb position", further exacerbating asymmetries. This is a contributing factor for Torticollis - one-sided neck tightness that often requires therapy to correct and often leads to one-sided head flattening. The cure for most minor newborn asymmetries? Lots of opportunities for movement and play to stretch and strengthen out of the womb position.
Which leads us to what your baby is NOT doing when he's in a Baby Holding Device.
An important early milestone is stretching out of the womb position. Babies are born with hips and knees, shoulders and elbows bent and back rounded in the stereotypical "fetal position". But that position isn't meant to last long. Beginning in the first week of life, movement and play allow your little one to stretch her muscles and explore how her body can move in a variety of positions beyond the fetal position she arrived in.
In the first few weeks of life just moving the weight of the head, arms and legs against gravity is an important motor milestone. Popular baby holding devices are designed to be soft and supportive, holding your baby in a comfy, cozy position. But that supportive holding restricts your infant's ability to strengthen through movement. Research* shows that infants with high use of baby holding devices score lower on infant motor development tests than babies who don't spend as much time in equipment. Whoa - what? As parents, we're blasted with information about reading and speaking to your baby for language development, playing music for brain development but somehow the message isn't getting out that movement and play unrestricted by baby gear is important for motor development.
The other major area of development impacted by extended time in Baby Holding Devices is sensory processing. As a pediatric Occupational Therapist, I'm particularly aware of the critical importance of the first months of life for developing sensory processing and integration skills. Simply put, your baby must actively engage with her environment in order to figure out how to get accurate information from her senses. Too much time lounging and watching the world go by deprives a newborn of opportunities to use her pressure & stretch sense (proprioception) to feel his body wiggling on the ground. She spends less time lifting and turning her head which helps her learn through her movement sense (vestibular). Opportunities to touch a variety of textures - soft fabric, scratchy carpet, her own bare skin - are missed (tactile). The rich sensory experiences of simple movement and play lay the foundation for lifelong sensory processing skills and contribute to body awareness, balance, coordination and more.
It should also be noted that some Baby Holding Devices are marketed for sleep, using terms like "napper" or "sleeper" in their names, despite American Academy of Pediatrics recommendations for "back to sleep" on a firm surface as the safest position to reduce SIDS. The AAP specifically states that car seats and other sitting devices are not recommended for routine sleep and recommends babies be moved to a flat sleep surface as soon as is practical. Ugh - what new mom wants to wake a sleeping baby??!!! By moving your sleeping newborn out of baby holding devices and into a crib, bassinet or other firm sleep surface from week one of life, you help him get used to these transitions so that they aren't as disruptive to his sleep in later weeks and months. You also create healthy, safe sleep habits.
So there you have it - probably the news you never wanted to hear! All that super cute and convenient baby gear that helps you get things done isn't so great for your kiddo when used too much. Be sure to read Part 3 : Ways to Reduce Your Baby's Time in Baby Holding Devices to learn how much time in baby gear is okay and strategies to reduce your baby's time in infant positioners. Help get the message out to other parents that babies were born to move and play from week one of life!
*Abbott, AL & Bartlett, DJ (2001). Infant motor development and equipment use in the home. Childcare Health Development, 27 (3), 295-306.
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