Selecting a stroller - often a car seat and stroller travel system - is one of the top big gear decisions you’ll make. Some expectant parents agonize over specs and reviews while others ask all their friends what they used.
More often than not when buying a stroller, we consider practicality, cost and convenience without consulting anyone about what’s developmentally best for our babies.
Reviews and comparisons of specific stroller models and specs are abundantly available online. Instead, in this series I’ll be sharing tips for selecting and using a stroller from a developmental perspective. Let's look at wise use of a stroller and common bad stroller habits even great parents have.
Why Flat On The Back Is Best
My advice to parents and parents-to-be who want the best type of stroller for infant development?
Find a stroller that allows you to lay your baby flat until he or she can sit upright with just a little support.
Wait, wait, wait...you might be asking yourself why this lady who's so passionate about reducing rates of Plagiocephaly (flattening of babies' heads) advocating for more time on the back? Won't that just make your baby more likely to have a flat head?
As I've discussed repeatedly here at CanDo Kiddo, infant car seat carriers and other baby gear that support baby in a semi-reclined position contribute to head flattening by limiting active movement of the head and neck and supporting baby in a fixed position. The semi-reclined position allows gravity to pull baby into a preferred position (the path of least resistance, you might say), which often exacerbates minor, subtle muscle asymmetries that result from babies' squished womb position - contributing to the dramatic rise in rates of Torticollis (neck tightness) and Plagiocephaly (head flattening) we see in infants today.
(if you want to learn more about preventing and treating Flat Head Syndrome in babies, I've got you covered!)
The biggest take-away I hope you get from reading this article is that infant car seat carriers are designed for safety and convenience, NOT for development.
Bad Stroller Habits Even Great Parents Have
Let's talk about some bad stroller habits that well-intentioned, loving parents fall into all the time. Developing these habits doesn’t mean you’re a terrible parent, it simply means that you’re learning new information that can make you a better parent today than you were yesterday!
Leaving baby in car seats for extended periods of time on a regular basis
Strollers that use an infant car seat carrier as the seat are MAJOR contributors to the rampant overuse of Baby Holding Devices and the negative developmental effects association with this overuse. I recommend an average of 2 hours or less per day of time supported in a semi-reclined position in any Baby Holding Devices (these include car seats, infant swings, bouncy seats, Rock 'n Plays, napping wedges, infant lounge pillows and other baby positioners) to reduce your baby's risk of Plagiocephaly (head flattening), Torticollis (neck tighness), motor delays, sensory processing challenges and more.
Allowing baby to routinely sleep in a car seat outside of the car
Most parents don't realize that sleeping in car seats and other baby gear increases baby's risk of Sudden Infant Death Syndrome. The American Academy of Pediatrics SIDS prevention guidelines specifically recommend that babies be moved from car seats to a flat, firm sleeping surface as soon as is practical.
It's also important to note that a frequently cited 2009 study published in the journal Pediatrics found that healthy newborns sitting in a car seat had significantly decreased blood oxygen levels compared to those laying flat and the researchers concluded that infant car seats should be used for car travel and not as a replacement for a flat sleeping surface. Your infant getting sufficient levels of oxygen to the brain is pretty important for health and development!
Not noticing & correcting baby’s posture in a stroller or car seat carrier
Learn more about properly positioning your kiddo in baby gear and why it's important.
Continuing to use an infant car seat carrier as a stroller once baby is able to sit upright
Once babies can sit upright, it's important for sensory, motor and cognitive development that we allow them sit upright as much as possible when awake in order to interact in an age- and developmentally-appropriate manner with the world around them. A baby being pushed in a upright seated position can make eye-contact and wave to people. He can turn his head toward interesting sights and sounds and take in a much wider perspective of his environment than when he's semi-reclined staring upwards and the only person he sees is the one pushing the stroller (who, for the record, he very likely loves but sees A LOT of).
Also, once a baby can sit, his whole sensory orientation to the world has shifted. His vestibular (movement) and proprioceptive (pressure & stretch) sensory systems have oriented to upright and, when he's alert, want to function to keep him that way. I can't tell you how many times I see a "bigger baby" literally trying to pull himself upright in a car seat travel system stroller, craning his neck because he wants to see the world around him. Babies who can sit, should sit when they're awake in a stroller (and when they're awake for play at home).
Why Great Parents Develop Bad Stroller Habits
When I speak to fellow parents, a fear of waking a sleeping baby and a desire for convenience are the two biggest reasons given for wanting to use an infant car seat carrier as a stroller seat. A lack of knowledge of any negative effects of too much time in car seats and/or a lack of awareness of how much time their baby is actually spending semi-reclined in Baby Holding Devices make bad stroller habits even easier to form.
Here are a few things to consider before allowing fear of waking a sleeping baby and perceived convenience be the sole determinants in your stroller purchase:
-Infant car seat travel systems/strollers have only been available for the past decade or so. Generations upon generations of new parents have navigated the (presumed) challenges of moving a sleeping infant from car to stroller, to a wrap or sling, or to loving arms to be carried or held. Allowing your baby from birth to learn to resettle when slightly awakened during transitions is a valuable sleep skill. You’d be surprised at how adaptable most (not all) newborns are to falling back asleep (especially when worn in a snuggly baby wrap right up close to one of their favorite people, if babywearing is a viable alternative to a stroller for you).
-While an infant car seat sounds convenient, there are certainly conveniences of NOT using one outside of the car. Leaving the car seat in the car means 8-12 extra pounds you’re not lifting in and out on every trip and an extra 8-12 pounds you’re not pushing in the stroller.
It's Not Too Late To Break Bad Stroller Habits
Even if you've already purchased a stroller, it's not too late! In Part 2 of this series, I share my professional OT recommendations for wisely using different types of strollers - Snap 'n Go, car seat travel systems, bassinets and more.
Looking for a way to keep your baby's head round and avoid a baby helmet?
The great news is that there are simple steps you can take starting TODAY to impact the shape of your baby's head and promote healthy development at the same time. Current research and the clinical experience of many health care professionals (including me) point to the fact that there are effective strategies for fighting Plagiocephaly and other forms of head flattening without using a helmet. Available in print and eBook. Here's what others are saying:
Until now, a comprehensive guide to those strategies hasn't been widely available to the parents who deserve and desperately want the best information about how to help their babies.
That's exactly why I wrote The Flat Head Syndrome Fix. Let's get to the bottom of this Flat Head problem!