I always say here on the CanDo Kiddo blog that I'm a new parent just like you - alongside you in the trenches of sleepless nights and diaper blowouts. So here it is, friends, a fellow mom confession:
My baby W-sits.
*GASP* the horrors! I'm a pediatric therapist and my child sits in one of the positions most despised by Physical Therapists. Parents have asked me about W-sitting in the past and I've given my professional answer, which tends to be a more moderate view than some other therapists (I'll share some links at the end of this post with other perspectives on W-sitting). Today I can add to that professional answer my personal "mommy-take" on this topic. Let's begin at the beginning:
Why Is My Child W-Sitting?
Common reasons why children W-sit that SHOULD BE ADDRESSED:
- Limited core strength: The W-sitting position gives kids a wider base of support. This may be used to compensate for weak belly and back muscles that make it tiring or challenging to sit in other positions.
- Muscle tightness: Tight muscles of the legs (particularly the hamstrings on the backs of the thighs) and hips can lead a child to prefer a W-sitting position over long sitting (legs stretched out in front) or tailor sitting ("criss cross applesauce" position).
- Low muscle tone: We often talk about muscle strength, which refers to active, contracted muscles. Muscle tone is the resting state of the muscles and is controlled by the brain. Some kids have what's called hypotonicity, or low tone. When they aren't actively firing their muscles, these kids have floppier, softer muscles that have a harder time holding their bodies upright. W-sitting is very often seen in kiddos with low muscle tone.
- Poor trunk rotation skills: If a child is lacking the ability to twist the torso adequately, he will struggle to transition into and out of a sitting position on his bottoms and may compensate by W-sitting. See photos of trunk rotation and learn how to play to encourage it here.
One of the factors that can contribute to baby having limited core strength and poor trunk rotation is too much time spent in Baby Holding Devices ; this may be why we seem to see more W-sitting in kids today. Children begin developing these important foundations of strength and movement skills in infancy - EARLY infancy. Try to follow the Rule of 2 and 15 to limit your baby's time in baby gear and help give him the healthiest start possible.
Here's a great post about "the container shuffle" that many babies today experience and how it can contribute to difficulties with transitional movements, like those required to get into and out of a good sitting position.
Common reasons why children W-sit that are TOTALLY NORMAL:
- Fine motor control: Children (and adults) get the most coordinated, controlled movements of the hands and fingers when they are really steady through the body and arms. It is normal that at times your child will assume the most stable sitting position possible when completing challenging fine motor tasks.
- Flexibility: Let's face it, most adults don't W-sit in part because we can't. Most children have the flexibility to easily assume a W-sit position and so they likely will at times.
- Convenient transitions: This one applies particularly to babies. The quickest way to find a seat while crawling is to plop the bootie down into a W-sit. Sure, your baby could rotate and get into a nice seated position but when the dog barking grabs her attention mid-crawl, it makes sense that she finds the quickest transition possible to sit up and check things out. Similarly, if your baby plays in a tall kneel position (balancing on the knees, shins and tops of feet with bottom lifted), she'll likely drop down and back to sit on her calves and possibly to W-sit. It's a natural, easy transition.
So Why Is My Kid W-Sitting?!
To get to the bottom of why my baby is doing, well .... anything, I put my detective hat on and look for clues. Here's my OT Mommy thought process:
I've wrestled my kid on the changing table and watched him climb the furniture enough to know he's got great core strength. Despite W-sitting, he is able to sit in a variety of positions. I don't see signs of hip and leg muscle tightness such as feet that turn in or out, abnormal walking pattern, inability to sit with legs out and knees straight, or back rounding when sitting (which can reflect a pelvic compensation for tight hamstrings). I'm not concerned about his muscle tone because his muscles feel firm to the touch even at rest (underneath that cute baby fat, of course) and he's never felt floppy or had trouble staying in upright positions.
So, I can rest easy that my kid is probably W-sitting for very normal reasons. You can think through a similar process with your kiddo. Try to think of other activities or opportunities for you to observe and watch for the problematic causes of W-sitting I listed above.
How Will This OT Mommy FIX Her Kid's W-Sitting?
Short answer: I won't.
At least not now. I know, I know, my fellow therapists might be throwing things at the computer screen and groaning right now. But hear me out....
I think W-sitting can be harmful for a child's development IF:
- there is an underlying problematic reason for W-sitting that isn't addressed
- a child has known orthopedic, neurological or developmental challenges
- a child extensively W-sits (Note: MANY children W-sit when watching television and other screen media. Given the fact that the average American preschooler has over 4 hours of screentime a day, I'd consider that excessive W-sitting!)
In my role as a therapist, I certainly have encouraged kiddos with known issues to find different ways to sit. I've also used play to try to rectify some of the underlying weaknesses and issues when appropriate.
If you've read here before you know I'm a big fan of moderation and I don't buy into the argument that some W-sitting as one of several sitting positions is going to deform my kiddo's bones and joints, tighten his hips, make him have a weak core, etc. I'm a firm believer that all the active play my child gets by not being restricted in baby gear, not spending time in front of screens and getting outside every day is enough to overcome any ill-effects of W-sitting for a few minutes a day. Right now, his baby attention span is such that he rarely sits in ANY position more than a minute or two.
My son is still a baby (11 months old) so my approach is specific to W-sitting in babies and young toddlers. I suspect my kiddo mainly W-sits right now because it's an easy transition from crawling and tall-kneeling positions, which are his favorites. Now that he's starting to walk, I anticipate I'll see far less W-sitting.
If he continues to W-sit and I see less and less of other sitting positions (side-sitting, ring sitting and long sitting), I will try to break his habit. I'll encourage him to sit in a chair for fine motor play. I may ask him to imitate me sitting in different ways. When he's old enough I might explain that sitting that way can hurt his knees and hips. But, you won't hear me telling my kiddo to "fix your legs," because let's face it, they're not broken.
W-sitting is something for parents to be aware of and keep an eye on. It can be a red flag of an underlying issue. It can develop into a bad habit. OR it can be a short-term transitional posture. There are a wide variety of opinions in the therapy world about W-sitting and we don't all agree. Here are some different perspectives:
Do you have a W-sitter? What's your take on this popular topic? Leave a comment below or hop on over to the CanDo Kiddo Facebook page to join the conversation!
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