Containing my Lack of Enthusiasm about Containers

If you are pregnant or have a child, you know that the baby gear industry is making billions of dollars each year. I'm on social media and I see all the questions about what is the best stroller; safest carseat; most popular swing; the most magical sleepsack that will ensure sleep and on and on. I have to say that when my kids were little we had about 20% of the products that are now available. At the time I was working with adults so I was very uneducated about these things and I chose based on price and what my friends said. (maybe not the best criterion)

In this blog I can't evaluate every piece of equipment out there because the field is just too vast. But I can give you some basic knowledge that you can use when you're doing your registry or walking the aisles in Buy Buy Baby. Let's start with a basic definition of container. Its anything that holds your baby in one position or prevents movement. This includes carseats, swings, momaroos, bouncy seats, bassinets with swaddle inserts, exersaucers, jumpers, baby walkers and play seats to name a few.

First things first - you will not be allowed to leave the hospital without a carseat that is installed in your car properly. Carseats are a must and should not be skimped on. The infant carseat usually comes with a stroller to which it can attach. Of course you will use this piece of equipment daily. It cannot be avoided.

As for the other containers... lets set some ground rules. You will need a container that keeps your baby safe so you can brush your teeth, go to the bathroom, or take a shower. Do not feet guilty if you need to set your baby down to take care of yourself. You have needs and are still a person. But it can become habitual to leave your sleeping baby in the carseat when you come home or place them in a bouncing seat to calm them.

Long term use of containers can result in multiple issues. The first is flat head syndrome or plagiocephaly. Your child's head is very soft and the bones in the skull move easily. So if you leave your baby laying in a container, the back of the head (or one side if they lay with their head turned) will inevitably flatten. At first this is a cosmetic issue but if allowed to continue that pressure on the back of the head can result in deformity in the front (uneven ears, eyes, cheeks, sinuses). Flattening on one side can result in torticollis (tightness in the neck) because baby won't be able to turn to both sides. Plagiocephaly (if left untreated past 4-6 months) is the condition which is often treated by a helmet.

Another issue is the baby's vestibular development. Our vestibular system is highly involved in the development of balance. When babies spend too much time in containers instead of moving they don't tolerate the changes in position that come with rolling, sitting up and crawling. Think about how you feel after you've been sick and lay in bed all day. When you sit up you might feel dizzy. This is one reason babies cry when the PT tries to move them.

Container use also can put your baby's hips in bad positions. Jumpers, exersaucers, and baby walkers are marketed for use with children who are not developmentally ready to stand. They put unnecessary weight through legs and hips that are not ready to support weight. The bouncing on these developing legs causes the baby to tighten the calf muscles and try to stabilize by bouncing on toes. Unequivocally, these devices will not help your child learn to walk. Strength and balance needed to walk has to develop through the progression from sitting to crawling to standing. It doesn't happen if you take a baby straight from laying down to upright with outside support of a container. (Please reach out if you need more explanation on why standing containers are not recommended by PTs.)

While lying in a container your baby is not weight bearing through his arms. The weight bearing part of tummy time develops strength in the shoulders, elbows and wrists. The tummy time position also helps open up the hands so your baby can begin to hold toys. The tummy time position brings the hands to midline where the baby can see them. Bringing hands together begins to develop around 4 months and is important because that is how we hold objects and do many tasks. (Very few tasks require us to keep our arms out to the sides.)

Lastly your baby doesn't learn skills to self-calm when they spend so much time in a container that rocks them. So set your budget for your baby, whatever that may be, and chose wisely. Everyone needs help handling their baby's needs. Babies need to do tummy time but they also need to lay on their side for play and be on their back for safe sleep and to work against gravity. Look into pack-n-plays and play yards to allow your baby to safely be on the ground and develop gross motor skills appropriately. The baby gear industry will make lots of claims about what their device can do for your baby but remember these skills develop through time and physical activity. They don't magically appear using a container that over supports (or under supports) your child. Use your chosen container to help you manage tasks but try to limit use to 15 minutes at a time. And if you suspect your baby is having difficulty developing gross motor skills, ask your pediatrician to refer you to a pediatric PT that can give you peace of mind and sound advice.