Thinking Outside of the Box/More Uses for Boxes

You may have seen posts all over the internet and social media this week that the Boppy Lounger was recalled due to multiple infant deaths. They are offering a refund process if you are so inclined. Many practitioners are giving families some ideas for alternate uses for this product including but not limited to pet bed, knee pad for bathing your little, use with toddlers in a reading corner.

This recall and some comments from my previous post on containers has got me thinking that I have a lot more explaining to do on this subject. First lets discuss some issues with the Boppy lounger. It is a soft pillow-like product which makes it a poor choice for infant sleep. Infants are recommended to sleep on firmer surfaces. The babies that died suffocated because they rolled to their side or into prone and onto this soft surface and could not roll back. Another issue with containers and sleep to keep in mind is what angle of incline the container puts your baby in. Many bouncers, swings and infant carriers elevate your baby into a semi upright position. When they fall asleep their head falls forward and can compress the trachea and cause suffocation.

I know all this information sounds scary. How should I handle this and what are my options? First, if your car seat is properly installed and fit for your infant it is safe for use in the car. Use a small mirror to allow visibility when rear facing so you can monitor your child in the car. When you remove the infant carrier from the car, remove your baby from the seat.

As for the other containers, let's reframe our thinking about them. Containers are a convenience item for parents. They are not going to teach your child to sit up or walk. Let me explain. As a therapist I use my hands to tell baby's muscles to turn on. I'm trained to know what muscles are needed to help baby rollover, sit up, crawl and walk. I don't passively move your baby from position to position. I tell baby's body what muscles it needs to use so he can move. That's how baby learns. A container manually stabilizes baby in one position. Baby rests in that position without using muscles. OR even worse, the container causes baby to use the WRONG muscles and when the container is removed they can't figure out what to do. An example of this is the high back on some of the seats like the Bumbo. They cause your baby to push back or use their extensors (back muscles). Thrusting backwards does not help a baby sit unsupported. Here's a second example of why outside supports don't help strengthen your baby's muscles. Think about that time you broke your leg and were put in a cast. The cast allowed you to put weight on your hurt leg but when the cast was removed your leg muscles had atrophied because they were not allowed to move. Your baby's body functions in the same way. Placing a baby in a bouncer or walker does not help your baby learn to use muscles necessary to stand.

So now that we know containers are for our convenience, what can we do to make a better choice? Here are a few solutions:

• Bassinet or Moses basket for newborns

• Play yard or play pens or play mats for floor time in a limited and safe area

• Fisher Price Dome - this is portable for use in the park or outside and has a cover if baby falls asleep.

But Lisa, I need something for my baby who is awake while I cook dinner or get dressed. And here's were we come back to that BOX. You know the one that all your diapers come in? Its a great way to sit your 4-6 month old baby up for play. Put some balls, toys, books inside and let your baby go to town. They should be able to see you over the side which will motivate your baby to hold their head up. The sides of the box also give them a surface to prop up on if they are not proficient sitters yet. A blanket or towel can also be used inside the box to help prop baby or add comfort. Pro-tip - use a laundry basket for this if your baby needs a bit more space. And use your diaper box for tall kneeling or as a push walker once your baby is ready to get more upright.

I want to end with some reassurances. The companies that make these items are in the business of making money. They often advertise promises that they can't keep. Its not our fault as parents that we have difficulties wading through all the equipment out there. Many of us have budget constraints in regards to providing for our babies. I know I did. So think outside the box (or inside the box) and remember your baby doesn't need multiple containers that will crowd your home and prevent your baby from learning gross motor skills. A pediatric PT can help you figure out your needs; help you learn to use the products safely; and teach you how to purposefully play with your baby. You can ask your pediatrician for a PT referral or seek out a wellness visit to make you feel more confident.