Baby Equipment

The only recommended baby equipment is a high chair, defined by its high back and shoulder straps. It can be a free-standing one or one that can be placed on another chair or the floor as long as it has a high back. High chairs without these features, allowing the baby to arch their back over the chair, are not recommended.

The recommendation for baby equipment use is 30 minutes total per day for all equipment combined, excluding the high chair. Many are eager to acquire this equipment due to positive feedback from other families and often receive them as gifts. While I admit to using them more than recommended when my kids were little over 20 years ago, my experience as a pediatric PT shows how things have changed. More equipment is now available, with impressive marketing appealing to parents and grandparents for the convenience and happiness it provides to the little ones but also the parents. Research indicates that excessive use of baby containers can lead to delays and other issues. As a clinician since 1999, I've observed this too.

Encouraging children to explore an environment that allows free movement is ideal:

• Playing on a safe, flat surface such as the floor, crib, bassinet, or portable crib

  • It is not recommended to use beds, couches, or elevated surfaces without sides. The likelihood of babies rolling off, even with someone present, is higher than anticipated.

• Using a high chair when they are ready

  
  

What is considered a baby container/baby equipment:

• Car seat/stroller/baby carrier used not for transport outside the home

• Stander/walker that has sling seat

• Nursing cushions used to position babies

• Doorway jumper

• Bouncer

• Baby seat

• Swing

• Exersaucer

• Activity Centers with sling seat

So why are they generally considered problematic:

• They restrict the ability to explore the environment freely, which is crucial for developing strength, motor planning, cognitive skills, spatial awareness, and limits social interaction and sensory input.

• They can cause flattening of the head if pressure is applied to one spot for too long and movement is restricted.

• The American Academy of Pediatrics advises against the use of standers and walkers, including jumpers and standing activity centers (even those with a platform for standing). Reasons why are they discouraged:

  • Models with wheels are unsafe and can result in injury or even death

  • They are often used too early, applying excessive pressure on underdeveloped hips

  • They fully support the hips, preventing them from strengthening, which is essential for crawling, standing, and walking

  • They encourage an extension pattern of the legs and pushing off on the toes, potentially leading to tight ankles and abnormal movement patterns when learning skills like sitting, transitioning in and out of sitting, and crawling

  • They allow leaning without falling, which hinders learning where their center of gravity is to maintain balance for walking

References:

1. GUIDE: Physical therapy guide to container baby syndrome. Choose PT. (2021, August

26). Retrieved March 10, 2022, from https://www.choosept.com/guide/physicaltherapy-

guide-container-baby-syndrome

2. Hewitt L, Kerr E, Stanley R, Okely A. Tummy time and infant health outcomes: a

systematic review. Pediatrics. 2020;145(6): e20192168.

3. Anitha B. Container Baby Syndrome. Pon J Nurs 2019;12(1):21–24.

4. Schecter R, Das P, Milanaik R. Are baby walker warnings coming too late?:

recommendations and rationale for anticipatory guidance at earlier well-child visits.

Glob Pediatr Health. 2019;6: 2333794X19876849.

5. Gavin, M. L., M. D. (2019, October). Tummy Time. Retrieved October 3, 2022, from

https://kidshealth.org/en/parents/tummytime.

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our%20little,look%20up%20and%20push%20up

6. Dudek-Shriber L, Zelazny S. The effects of prone positioning on the quality and

acquisition of developmental milestones in four-month-old infants. Pediatr Phys Ther.

2007;19(1):48-55.

7. Rachel Y. Moon, Rebecca F. Carlin, Ivan Hand, THE TASK FORCE ON SUDDEN INFANT

DEATH SYNDROME and THE COMMITTEE ON FETUS AND NEWBORN; Evidence Base for

2022 Updated Recommendations for a Safe Infant Sleeping Environment to Reduce the

Risk of Sleep-Related Infant Deaths. Pediatrics July 2022; 150 (1): e2022057991.

10.1542/peds.2022-057991

8. Baby walkers: a dangerous choice. American Academy of Pediatrics. (2018, September

17). Retrieved July 13, 2022 from https://www.healthychildren.org/English/safetyprevention/

at-home/Pages/Baby-Walkers-A-Dangerous-Choice.aspx.

DISCLAIMER: The information contained in this blog is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition or treatment and before undertaking new activities. Never disregard professional medical advice or delay in seeking it because of something you have read or viewed in this blog.