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Baby Containers, Friend or Foe?
By Debra Lawson, PT, DPT, Doctor of Physical Therapy


Recently, a good friend of mine invited me to her baby shower. I went to a local store to buy a gift. There are two things you need to know about me. First, I had my babies almost thirty years ago. Second, I am a Pediatric Physical Therapist and more than one third of the children that I treat are infants. As I walked through the baby section, I was overwhelmed by the number of baby containers: strollers, car seats, bouncers, swings, bumbos, rockers, etc. There were hundreds of them. They never had all of these gadgets when I had my children. While these products are designed to keep our babies safe, they also keep them from moving and exploring their environment. Used properly they are our best friend; used improperly they are our worst enemy. Imagine if you spent more than 17 hours a day either asleep, or confined.

Did you know that newborn babies sleep12 to 17 hours a day? In 1992, the American Academy of Pediatrics recommended that babies be placed on their backs to decrease the risk of Sudden Infant Death Syndrome (SIDS). It worked, since then there has been a 50% decrease in SIDS. However, there has been a significant increase in Torticollis, which is a head tilt. Sleeping on the back can cause flat spots on the back of the baby’s head, called Plagiocephaly and/or Brachycephaly. Cranial orthosis, also called helmet therapy, has become a $1 billion dollar industry in the U.S. today. 1 in 5 babies will be recommended for helmet therapy. This occurs because the skull cannot grow wherever there is prolonged pressure. Once a flat spot develops, the head falls to that position at rest. Without helmet therapy, after the age of 18 month the normal infant cranial sutures fuse, and the flat spot on the back of the head will remain.

To make matters worse, 95% of infants under the age of 5 months spend an average of 5.7 hours per day in a container. There are times when it is appropriate to transport your child in a car seat or stroller. There are other times, when it is more beneficial for you to hold your child in your arms. Containers confine an infant, decreasing sensory experiences and preventing your baby from moving all parts of the body.

Being placed in a container for prolonged periods can cause:

  • Flat spots on the back of the head
  • Facial asymmetry
  • Torticollis
  • Decreased strength and coordination
  • Difficulty seeing, hearing, thinking, and talking
  • Attention deficit hyperactivity disorder
  • Increased weight and obesity

There is a new term used to describe developmental delays from spending too much time in a container. It is called Container Baby Syndrome (CBS). 1 in 7 babies are affected by CBS. Once symptoms are recognized by the Pediatrician, infants are referred to Physical Therapy to ensure successful treatment. The Physical Therapist will evaluate each infant and prescribe an individualized Plan of Care to increase the child’s strength, coordination, and symmetrical gross motor skills. The good news is that with early referral and proper intervention, 98% of these babies will achieve age appropriate gross motor skills and have excellent outcomes.

What can you do to improve your child’s development?

  • Carry your child in your arms whenever possible
  • Try to increase supervised tummy time to a total of 80 minutes per day
  • Limit the time in containers as much as you can
  • Allow your infant to play freely in a playpen
  • If you have any concerns about your child’s development, discuss it with your pediatrician

If you have additional questions or would like to make an appointment with WHS Children’s Therapy Center call (724) 942-6100. Locations in Washington and McMurray, PA.

Debra Lawson is Coordinator of Physical Therapy at Washington Health Systems Children’s Therapy Center.



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