Paediatric Physiotherapist (BSc Hons)
Infant positioning is made up from the way we hold and carry and the equipment we place our babies on or in. It isn’t something that many of us think about but if restricted, can have a significant impact on early motor and sensory experiences and subsequent development.
Bouncers, swing/vibrating chairs, baby walkers, play nests, play saucers/jumpers, prams, car seats, sit-me up style seats and highchairs are just some of the ever-increasing pieces of equipment we may find around our homes. Indeed, some are necessary for safety and some just make life with a baby that little bit simpler. However, this coupled with a modern baby’s busy schedule, means that a baby can lovingly and unconsciously in a day be moved from one piece of equipment to another with limited daily time for unrestricted movement on a flat and firm surface.
Common structural and physical alterations of the maturing neurological and musculoskeletal system are associated with (a term that was coined in America) container baby syndrome, which develops from prolonged time in equipment, that isn’t balanced with time to move unrestricted by a ‘container’. In the short term, if not addressed, these alterations may change the course of development and could potentially even cause longer term developmental issues, not only with the way babies and children move but also how the nervous system deals with information from our senses.
Below is how I try and explain to the families I work with why infant positioning from birth is the key to early motor and sensory development:
We all recognise the tucked up foetal position our babies are born in and that it takes time, gravity and opportunity for movement, for our babies to unravel and stretch out their limbs. Baby equipment generally supports babies in their tucked-up position, thus providing limited opportunity for unravelling, stretching and moving and exploring their increasing range and repertoire of movement. Awake and unrestricted floor time is also the only time our babies can be truly independent, away from things being done to and for them.
This includes the introduction of rotation of the head and trunk i.e the twisting and turning necessary for rolling, weight transfer and the integration of the left and right sides of the body, which when repeated over and over again lead to the important integration of infant reflexes, such as the grasp reflex and ATNR.
Our babies are not shaped like cylinders but I explain to the families I work with, for them to consider them like this when it comes to infant positioning. A 3 dimensional object with one continuous side, rather than just a front and a back. Babies need to master moving in all directions, with freedom, options and variety and when handled and positioned to do so they build up a 3 dimensional map of their body in their brain, enabling proficient motor control and sensory feedback – which in essence is the foundation of learning and development moving forwards.
So here are my top tips for optimising infant positioning:
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’The Chartered Society of Physiotherapy is the professional, educational and trade union body for the UK’s 58,000 chartered physiotherapists, physiotherapy students and associates’
’The Chartered Society of Physiotherapy is the professional, educational and trade union body for the UK’s 58,000 chartered physiotherapists, physiotherapy students and associates’
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