Container Baby Syndrome (CBS) is a term used to describe a variety of conditions that can result from a baby spending too much time in a positioning device. These devices can include car seats, strollers, Bumbo seats, bouncy swings, rocker sleepers, bouncer seats, jumpers, ExerSaucers, activity gyms and centers, free standing or doorway jumpers and walkers.
Increased time in these containers lead to delays in the development of movement, cognition, social skills and can even cause skeletal deformity. They restrict a baby from being able to move all parts of his or her body. Although a baby may seem to enjoy these spaces and parents like them for providing a confining place for a child to play, this kind of ongoing immobilization can lead to delays in achieving gross motor milestones, such as rolling, sitting, crawling and walking.
Many parents may feel that these devices assist in teaching their children skills, but containers actually prevent babies from sitting or standing in correct alignment, which prevents them from activating important muscles needed for motor development. In addition, prolonged container use can also cause:
- A flat head shape (known as plagiocephaly) due to lack of movement
- Facial asymmetries
- Decreased movement, strength and coordination
- Issues with speech, vision, hearing and thinking
- Increased weight/obesity
When infants are held in their caregiver’s arms, they can practice the development of head control. In a container, an infant’s head is constantly resting against a surface, so there’s no need for the baby to work on head control. Tummy time and the ability to learn to move in space is essential to normal development. Tummy time strengthens the muscles of the neck and trunk, promotes a rounded head shape and facilitates the development of movements and coordination. A baby may fuss with tummy time, but that is generally because it is hard work for a baby to lift his or her head off the floor. Increased frequency of tummy time practice throughout the day will make this skill easier over time.
But, let’s be realistic for a moment! Sometimes, you must place your baby in a container for safety while you shower, make dinner, care for siblings, etc. A good rule of thumb is that for every hour that a baby spends in a container, they should spend one hour playing on the floor.
The following guidelines, as recommended by the American Physical Therapy Association, can be used to prevent CBS:
- Limit your baby’s time in containers, such as car seats and strollers, to only when the baby is being transported somewhere.
- Increase frequency and duration of awake tummy time opportunities with supervision.
- Hold your baby in your arms or in a sling for short periods of time throughout the day.
- Let your baby play freely on the floor in a safe environment.
If you have any concerns or questions regarding Container Baby Syndrome, please speak to your child’s pediatrician. Physical therapists can also help address problems that result from Container Baby Syndrome through positioning strategies, stretches, strengthening activities and facilitating age appropriate development.
Kristin Andraka, D.P.T., is a physical therapist at MidMichigan Health.