Amanda Dyer, MS, OTR/L, CIMI

Taylor Adkins, DPT

Seats and toys that hold our babies are convenient ways to entertain our kids while we have other things to do such as cooking dinner or doing laundry. In the therapy world, these seats have earned the name “containers” because they contain our babies.

What is container baby syndrome?

“Container baby syndrome” is a term for infants who have developmental delays as a result of being in “containers” too long. This can include car seats, Jumparoos, high chairs, Bumbo seats, swings, and infant carriers. These can be very helpful to keep baby safe and out of trouble while you take care of things around the house. However, time in containers can add up throughout the day.

Signs of container baby syndrome include:

• Gross motor skill delays (late sitting, rolling, crawling, etc)
• Flat spots on the head from staying in one position too long (plagiocephaly)
• Stiff or tilted neck (torticollis)

Convenience is the biggest benefit of using "containers," but there are downsides including:

• Reduces the time and space baby gets to practice moving their arms, legs, and heads
• Can delay learning the skills that help baby to roll over, crawl, sit, stand, and walk
• Hold baby’s joints in incorrect positions, placing stress on their body
• May be unsafe despite being marketed for babies

To avoid container baby syndrome, you should encourage your baby to move and get strong without the use of equipment. For example, try tummy time on a flat, firm surface. Help baby reach for toys, put weight on their legs, and look at themselves in a mirror. You can alternate what toys they have at a given time to keep them interested in a variety. You can also use a "play pen" or baby gate to contain baby in a supervised area while you complete household tasks.

Container Rules of Thumb

There are a few general rules of thumb to keep in mind when choosing a piece of equipment or “container” to place your baby in:

1. If your child cannot control his head (has a “floppy head”), don’t put them in a seat that doesn’t provide head support. For example, a Bumbo seat does not provide head support because there is nothing for a baby to rest his head on.
2. Make sure your baby is comfortable and they fit well in the seat. If the harness is sliding up their chest, feet can’t touch the floor, etc. then it is not an appropriate “container” for your child.
3. Limit time in “containers” to less than one hour total in a day. This does not include when your child is in the car seat while driving. It would count if you are grocery shopping, and your child stays in the car seat the entire time.

We realize that limiting time in these seats is not always convenient. However, keeping your child out of “containers” for significant periods of time will improve your baby’s ability to learn and move on their own.

Examples of Common Containers + Tips

Here are some examples of common seats with tips on when it is appropriate to use these seats and how your child should look when sitting in it.

Bumbo seat

Bumbo seats are most appropriate for children that can sit by themselves or are almost sitting by themselves. This way we are positive that your child is strong enough to sit with proper posture. You can use bumbo seats with children who are not sitting by themselves, but you want to make sure they are in the seat with an upright posture and not tilting to the side.

Bumbo seats are NOT appropriate at any time for children who cannot control their head position. If your baby often has a “floppy” head then they should not be seated in a bumbo seat at all.

Jumper

Jumpers are a fun way for baby to learn how to use their leg muscles in ways like jumping. Your baby should be able to place his feet flat on the floor with weight through his feet while in a jumper. If his feet barely touch the ground or just his toes are on the ground then you either need to lower the jumper or wait until the baby is taller. Sometimes, babies will only jump on their toes, which can turn into learning how to walk on their toes (a hard habit to break). You also want to be careful that your baby is able to maintain an upright posture in the jumper and not leaning to the side, forward, or backwards. Again, if your baby cannot control his head then a jumper is not appropriate for them.

Baby walker

Activity center

Walkers and activity centers are most appropriate for children who, when placed inside, can place their feet flat on the floor and weight bear at least slightly. Similar to the jumper, if your child can only put his toes on the ground or isn’t able to put weight through his feet when they are on the ground, then this equipment is not appropriate for your baby. You can adjust the seat so their feet are flat on the ground or wait until they are a little taller. We also want to make sure that they are not leaning in any direction or slumping but instead able to maintain an upright position.

Baby swing

Swings are often used to lull babies to sleep. However, sometimes the bad habit of letting baby sleep for several hours in the swing is formed. This is not a great position for your baby as they are not flat on their back like the AAP recommends. If baby falls asleep in a swing, the baby should be moved to his crib where he would be more comfortable and safer while he sleeps. For more information on safe sleep practices, visit the American Academy of Pediatrics website here.

Watch your baby’s head position in the swing. If they always hold their head to one side or you notice they can’t move their head or turn it, then a swing is not appropriate right now. When a baby has enough strength to control their head position, then a swing can be appropriate. If a baby is in a swing for a long period of time without being able to control their head, then this could lead to muscle tightness which makes it harder to learn how to control their head in other positions. A swing does provide more head support than a bumbo seat, for example. However, the motion of the swing is what makes having head control important. Having head control allows the baby to move their head any way they want instead of being controlled by the motion of the swing.

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