Current recommendations around safety and motor development for baby equipment
Keri Venz - Physiotherapist
Parents have a wide variety of infant equipment to choose from when considering what to buy for their infant. Choices include, but are not limited to, jolly jumpers, baby walkers, exersaucers, and infant seating devices.
Often, the equipment is marketed as a “fun way to entertain baby while providing aerobic exercise, improving pre-walking skills, and developing basic motor skills”. What parent wouldn’t want this for their baby??
In addition, parents and caregivers need a safe place to put their baby down sometimes. Parents in a 2006 American study reported they choose jolly jumpers for their babies for enjoyment, and a place to keep baby safe while they are busy.
With all these apparent benefits, why has this equipment come under scrutiny to do more harm than good for baby’s lower limb and motor development? This is a question I have been frequently asked by parents, who encounter an overwhelming amount of mixed opinions as to whether or not to use infant equipment. To help parents make an informed decision, I have explored the current research on various equipment from a motor development and safety perspective.
Gross motor development
Amongst the most popular equipment available are walkers, exersaucers, and exercise jumpers (Jolly jumpers). The research around how these affect babies reaching their gross motor milestones is mixed. Several studies have demonstrated that babies who use these are also delayed in the acquisition of sitting, crawling, and walking, while other studies found no delays when compared with babies who have not used a walker or jolly jumper. When considering research, it is important to remember there are lots of variables that can affect a baby’s motor development, however there is no research demonstrating a favourable outcome for the use of these in terms of improving motor development.
Why don’t these facilitate gross motor skill like companies advertise?
It has been shown that excessive use of walkers, exersaucers, and jumpers encourage unusual/atypical movement patterns in the core and legs. The manufacturers advise use from as young as 3 months old, therefore babies are often placed in an upright position well before they are developmentally ready for walking and jumping.
Babies sit in a harness with their weight supported through hips, crotch, and under the arms which pushes weight distribution forwards rather than the upright posture needed for independent standing and walking. Their hips are placed in an unusual position, with legs suspended and tip toes touching the ground, altering the way muscles are later used for walking. It is thought that this position can promote toe walking and is counter-productive to the typical heel-strike pattern.
Trunk control is crucial for sitting, crawling, standing, and walking. The harness provides trunk support, removing the need for babies to use and develop core muscles, which can lead to delays in sitting and balance reactions.
Similar in floor seated products like Sit-me-up or Bumbo, the additional trunk supports remove the need for babies to practice independent sitting, where they learn to use their core muscles for strength and balance.
What about safety?
Several health and consumer services recommend against the use of walkers and jolly jumpers:
The Australian Competition and Consumer Commission reported on the risks and injuries to babies when using an exercise jumper:
limb and head injuries after falling if the laces snap under tension or if the baby is not securely strapped into the harness
injuries to fingers if they become trapped or pinched in the springs and chains on the jumper
injuries when a baby has lurched sideways into the doorway frame, or has been pushed by another young child
delays in learning to walk if they repeatedly spend periods of 15 minutes or longer in the jumper.
With walkers allowing for mobility throughout the house, 12% and 50% of UK parents reported that their child has suffered a walker-related injury, including burns and head injuries. Numerous studies have examined the injuries related to baby walkers and in 2004, the Canadian government banned the sales and use of baby-walkers, following a serious spinal cord injury. Here in Australia, CHOICE has strongly recommended against the use of baby walkers for the above reasons.
The ACCC and Kidspot have raised safety concerns with infant seating devices such as the popular Bumbo, following a worldwide recall in 2012 when babies fell out of the unrestrained seat. Since then, there continue to be serious head injuries and drownings due to misuse and non-adherence to the warnings issued on the seats themselves.
What if I’m already using these?
Due to musculoskeletal development, babies should only be in equipment at certain developmental stages:
supported seating: when they have adequate head and trunk control to sit independently.
exersaucers, walkers, and exercise jumpers: when they have adequate head and trunk control PLUS the ability to maintain weight through their legs. This is usually just prior to walking
Safety aside, the good news is that research shows little effect on motor development, when equipment is used for short periods (10-15 minute periods, less than 1.5 hours total per day). Parents can feel reassured that supervised use for short periods and adherence to warnings can make use acceptable for times that parents may need to get something done.
Research also demonstrates that any altered muscle development and movement patterns generally tend to diminish a few months after equipment is no longer being used.
What are the alternatives?
Parents need not think of these equipment items as “must haves”, particularly for enhancing motor development. While I encourage friends and family not to purchase jolly jumpers and similar equipment items, lots of families already have these, where babies absolutely love them.
I believe that parents are the experts in their children, therefore we discuss the risks and benefits that families find in using certain equipment and how it relates to their individual child at that moment in time. If this is the only place their baby is happy while parents have a shower, we then then aim to work through alternatives together.
Floor time and tummy time continues to be the best practice for encouraging motor advancement, which is consistent with the Australian national guidelines for infant physical activity.
When parents need a safe place to put baby down, alternatives to walkers, exersaucers, exercise jumpers and Bumbo seating are:
interlocking baby gates with interactive toys on them (http://mamaot.com/2012/09/07/a-different-kind-of-baby-gate/)
a pack ‘n play with ball pit balls in it (http://www.rookiemoms.com/create-an-easy-ball-pit-at-home/)
supervised floor time, if possible, which allows a baby to move around but still keeps them safe; use a blanket, or foam pieces if you have hardwood floors, to create a safe place on the floor
Nursing/Boomerang pillow behind baby for supported sitting - https://www.babieslike.com/how-to-use-a-boppy-pillow/
and supervised play tables for babies who want to stand (http://www.amazon.com/s/ref=nb_sb_noss_1?url=search-alias%3Daps&field-keywords=baby+play+table)
Take Home Messages
Infant equipment may be associated with gross motor delays. There is no evidence to show that using infant equipment with typically developing babies enhances motor skills
Prolonged use of infant equipment alters babies’ posture, balance, and the way they use their muscles for sitting, crawling, standing, and walking
With discontinued use, motor patterns usually return to normal within a few months
There are major safety concerns with the use of these items, leading to worldwide recalls, bans in Canada, and serious injuries here in Australia
There are alternatives you can try, which provide opportunities for sensorimotor development
If you have any questions or concerns with equipment use or your baby’s development, consult with a professional.