Parenting Advice From Your Physicians at Kaiser Permanente

Until a certain age, babies stay where you put them. They lie on blankets, enjoy being in your arms, and have tummy time on the floor, but they don’t really go anywhere. Then suddenly, they learn to crawl, walk, and run. I remember that’s when my days of sitting still were over for what felt like many years!

So, enjoy the time when your baby is fairly stationary, but know that during this time, babies need to move and explore as much as they can – even if they don’t actually go anywhere!

Allow your young infant to safely explore their world so they can develop normally!

Too much time spent contained in things like walkers,  jumpers, bouncers, swings, car seats, or strollers can cause issues for young babies They can fall behind in developing strength, coordination, and learning new motor skills like crawling and walking. Too much time spent lying on their back can cause head flattening and a lopsided appearing face.

To learn how parents can avoid these problems, I spoke with 3 of our pediatric physical therapists: Julia Nattkemper, Kimberly Moore, and Sarah Pomarico-Munoz. Here’s their advice:

Give infants lots of tummy time

Give your baby tummy time right from the beginning. The American Academy of Pediatrics (AAP) recommends that you play and interact with your baby while they’re on their stomach a few times every day while they’re awake – starting from the first day you bring them home after birth.

To do tummy time, you can place your baby on a blanket on a flat surface and lie next to them. talking and interacting with them. Tummy time can also be done on your lap when you’re sitting up or on your chest when you’re lying down.

You should slowly increase the amount of time that your baby spends on their tummy every day with a goal of reaching 15 to 30 minutes daily by seven weeks of age and about 60 minutes a day by four months of age.

The AAP also has a great saying: “Back to sleep and tummy to play.” This reminds us that babies should always sleep face up—never face down—and, if your infant falls asleep while doing tummy time, you need to flip them over to sleep safely on their back.

Avoid baby containers

Try to avoid having your baby in a container that limits their movement. Examples of what we mean by containers are walkers, standers, activity centers, jumpers, bouncers, swings, baby seats, car seats, or strollers. Of course, if your baby is  being transported somewhere, you do want them safely in an appropriate container (rear-facing car seat for car or airplane travel, stroller or baby-wearing device for walks, etc.)

Some parents like to use exercisers or activity centers that have a sling seat. These can be used but limit your baby’s time in them to 30 minutes a day or less. And make sure these items don’t have wheels on the bottom because babies with wheels can roll themselves into all kinds of trouble!

Why aren’t these containers good? When a baby is held in a seat with straps or a sling, they use their muscles less than when they’re on the floor playing or being held by you. Too much time in sling seats, infant jumpers, or walkers can make it hard for babies to learn balance and can cause ankle tightness that leads to toe-walking later. Also, putting your baby into a position that they’re not yet ready for can negatively affect their development. Babies pull up to stand around 9 to 10 months of age, and, at that time, their hips can handle the force of standing. Standing in equipment before then can harm their hips.

Children also start jumping at around two years old. Starting to use a jumper when they’re a small infant exposes their legs and hips to stress that they’re not yet ready for.

Similar to exercisers or activity centers, too much time in jumpers or walkers can delay your child’s ability to walk well. To help prevent this, limit their use to 10 to 15 minutes at a time and no more than 30 minutes a day in containers total (aside from when they’re being transported in a car, plane, or on a walk).

In addition to this great advice from our physical therapists, the AAP also has recommendations for parents about safe infant sleep.

Skip swaddles, straps, and weighted sleep sacks

When a baby shows signs of trying to roll over, swaddling is no longer safe. This can be as early as two months – so the safest recommendation is to stop swaddling at that time. The AAP also strongly recommend that you don’t use any weighted sleep sacks – these can lace too much weight on a baby’s chest and lungs as well as make it hard for them to move freely. Prolonged swaddling can lead to hip dislocation (dysplasia).

Things you can do to help your baby grow strong and develop new skills:

• Let them have lots of tummy time to develop strength and coordination.
• Give them supervised time to move freely on the floor.
• Let them sit without support as soon as they’re able to.
• Help them learn to stand by offering things with different heights like furniture or activity tables to practice at. They can use these to first learn how to pull to their knees and then all the way up to standing. Don’t just place them in a standing position but give them a chance to learn on their own!
• Know that a little time spent in a crib, highchair, playpen, or pack and play is okay, when you need your hands free and want your baby safely contained.