Is weightbearing (standing, sitting) unsafe for young babies?

[meg2]

What is the latest school of thought on weightbearing in young babies? Are the suggestions that it causes problems in spinal development such as spondylolithesis true? Is a baby who is 6-12 weeks old is able to fully support her own weight, and loves standing (e.g. next to a couch for support - with very close supervision) at any sort of risk to her development? The same question applies to using a jolly jumper or sitting vertically in a front pack with legs dangling.

Thanks, Megan

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[1234nale]

Hi!
I Am very surprised with this question. Or did you mean 6-12 months, not weeks? I fairly hope so...
I will try to answer: I n earlier years of education recommended siting for the babies was not before 6 month,with supporting diagnosing treatment of baby's hips, but now new research was done and it is proven that is too much of vertical pressure to baby's spine in sitting ( or worse standing) position, witch can result in latter baby's life time with degenerative changing of the spine, so recommendation is about 8 month( for sitting), and about 12 m for standing. Anyway,main recommendation is to not to forcing baby in next stage of motor development, yet to let her go to develop in her own speed( cause every human being is different), within normal schedule of normal motor development. Thats mean, no supporting in sitting with pillows, no supporting in standing, let your baby's develop in their own way... save their bones and joints they will be needed them whole life time....

[Tommy77]

Hey Megan

don't worry too much about that reply, its a perfectly reasonable question. However, what I would to see is some references to all this "research" that nale seems to like quoting?? I'd also be more than interested in which school taught him all this information, because it certainly wasn't part of my degree.

One comment on your original post tho, I'm not a fan of the jolly jumpers for a few reasons. When I was a student, we were always taught that they were bad news for a number of reasons, and as far as I know that hasn't changed in the last 10 years that I've been working in paediatrics. However, I don't recall predisposing a kid to spondylolisthesis being one of those reasons.

Sorry I couldn't be of more assistance.

[1234nale]

Ahh prejudice, that prejudice!
Tommy77, I don’t think it’s relevant where from you are, as long you say you are physio. It is very insulting and that you think that someone is less physio, less human or less valuable, than you just because he’s (in this case she’s) from another country (or maybe not you don’t know that). On this site are our colleagues from all over the world, I don’t need to know where are they from, I don’t care, they are physios. It’s horrible to close your mind like you did. And yet, who give right to you to say whose diploma is good?!
Regarding researches, because you had your prestige diploma (10 or 20 years ago) it doesn’t mean you should not read or learn anymore, medicine is going forward.

I am just very disappointed that you are working in pediatrics for 10 years and still think that 6-12 weeks old child should be seating and standing???

There will be always different point of viewing in lots of questions and dilemmas in our profession but I don’t see why you must insult anyone? This forum exists for learning and exchanging different opinions and that is good. Don’t turn it in something bad.

Best regards Natasa

[Tommy77]

Dear Natasa

I really don't understand how you come to be calling me judgemental and prejudiced after your original reply. Your line " Or did you mean 6-12 months, not weeks? I fairly hope so..." may well be the most insulting and superioristic piece of egocentrism I have ever seen on this forum.

As for the rest of your rebuttal, I understand english is your second language, so I'll try and make this clear for you. I am not in any way recommending standing for 6 week old infants, I merely acknowledged Megan's right to ask, without having to be insulted by you. I am also VERY interested in the literature, which is why I requested you to give references of this research that you have used to support your own point of view. If you could get back to both of us with those references, then that would be helpful.

My apologies if you have interpreted that I think physios who went to schools other than mine are somehow less qualified to discuss things on here.

[1234nale]

Hi Tommy77,
My sentence ’ or did you mean 6-12 months’ was not sarcastic, I really believe that Megan make mistake in writing, because timing 6 m (for sitting) and 12m (for standing) and I hope so because I didn’t like image in my head of child that old put in that positions. In this case I didn’t meant for any particular research, just that in years before was thought that if child don’t seat by 6 m it is not normal and demands treatment (which bring parents to put their babies to forced sitting or standing positions, which, again I believe this is the case), and in now days that line for normal motor development is moved upwards (8m for sitting and 12 m to even 18 m for standing), depending individually from child to child. I think you don need references for this it’s in most pediatric books dated from 2000 onwards.
And if Megan did not make mistake in writing, then I still think it’s very unusual question. Yes of course that everybody have right to ask everything that is what I try to do- to answer, in my own way, we all are different. But don’t look for last thoughts in my writings because there are no any. Like you said English is not my maternal language, like I believe and for majority of people on the site, so don’t immediately jump on the conclusion that someone is ‘ insulting, superioristic or egocentric‘, maybe our English simply are not that perfect as yours…
All the best Natasa

[ramywhite]

Hello every body,
I am agree with 1234nale about not enforced any child into tasks he can't do it yet whether he is handicapped or normal one . But, sitting needs many things to be achieved like head control, trunk contol, righting reactions and balance. So, to achieve sitting you can start with head and trunk control in the first 3-6 months and so on but you shouldn't put your 3-6 weeks CP child in sitting position for about 1 hour daily just to learn him how to sit; that's very weird. You can't even know if your patient will sit probably after that or not if he is now just 6 weeks of his age. So, why any one enforce him to sit. Focus on his age related problems and try to fix them first.
But I am not agree with insulting stuff I read. We don't login to write or read that.

[wutti]

hi everbody!!

christ, that is a really though diskussion here. I agree with most of the statements. if an infant or child is normally developed (no neurological disorders) it goes his own way. every individual has its own way and speed of development. to force these things often results in problems. if an infant is not able to sit, stand or walk on its own, or starts to do so on its own, it needs more time to develop these motor skills and control mechanisms. Most people think, that if they bring the infant in the special position (jumper etc. )it might help or speed up things. but this is all passive and only active movements with repetition has real learning effects.
i would suggest to give a little baby the time to make its own experience, as long as its physiological.
cheers

[phunphysio]

Yes, a discussion and a half! The enthusiam and passion is great! Yes it's a question of a child developing at it's own rate vs exposure it centain positions. I face this battle everyday in my clinic where mothers are either doing too much or too little to facilitate normal development of the infant. I too do not support jolly jumpers or walkers and there is reasonable evidence to support their non-use. Teaching a 6 month old child to jump when they are not yet sitting is a case of common sence lost in our world today. Both have evidence for the danger in use (children can access things they otherwise couldn't-jug cords, christmas trees, hot coffee-you name it) On the other hand some parents don't do enough to help the little ones develop-especially low tone babies- floor time is essential, rolling, sitting, commando crawling etc. It doesnt take a rocket scientist to work out if a child has enough muscle tone to support the position they are in, early sitting is flexed and I havn't seen evience to support wearing of joints etc at this young age. How is a child supposed to sit if they have never been exposed to the position?

[meg2]

I must clarify my original question. I am referring to our perfectly normally developing baby. We are not trying to encourage her to sit, stand or do anything else early. She simply loves being in an upright position- either sitting (on our stomach or on the couch- supported by backrest) or standing (either holding our hands, standing on the ground and holding the couch for balance or simply with us holding her around her chest). She will go from a grizzly baby to a happy/laughing on when in these positions. She is not in these positions for long periods- a few minutes at a time. I am simply concerned as I have heard a few suggestions that babies being upright before the normal curves have developed in their spine can cause long term spinal problems. One of my main concerns is the idea that sitting in a front baby carrier is not recommended for the same reasons, as that is a position that she would spend many hours.
Sorry about the confusion,
Megan

[meg2]

Sorry, I forgot to clarify, she was 6 wks old, she is now 14 wks and still seems to love standing, sitting etc. I work in a general private practice and dont have much paediatrics experience, but I imagine in a normal child, they will achieve these milestones at their own pace regardless of any "training" they receive. We are not trying to teach her anything, we are just doing it with her because of the smile it puts on her face.
Thanks for your ideas.
Megan

[wutti]

hi meg2,
i think there is no problem with sitting for a few minutes, if the baby is happy with that. have a look at the babies back. if it is extremly flexed, the baby has not the core stability to sit in an upright position. in this case the baby shouldnt sit to long.babies often like the sitting pos. because they have a better persperctive in viewing and looking at things. my son (9 month) is not able to get in the sitting pos. on his own yet, but if we help him with that, he sits very good, with an erected spine. Thats most important. the same counts for standing etc. the baby must be able to keep all erected pos. on its own.
keep smiling...

[wutti]

hi meg,

i would say, that this is to early to sit for a baby. the milestone for sitting and crawling is 9 month. your baby is definetly to young for such active pos. you see, the baby has to keep the pos. on its own, without any helping advices. passive sitting puts to much load on the spine. your baby should be able to lift up on elbows and hold the head on its own. the trunk rotation should start and maybe sometimes the baby presses up on hands.(milestone for 3 month old babies). but i am sure that it is not strong enough to sit properly and free on its own. but as i told you, the baby likes the position because its easier to see the environment. for a few min its ok, but to long will weaken core muscles and development of the stabilising system.
cheers

[boja1]

Megan,
I have to agree whit 1234nale, and phunphysio, because I think that she is absolutely right to wonder whether you had in mind 6-12 weeks or 6-12 mounts old children.
I’m telling this because 6 week-olds still don’t have neck muscles and head control strong and steady (control over their head and neck). They’ll begin to develop this skill at 2 months (8 weeks) and complete it in most cases by 3 months (12 weeks), so we cannot even discuss sitting and standing.
At 6 months, children can turn over from supine to prone position (from the beck to the stomach) and when in prone position they can raise themselves up on extended elbows and lean on their hands and pelvises. While when in supine position they can put their feet into their mouths, stretching their spinal columns and they find support on their backs and heads.
If we put a child into a sitting position, we would weaken his spinal column and reduce 90% of support as if when we stand on one leg. Child is not in a stable position.
Children, in most cases, begin to walk at 12 months, according to Bobath and Vojta scheme of motor development of motor skills can be tolerated by age 18 months.
These data have been taken from above-mentioned scheme, and whit mine working expires.
I have to mention that each child is a person for himself and +- 1 month can be tolerated.
Anyway we don’t need any shames or researches, as Tommy77 says but just comwon seance to rearire this.
I don’t know what type of school Tommy77 has finished or for how long he has been working, I don’t think that he has any reason to be so arrogant.

[1234nale]

Hi Megan,
I am sorry, but if she isn’t taking actively any of that position by her self you are putting her in the same. I believe you that she is happy every baby is in upright position, she maybe even is crying for you to put her up. I can understand that it is absolutely normal. But problem is that you show to her to early what is like in upright position. And you did show to her, because even if you think that she is taking mentioned positions by her own she isn’t, you are putting her in sitting on the couch ( that is passive sitting she didn’t take any of that positions by her self), you hold her hands wile she walking etc. You are interrupting with her normal motor development. She suppose to be going into phase trough phase, first holding head, then having normal reactions ling prone, then to turn on stomach, steady on her arms and have good balance there, on all for, roll to side and sit, crawling, high all for, kneeling and upright in standing caching balance in standing etc… (and this is very, very short). Best thing is to let her take position her self, if she can’t then she isn’t ready yet for that phase it is simple as that. Sorry for the bad English, if I get something written wrong our colleagues who work in pediatrics will correct me.
I know you love your child very much, that’s why you do all that. I see every day that parents think that their child is super human, but there is normal development of one baby, takes time for central nervous system to mature and that all goes in some order with minor variants.
Your original question was does it is good for your baby for sit and stand at such young age, answer it isn’t. It is bad for many reasons for her spine, knees, hips, ligaments, not now she is not in pain she is happy for psychological reasons but you don’t want her to have any problems of musculoskeletal nature later in her life time, because you love your child. I know you can’t put her back in lying position but, my advice is put her on floor on mat trace or blanket where she can be safe ( nothing dangerous that she could reach) and play with her.
I hope you did not understand me wrong, my intentions was not to confuse or worse to offend or afraid you. I don’t believe that you did something that big that is bad for her, but if there is reasonable doubt - why taking a risk?

[1234nale]

I know I could be criticized for this, but I couldn’t help my self not to wonder, how you did get idea to put your baby in standing in first place-when she was 6wks old? Did you saw some postural reaction that confused you (e.g. automatic walking or something similar)? Please, if you can remember clear my dilemmas.
Regards

[Sharedfield]

This is an issue of great interest to me and I am inclined for many reasons to agree with the thoughts that putting a baby in a sitting or standing position before they developmentally achieve these tasks on their own is not a good idea. Does anyone have links to any solid studies on this issue? I would very much appreciate finding relevant research.

[patriciama]

What is the latest school of thought on weightbearing in young babies? Are the suggestions that it causes problems in spinal development such as spondylolithesis true? Is a baby who is 6-12 weeks old is able to fully support her own weight, and loves standing (e.g. next to a couch for support - with very close supervision) at any sort of risk to her development? The same question applies to using a jolly jumper or sitting vertically in a front pack with legs dangling.

Thanks, Megan

I found this post during a web search, as I am looking for similar information. I find some of the responses appalling, many of which add nothing whatsoever to the discussion. Suggesting this person is a bad mother for asking a reasonable question is silly, and then crying "prejudice!" simply because someone doesn't agree with your answer is shameful. Here are my questions:

Can holding a young baby in an upright position cause physical problems later on? For example: Holding a baby in a sitting position to help relieve gas, or holding a baby upright against one's shoulder for the same reason (some babies need to be held upright for up to an hour after feedings); propping a baby upright due to reflux issues (semi-reclining does not alleviate the problem for some babies); carrying the baby in a front pack carrier with the legs dangling; allowing a young baby to play in an ergonomic jumper with weight on legs at times, etc. Does allowing a baby to put themselves into a sitting or standing position at a younger-than-avarage age have any real dangers?

I am NOT asking if it is okay to force a baby into sitting or standing positions, or to attempt to force development before he or she is ready.

I purchased a bouncer for my 2 1/2 month-old (even though the recommended age is 3 months and up. Bad mom!) What are some potential developmental dangers when using jumpers such as the Tippitoes, the Lindam Jump, or the Merry Muscles, which support the upper body (including the spine and in some cases the head) without putting pressure on vital organs?? Additionally, are there any potential issues with using ring-sling type carriers? What safe options to baby-wearers have? Then, I understand that walkers these days aren't safe, assuming mothers are putting them at the top of stairs or some other dangerous drop-off. In a safe environment, is there a supportive walker on the market that won't harm a baby's development? I am looking for developmentally safe alternatives to holding my baby upright constantly, since she eats, burps for an hour, eats again, sleeps on her stomach and still spits up or screams if I don't pick her up every few minutes to relieve gas/reflux. This routine doesn't allow any down-time.

Some babies mature at different rates than others, a fact that might shock those of you supplying outdated textbook answers on this forum. My child could hold her head up, roll over, and army-crawl as a newborn, and would hold on to the edge of her bed and pull herself into a sitting and sometimes standing position, make jumping movements, etc. on her own by the time she was 7 weeks old. She was only happy when she was upright. Not unusual in my family. Should I rush to her and tell her to stop because it is not "safe" until she is 6 months or 12 months of age? What sort of psychological effect would that have? Then how do I safely keep her upright after feedings? The answers provided on here suggest it would be detrimental to carry her upright, or allow her to pull herself a sitting position while we play until her gas is relieved. What is my alternative? Do I strap her immobile into an upright car seat for an hour while she screams? Sounds like child abuse to me. Our pediatrician says it is fine if the baby wants to bear her own weight, and holding her upright isn't an issue. Is he wrong? Reflux issues early on are a problem with young babies in my family, and my siblings were all held upright as babies, against the shoulder and at times in walkers, which were not very supportive. Now, in our 30's and 40's, we are all long, lean, toned and graceful, without any back or leg issues. So, how real are the dangers of developmental issues when genetics, environment, and exercise habits later on are taken into consideration?

If someone could weigh in and provide some helpful information it would be much appreciated. And yes, links to supporting research are welcome.

Thank you!