Container Baby Syndrome & Tummy Time

by Kids Place Pediatric Physical Therapists

The first year of life is critical for your baby to acquire gross motor skills such as gaining head control, ability to roll, crawl, sit, stand, and walk in order to efficiently explore her environment. Primitive reflexes like asymmetrical tonic neck reflex (ATNR), symmetrical tonic neck reflex (STNR), moro reflex, and spinal galant reflex integrate during this time period as your newborn begins to explore her environment.

Container Baby Syndrome is a term used to describe a collection of movement, behavior, and other problems caused by your baby spending too much time in a container1. To define containers, think about any piece of equipment used to provide positional support, playtime, or transportation. When used for prolonged periods of time, containers can have a negative role in significantly confining a baby and restricting movement required for healthy motor development. Common examples of these containers include Bumbo chairs, rockers, bouncer seats, swings, car seats, and strollers.

In 1994, the “Back to Sleep” Campaign was created to reduce risk of Sudden Infant Death Syndrome (SIDS) by encouraging parents to put their babies to sleep on their backs. The Centers for Disease Control and Prevention reported that SIDS rates declined from 130.3 deaths per 100,000 live births in 1990 to 38.0 deaths per 100,000 live births in 20163. This campaign was successful. However, tummy time has frequently been misconceived by parents as unsafe as a result.

A lack of tummy time can result in delays in gross motor skills, an increased incidence of plagiocephaly and torticollis as well as muscle strength and coordination deficits, Attention Deficit Hyperactivity Disorder, and obesity1.  Further, without appropriate integration of reflexes, a child may have difficulty participating in activities of daily living as their retained reflexes may obstruct function.

Time in containers should be limited to no more than 30 minutes maximum per day, with stronger emphasis on spending more time on their tummy to facilitate development of gross motor skills. The American Academy of Pediatrics recommends 3-5 minutes at a time at least 2-3 times each day, and building up time spent on their tummy as the child is able to tolerate it more2. For maximum benefits, it is recommended that an infant spends a minimum of 10 minutes on their tummy for every hour that they’re awake. She can start on her tummy on day 1!

It is crucial for parents to understand that as long as your baby is supervised while she is on her tummy, it is actually a better position to aid in development. Tummy time allows for muscle strengthening, development of gross motor skill, and integration of reflexes to improve function. It also allows your baby to more efficiently explore her environment.

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  1. Physical Therapist’s Guide to Container Baby Syndrome. American Physical Therapy Association Web site. Accessed November 8, 2018.
  2. Safe and Sound: Tips for Using Infant Swings. American Academy of Pediatrics Web site.
  3. Sudden Unexpected Infant Death and Sudden infant Death Syndrome. Centers for Disease Control and Prevention Web site. Accessed November 8, 2018.