What is Container Baby Syndrome?

The convenience of popping your baby into a pram, highchair, carseat, walking ring, swing, activity gym, bouncer or bumbo seat to entertain themselves while you are busy with something is all too tempting. It also provides an opportunity to interact with your baby face to face knowing they are comfortable and supported.

Often parents think that because there are toys attached to one of these devices their development is being encouraged. However, there is a growing list of developmental delays which can be attributed to overuse of these devices. The continuously growing epidemic has been termed "Container Baby Syndrome" (CBS). What is Container Baby Syndrome and should parents be worried?

Container Baby Syndrome (CBS), also referred to as Bucket Baby, is the term used to describe a group of physical and developmental concerns and delays created as a result of a baby spending too much time restricted in a baby device or container. The extended periods of time spent in these devices leaves fewer opportunities available for tummy time and floor play. In order to strengthen the necessary systems needed for normal development, a baby needs to be able to engage in and explore their environment. 

This may sound alarming and concerning to you as a parent and so it is important to learn more about CBS and what can be done to prevent it. 

Where did THE TERM container baby syndrome come from? 

In 1992, specific guidelines regarding the best position for your infant to sleep in were put forward in an attempt to decrease the growing number of Sudden Infant Deaths (SIDS). The practice of putting babies to sleep on their tummy on a soft mattress was changed to sleeping on their backs on a firm and flat surface.

Whilst these safe sleep recommendations had a substantially positive effect on the number of SIDS cases that were reported and appeared to halve the numbers, a slow increase in the number of children identified with CBS was noted.

It has been reported that the rate of CBS increased by 60% from 1992 to 2008. In addition to not spending any time on their tummies while sleeping, it is likely that parents felt more nervous about allowing their baby to play in a position other than on their back.

The fast paced life and abundance of devices on the market aimed at making life easier for you and your baby further added to reduced time spent engaging with their environment and on their tummies. 

What are the signs of container baby syndrome?

Knowing what to look out for can often lead to early intervention which is critical. The following signs are associated with:  

• Delays in rolling, sitting, crawling and walking
• Reduced muscle strength and coordination
• Speech, vision, hearing as well as a negative impact on processing speed due to lack of multi-sensory engagement
• Plagiocephaly which is a flattening of the back of the head
• Facial asymmetry
  
• Torticollis which is when your baby has difficulty turning their head to the one side due to tightness of their neck muscles
  
• Weight gain due to lack of activity
  
• Poor ability to weight bear through their hips and shoulders
  
• Development of the hip and spine can be impacted due to inappropriate alignment or support 
  
• There is an increased risk of ADHD as a result of insufficient sensory stimulation
  

If you are worried or concerned that your infant displays any of these signs, it is best to have them assessed by a professional who will be able to guide you appropriately. It is best to make contact with either your paediatrician, an occupational therapist or a physiotherapist. 

How long is too long in an infant device?

The amount of time that your infant spends in these devices can be deceiving.

While 15 minutes here or there in a device will not contribute to any long term concerns, using various of these items multiple times a day greatly increases your baby’s chance of developing signs of CBS.    

Parents often think that because they are moving their baby from one device to another that different opportunities of engagement are available to the infant. While the position of the baby may have changed, the one thing that has not is that the infant's ability to reach out and move their whole body to interact with their environment.

The opportunity for them to move into new positions, experience different movements and sensory possibilities is limited which makes strengthening muscles and developing coordination challenging. 

How can you prevent baby container syndrome?

Education is key in making informed decisions regarding the wellbeing of your baby. These are some ways to avoid your baby developing container baby  syndrome:

• The age old saying of “everything in moderation” also applies to infant devices. Try and limit the amount of time and frequency that your baby spends in a device.  
  
• Only use the device for its intended purpose. For example a car seat should only be used when you need to transport your infant somewhere and not to sleep in. 
  
• Becoming more cognisant of the amount of time as well as the devices that your baby spends in each day in addition to the amount of “free time” they have to explore will help you find a good balance.
  
• Create a safe space for your baby to explore in.
  
• Try to hold your baby in your arms during the day rather than place them in a container. You can also use a sling or a carrier as these are less restrictive than containers.
  
• Encourage your baby to play and engage with their environment in different positions. 
  

Along with all of these suggestions, the most important way to prevent CBS is by doing sufficient tummy time. 

WHAT IS The importance of tummy time?

Encouraging your baby to do tummy time helps undo some of the negative effects of lying on their back for so long. Along with the guidelines developed by the American Academy of Pediatrics (AAP) regarding safe sleep practice, they also indicate the importance of supervised tummy time to assist with normal development. It helps strengthen the necessary muscles and builds coordination required for rolling over, crawling and reaching and playing..

Tummy time can be overwhelming for parents especially if their baby cries each time they are placed in that position. The reason babies often seem uncomfortable and frustrated in this position is because they are exercising their neck, back and trunk muscles which is hard work.

In order to have a positive effect, tummy time should be done for between 60-90 minutes a day when your baby is awake. As unbearable as that may seem, it can be split throughout the day into smaller and more manageable increments. Tummy time also needs to be supervised to make sure that your baby does not get into any compromising situations.

By interacting with your baby during this time, you prevent the risk of suffocation and entrapment or entanglement caused by soft surfaces and loose items.

HOW CAN I MAKE TUMMY TIME EASIER FOR MY BABY?

• Get onto their eye level to interact with them
  
• Use your baby’s favourite toy and game to engage them 
  
• Play peek-a-boo
  
• Sing songs  
  
• Place them on their tummy on a gym ball and roll the ball backwards and forwards and side to side
  
• Place them over your legs while you are sitting and sing songs with movement
  

A helpful resource with more in depth information on how to make tummy time more attainable can be found at:

https://www.aota.org/-/media/Corporate/Files/AboutOT/consumers/Youth/Tummy-Time-tip-sheet.pdf

Sometimes placing your baby in some type of a container is the only option to keep them safe while you get something done and that is absolutely ok. Just remember that they still need to be supervised and to limit the amount of time they spend in it as much as possible. And do not forget to engage in tummy time with your little one so that they are equipped with the necessary skills to meet their milestones.

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