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Horizontal transport stresses an infant’s body… while the upright position provides a variety of health benefits
Europe seems to host the greatest number of pediatricians who recommend that, in order to avoid pressure on their underdeveloped bodies, newborns and infants should lie flat on their backs in a stroller and not be carried. Yet, laying a young infant on his back alone in a stroller is actually physically and emotionally stressful, and can be developmentally inhibiting. Being carried or worn in an upright position with proper leg support is not only developmentally sound but often preferable to mothers and babies alike. Upright carrying optimizes the physical, emotional and intellectual growth of your baby.
Infant Spine Development
Our spines are not perfectly straight, even though they may appear so from the front or back. When you look at a person from the side, four slight curves are visible, forming an elongated S shape. These curves help keep us flexible and balanced. They also help absorb stresses placed on our bodies through our daily activities, such as walking, running and jumping.
We weren’t born with these curves. Normal curves of the spine develop gradually, as a means of adapting to gravity. At birth, babies are in a state of flexion, still curled up, with their spines in a natural, long Cshaped (convex) curve. At first, a baby does not have the strength to hold his head up, nor the balancing curves in his spine to do so. But gradually, as the muscles in his neck get stronger, he begins to lift his heavy head against gravity, and a curve starts to develop in his neck (the cervical curve) to help balance his head. When your baby starts to creep and crawl, the lower back (lumbar curve) and the muscles that support it develop. It takes about a full year for your baby to attain these curves in his spine.
The Stresses of Lying Flat
Laying your young infant flat on his back stretches the C-curved spine into a straight line, against its natural shape. Research shows that keeping an infant’s spine straight is not a sound physiological position. In addition to stressing the baby’s spine, it can also negatively influence the development of the baby’s hip joints.
Infants who lie frequently on their backs in a stroller may end up with plagiocephaly (deformed skulls, flattened on the back or side) and deformed bodies with poor muscle tone. Research backed by the American Academy of Pediatrics states that “with prolonged immobilization on a firm mattress or a flat bed (as in a stroller), the constant influence of gravity flattens the body surface against the mattress producing positional disorders and infants with decreased muscle tone.”
Existence in Containers
This does not mean that laying the baby flat for a couple of walks around the block in a stroller is going to wreak havoc on your baby’s physical development. But the truth is that the average Western infant between 3 weeks and 3 months of age is carried little more than two and a half hours a day. Babies spend most of their time in containers, such as car seats, cribs and strollers. The West has diverged from eons of child rearing, and we have gotten to the point of letting objects determine our babies’ sense of contact, rather than us.
The Fetal Tuck
Newborns are virtually impossible to stretch out unless wrapped or swaddled. When you place an infant flat on his back, his thighs will usually be pulled up toward his chest, or when sleeping, straddled and bent in a frog position. The fetal tuck, the natural position of babies, is the most calming and the most adaptive.
Infants use less oxygen, which conserves energy and wastes fewer calories. They digest their food better. Also, we have more efficient temperature-regulating cells and more fat on the back sides of our bodies, so when we hold our infants stomach-tostomach, we are protecting all their receptor and vital organs.
The instinctual flexed widespread legs that an infant maintains when picked up, coupled with the palmar and plantar reflexes that help an infant cling to his mother, suggests that infants’ little bodies are adapted to be carried upright and oriented toward their mothers.
By holding your baby with his knees flexed flat against your chest and supporting his bottom, you are supporting your baby in the natural position that his body instinctively assumes to ensure that he is comfortable, warm and safe.
The Trouble with Car Seats
Strollers that position a baby in a somewhat upright position (such as in infant car seats) may be gentler on the baby’s Cshaped spine, in that they do not stretch it flat. But car seats are not a much better option for transporting your little one. Research by the International Chiropractic Pediatric Association shows that they are not the ideal transport for your infant when not in the car, due to “restricted postural options which can impact your baby’s developing cranium and spine.”
By keeping the spine in a C-shaped configuration, these contraptions
can actually prevent the natural curves from forming. Babies can have a hard time acquiring adequate muscle strength to hold up their heads if they don’t get much of a chance to experience gravity.
Positive Physical Development
When infants are held upright, they are allowed to practice compensatory movements, enhancing muscular strength and allowing for more control over their fine motor skills. When the mother walks, stops or turns, an infant’s body naturally works against the pull of gravity to maintain his position.
The force of gravity is a positive element in infant development. It allows them to learn to hold their heads up and keep their bodies balanced.
Discord with Upright Carrying
So why do some still claim that the horizontal position is better for your infant in her first months of life? This argument is often rooted in the assumption that the upright position may be stressful to his underdeveloped spine and pelvis.
Although some pediatricians are advocates of natural parenting, many don’t have much hands-on experience with baby carriers. They might be acquainted with the upright carriers from the eighties and nineties with their typical lack of adequate head/neck support and tight or chafing leg holes, leaving babies to dangle from the crotch due to complete lack of leg support. Perhaps they have seen so many babies facing out when carried upright that they assume all upright carrying is non-supportive.
The first two images on this page are perhaps the carriers that many doctors imagine and classify as unsafe or harmful. Both are non-physiological-carrying devices. These front-facing carriers, unlike wraps, slings, mei tais and soft-structured carriers, do not provide proper leg support, which can make the pelvis tilt backward and place babies in the dangerous “hollow back position.”