Let's Learn Something: Bouncers, Jumpers and Walkers
A tale of caution from Dr. Diane
My 10-month-old daughter Abby has some developmental delays.
She is a sweet and happy baby who loves to babble ("mamama"... be still my heart!), pick up small toys and explore them slowly, play peek-a-boo, pick up her tiny foods with two fingers, point, laugh, and clap.
Things she cannot do? Crawl with her belly off the floor. Pull up to stand, or really put much weight on her legs at all. Shift from sitting to crawling to sitting again. Cruise along the furniture while holding onto it. She has delays in what we call “gross motor development” – the development of the “big movements.”
I see patients all the time at our Willow Park office that have gross motor delays, so I know not to worry. Lots of things can contribute to this. Sometimes it's just genetics. Sometimes it’s the baby's weight-to-height ratio. I notice that leaner, smaller kids tend to develop these movements faster, and bigger, longer kids sometimes need more time to build the strength to try these things. As you can see from the pictures, Abby has not missed any meals. There are exceptions to every rule of course, but I think this plays a role.
The baby’s temperament can also lead to delays. Some kids want to go go go...and some are completely fine with sitting still and working with what is in a close vicinity. Abby certainly fits into this latter scenario.
Of course there are numerous medical conditions that can cause motor delays. Always make sure, if your child has delays, to ask your pediatrician for a good neurological exam to check things like muscle tone.
Unfortunately, I believe what has played a big role in Abby’s delay is the amount of time she has spent in her favorite jumpers.
Baby jumpers, bouncers, exersaucers, and activity centers (they’re all basically the same thing) are stationary devices that allow a child to “stand” and bounce prior to developing those skills naturally. Kids love them because they’re fun and stimulating – most have toys and games attached – and they get to see more of the room and things going on around them, along with getting a chance to bounce up and down easily. Parents love them, because, let’s face it – they’re a quick and safe option for a break.
Baby walkers are similar – except they are on wheels so babies can bounce/pull themselves around the house. I have never owned one of these because they come with safety risks – children can fall down stairs, tip over, touch a hot stove, get pushed by siblings, pinch fingers, and slam into walls in these devices, and as fun as they seem, they’re not a good idea.
Around 4-5 months we started putting Abby in a jumper and she was thrilled! Finally she could be propped up and see everyone! She could control her body enough to bounce, and loved it. We were happy too, because we were constantly chasing her 2-year-old brother around, and it was nice to have a safe place to plop her down while that happened. Admittedly, it became a habit. When we’d read books, Abby would be propped up to be able to see the pictures. When we’d sing songs and play music with her big brother…Abby would get to howl and jump along in the bouncer. When we had to deal with the 2-year-old tantrums (and boy are those frequent)…in she went. Emptying groceries? Bouncer. Going to bathroom? Bouncer. Cooking dinner? Boom. Folding laundry? Ker-splat. She was probably in them a total of an hour to an hour and a half a day.
Looking back, she was in the bouncer way too much. Learn from my mistake, friends. Yes, pediatricians make mistakes.
Other doctors may think these things are harmless, but I respectfully disagree. Especially since I suspect my own child has likely been affected. Physical therapists have been warning parents for years about the problems with bouncers. And the more I’ve researched it, the more I’ve realized that too much time in these things can be detrimental to a child’s development.
I spoke with Gail Abaray, a pediatric physical therapist in Weatherford, who told me, "Bouncers don't allow infants to explore and move. They are limited in what they can do, and are stationary. And that pull to explore is so important. When they cruise the furniture, they learn about lateral movement, and how to turn their legs and feet. In a stationary bouncer, all of that coordination can't happen."
Look at the picture of Abby in her favorite bouncer. See how she’s on her tiptoes? This is typical and leads to the majority of the strength being recruited from her calves and thighs. What is not getting a workout is her hip, gluteal, pelvic and core muscles – and these are the ones that help children crawl and eventually walk.
Their hips are spread unnaturally wide by a piece of stiff fabric. They often lock their knees, especially the younger babies.
Babies cannot see their feet or the ground in these devices either – and thus cannot coordinate their body well in them.
Their upper bodies are also thrust forward – taking all the pressure/weight off their gluteal and hip muscles. The very muscles they need to strengthen.
The same things happen in walkers – babies are pulling themselves along while most of their weight is supported, and this works out and coordinates all the wrong muscles. They also can’t see the ground or their feet. “Walkers” are a true oxymoron here – they lead to delays in walking naturally.
So what do I recommend to parents now? Well…go buy a bouncer! They’re great! But – use them in moderation. Don’t put one in every room, like I did – it’ll only lead you to use them more. Use it only for very short periods of time – maybe 15 minutes here and there, once or twice a day – 20 or 30 minutes a day, max! Physical therapist Gail agrees: "I always tell parents not to feel guilty for using them. I did! But moderation is key!"
Don't feel guilty if you've put your baby in a bouncer - we all need breaks. And it's hard to deny they're so happy in them! But remember the big picture - kids need to learn to explore their environment on their own. It's vital to their development!
As for miss Abby-pants? Well, we got rid of all the bouncers and for the past month have set strict tummy time rules – she must work for toys on the floor for nearly the entire day, and must practice standing several times a day. She yells at me about it all day, but boy has this tough love helped. She has already shown vast improvements. She is now able to stand supporting herself on a piece of furniture, can quickly army crawl (using her arms mostly), and is starting to lift that big belly off the floor! We are also enlisting the help of a local pediatric physical therapist to help with some exercises and strategies. Slowly but surely, she’ll get there!
Dr. Diane Arnaout joined the Cook Children's Willow Park practice in 2011. Dr. Arnaout was born and raised in the Dallas-Fort Worth area. She served as a leader on the medical education committees during her internship and residency in pediatrics at the University of Texas Health Science Center in the Texas Medical Center at Houston, Texas.