Baby walkers-why don’t physiotherapists like them?

Lots of parents choose to put their baby into a baby walker. These activity centre style walkers tend to be advertised as being for babies as young as 6 months old and are often marketed to parents as a way of encouraging a child’s mobility. So….why don’t paediatric physiotherapists recommend them?

A baby in a baby walker

An example of a baby walker activity centre.

 

There are 2 main reasons why we would not recommend a baby walker: The first is due to safety and the second because of development.

Safety: Any parent’s first priority is to keep their child safe. However every year there are many reports of babies being injured whilst in a baby walker. These accidents include trapping arms/legs, head injuries and burns/scalds. Some studies have shown that just under half of the babies that are put into a baby walker will experience some form of injury whilst using it. If you do use or decide to use a walker, never leave your child unattended.

Development: A baby will walk when a baby is developmentally ready. In order to get to the point of walking, a baby has to learn so many other things. The timescales for a baby to walk will also depend on their body shape, motivation, personality and many other factors.

Various studies carried out have shown that not only do baby walkers NOT encourage a child’s development but they can actually cause a delay in a baby’s motor development milestones. Spending lots of time in a walker limits the amount of time spent in other positions like lying on the floor. Here your baby will learn skills that are crucial to their motor development like rolling, sitting and using their arms and hands to lean on. Walkers also alter a baby’s ability to see their legs and feet. At such a young age babies are learning where their bodies parts are, relative to themselves and to their environment…again a skill that is essential for a developing baby. There is also evidence that suggests that the use of baby walkers can cause a child to walk on their toes. This may be because their muscles and joints are not ready to take their own body weight at such a young age. The toe walking may also continue once your child is walking independently.

It is for these reasons that baby walkers are not recommended. However if you do decide to use one with your baby, the APCP (Association of Paediatric Chartered Physiotherapists) have published a parent leaflet that advises that your child is ALWAYS under close supervision and that they use a walker for no longer than 20 minutes at a time. Also ensure your child’s feet are flat on the floor, not up on their toes. This can be found at http://apcp.csp.org.uk/publications/parent-leaflets

If you require any further advice or information about the use of baby walkers or your baby’s development, please contact Therapy Stars on 07813 764938 or info@therapystars.co.uk

 

Toe Walking-can physiotherapy help?

You may never have noticed, but some children tend to walk up on their toes, rather than keeping their heels down. This is referred to as “toe walking”. But why do they adopt this position?

 
In many cases, the reasons are never known why a child may start to walk on their tip toes. Some walk like that from very early on-as soon as they are on their feet. Others develop their walk in this position as they get older. Many children choose to walk on their toes for some of the time, as a game or to avoid a cold floor for example. But toe walking refers to children who walk up on tip toes for most of the time and often struggle to correct their position by keeping their heels down.

A child in a toe walking position.

A child in a toe walking position.

Toe walking can be very common and many toddlers grow out of it. However it can be associated with other conditions, such as cerebral palsy (CP). Children with CP may have tight Achilles Tendons due to spasticity (rigidity) in their muscles and this causes them to have to walk up on their toes. Some children who seek sensory feedback (for example children on the Autistic Spectrum) may adopt a toe walking position as a sensory strategy.

 
But for many there can be no definite reason for toe walking-this is known as idiopathic toe walking. Most children who are idiopathic toe walkers end up with some degree of tightness in their Achilles Tendon and calf. This is because the calf does not get a full stretch when in a pointed position, as it is when toe walking. But part of toe walking can also be attributed to habit…and this is often the hardest part to rectify. Therefore early intervention can be extremely beneficial.

 
For children who toe walk there are several methods of physiotherapy treatment that may help. Firstly a full physiotherapy assessment would be carried out. The Therapist would look at muscle length, particularly around the calf and Achilles Tendon. They would also assess muscle strength, especially the muscles of the lower limb and core (back, hips and abdominals). They would then provide an exercise programme that targets muscle lengthening and strengthening. For younger children this may involve parents being shown how to stretch certain muscle groups and encourage activities that help to strengthen particular muscles. For older children, it may be more appropriate for them to be taught how to stretch and strengthen themselves. They may also use a stretching wedge to specifically stretch the calf muscles.

 
Regular, daily stretching is important in order to gain some length in the muscles and therefore allow your child to be able to put their heels down more easily. However, for some children, stretching alone may not be enough. These children may require further intervention that can include serial casting (regular plaster casts being applied to the ankles over a period of 4-6 weeks to gain a consistent stretch), splints (made of plastic, they hold the ankle in a certain position, therefore preventing toe walking) or in very severe cases surgery.

 
If you have any concerns about your child toe walking or would like some advice, please contact Therapy Stars on info@therapystars.co.uk or 07813 764938.