A baby needs good positioning to avoid getting bone and muscle deformities as he grows. Good positioning also ensures that the baby is able to see and explore his surroundings adequately to reach developmental milestones.
Why is it important to properly position your baby
Hyperextension (arching) of the neck and trunk
Why…
The muscles of the neck and shoulders may grow shorter than they should.
Result…
Hyperextension encourages a “candlestick” posture (arms up and bent at the elbow). It is then hard for the baby to reach out with his hands, to put his hands together, or to bear weight on the forearms to raise himself when lying on his stomach.
He may also adopt a “glider” position on the stomach and find it hard to lie on his back. He may sleep slightly to one side to allow the head to tilt backward.
Head always to same side
Why…
The bones of a baby’s skull are soft and deform easily. If the head is always turned to the same side, the constant pressure of the head on the bed may flatten that side somewhat. Also, if the baby doesn’t yet move his head much, the muscles of the neck and shoulders may end up shorter on one side.
Result…
- The skull may suffer several types of deformity:
- Crooked head – also called “positional plagiocephaly” – affects the back of the head on one side
- Flattened head – also called “brachycephaly” – affects the back of the head only
- Narrow head – also called “scaphocephaly” or “dolichocephaly” – head is long and flattened at the temples
- Shortened neck muscles may lead to “torticollis” – difficulty turning the head to look around.
Arms fixed in a candlestick position
Why…
This position brings the shoulder blades closer together, such that several muscles may end up shortened. Some of these are strong muscles, like the trapezius, which connect the arms, head and shoulders.
Result…
The baby will tend to hold his head hyperextended, his back slightly arched, and his arms in “candlestick” position (arms up, bent at the elbow). He may also have trouble cuddling or leaning against your shoulder when you carry him. He may feel pain when moved.
Frog legs
Why…
This posture may lead to shortened hip and thigh muscles, especially those on the inside of the thigh. In turn, hip and leg bone deformities may result.
Result…
The baby may sit preferentially in the W position. Later on, he may end up walking with legs turned out. This posture is particularly important to watch out for in children with cerebral palsy, for whom the effects are more damaging.
The importance of changing your baby’s position
Allowing your baby to be on his stomach, then on his back or on the side will stimulate his muscle strength and motor development. The change in position will also limit deformities induced by placing the head always to one side. Each position has its own benefits.
- Encourages flexion and curling up
- Strengthens head and neck muscles
- Benefits motor development (sitting, crawling, position changes)
- Eases self-regulatory behaviours (hands closer to mouth), thus less crying
On the side
- Facilitates proper alignment of the head, arms, and legs toward the middle of the body, in flexed position
- Fosters self-regulatory behaviours (hands closer to mouth)
Semi-inclined (e.g. semi-inclined baby seat)
- Facilitates visual exploration of the surroundings
- Encourages social interaction
Watch for body aligment
In whichever position you place the baby, make sure the body is well aligned.
Head
- In line with trunk; chin in line with bellybutton; ears in line with shoulders
- In neutral position, not bending forward or back
Trunk
- Nipples and knees facing one another
Legs
- Legs bent at the hip and knees flexed.
Arms
- Close to body, hands near face
- Can move freely
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