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I am interested to know peoples thoughts on early weight bearing in babies. I have had a parent of a six month old baby asking if use of a "jolly jumper" would be detrimental to her child.
Are these alright to be used for short periods of time or should they be avoided all together? Any research or opinions would be appreciated.
The evidence (though weak) is that things like 'jolly jumpers' allegedly do delay the onset of walking (I think there was a publication in the BMJ about this a few years back).
HOWEVER, the Arena'ettes used a jolly jumper and were walking by 10 months!
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
This study provides additional evidence that babywalkers are associated with delay in achieving normal locomotor milestones. Babywalkers are known to increase the risk of injuries in infancy.The use of babywalkers should be discouraged.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
My son who is now just over 6, spent time in a jolly jumper & took his first steps at 8 1/2 months. He is a big boy (solid & tall) but is still well coordinated & pretty agile for his size.
This article and the letters are an interesting case study on research interpretation. Here are some snipetts from the letters
Quote:
Perhaps the authors' interpretation is more plausible still, but public good would be better served by checking out alternative explanations before making policy.
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Garrett et al in their article show that infants using babywalkers crawl, stand alone, and walk alone up to three weeks later than infants who do not use babywalkers.1 But they do not make a case that this has an impact in any other areas of a child's development, and I believe that use of the term "developmental delay" is unwarranted. These infants are doing other things that are interesting and stimulating to them and just get around to walking a little bit later.
They cite just one abstract that suggests that babywalkers are associated with an increased risk of injury: this may be true, but a quick look at the citation suggests that the control group was one tenth the size of the babywalker group, and the authors did not look at the level of injuries in children who did not use babywalkers. Garrett et al suggest that the use of babywalkers should now be discouraged. The standard of proof to justify interfering with parents' choices for their children should be much higher than this.
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Statistics may have been chosen to produce the required conclusions
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Perceived benefits of babywalkers need to be balanced against health risks
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
I have found that the research overall states that the use of this equipment does not speed up or slow down motor development significantly in healthy normal infants. There have been some research that children achieve walking 1 week later on average than those who do not use walkers. There were some letters written to an editor that reported 11/ 100 children referred to their clinic had abnormal development after excessive use of the baby walker, but no specifics on if those children had a diagnosis or were later diagnosed (and the research was from 1972- designs have changed since then).
I suspect using the equipment isn't the problem, but it's how much time they spend in it. If you strap a child in different positioning and walker/jumperoo equipment all the time, they don't get the chance to work on developmental milestones. They aren't getting the appropriate "tummy time" in. The only time I don't recommend jumperoo's is when a child is low tone and has laxity in the ankle joints or when they are high tone and only stand on their tiptoes.
So maybe the keys are to limit the use, provide safe environments for the equipment to be used (baby walker & stairs), and the medical condition of the child (abdnormal tone).
Here are some of the research articles I've looked at:
Pin T, Eldridge B, Galea M. (2007) A Review of the Effects of Sleep Position, Play Position, and Equipment Use on Motor Development in Infants. Developmental Medicine & Child Neurology 49: 858-867.
Fay D, Hall M, Murray M, Saatdijian A, Vohwinklel E. (2006) The effect of infant equipment use on motor milestone achievement. Pediatric Physical Therapy 18: 90
Ridenour M. (1982) Infant walkers: developmental tool or inherent danger. Percept Mot Skills 55: 1201-1202
Hagen KA, Lundeen HM, Speich SA, Mabey R, Mohr P. (2006) Recent trends and attitudes among parents/ primary caregivers and physicians toward the use of exersaucers. Pediatric Physical Therapy 18: 92-93
Simpkiss MJ, Raikes AS. (1972) Problems resulting from the excessive use of baby-walkers and baby-bouncers. Lancet 1: 747
Bartlett DJ, Fanning JEK. (2003) Relationships of equipment use and play positions to motor development at eight months corrected age of infants born preterm. Pediatric Physical Therapy 15: 8-15
I have two children that both had been in the Jolly Jumper for small periods of time every day and both walked at 8-10 months approx. When they started to walk they were very steady on their feet. My sister and brother refused to use them and their children all four walked later at around 14-18 months. My sisiters boy was premature only 2 lbs when born and Growth and develpoment therapists told her not to use them that they were bad for normal development in muscle and. Althought not scientific I believe this indicates they help. I thnk they have their roll if used for short periods of time to build up the muscle strength of the legs and core stabilizers etc. Also I think they are a lot better than forcing a child to stand and walk, when not ready, holding them up by there arms as most parents do. This probably causes more harm for the feet, legs, pelvis, let alone the Gleno humeral joint. I will continue to reccommend the use of Jolly jumpers if asked my opinion. Long Live Jolly Jumpers.
Nice little thread here. We let our last child (now 22 y/o male) use it (whilst I was enrolled as a podiatry student). I regret its use, no evidence, just a 'gut' feeling that extraordinary GRF's aren't necessarily good for the developing skeletal system. As for early weightbearing, David (the youngest), though he started walking @ ~ 14/12 (like his elder brothers and sister), began standing much earlier than the others .......................
Craig, the arena'ettes walking at 10/12, fair enough, but can they march in time to the Australian anthem yet mate?
"Australians all let us rejoice,
For we are young and free,
With golden soils and wealth for toil,
..............."
Babies develop their core stability from rolling and pulling themselves up. They learn to transfer their weight during cruising. While they are crawling they are learning weight transfer, bilateral coordindation, building up shoulder girdle strength, development of hand eye coordination etc etc etc.
I think when we discuss these types of things we need to take a step back and remember all the building blocks that need to be learnt for both fine and gross motor skill development.
Craig, we know those Arena'ette are extraordinary and break all the rules however we still need to exercise caution in our advise.
The overwhelming consensus in our centre (MSK and nuero physios, myself (pod) and our consultant paediatraic orthopaedic surgeon is a resounding no! There is barely a toe-walker or in-toe walker that we see that has not had an early weight bearing device. Floor time is crucial to developing core stability and co-ordination... bascially dont run before you can walk.
As a general rule of thumb, if they cannot support their own weight, unsupported, then don't put them in one. I personaly cannot see why a JJ would be contraindicated in a fully independant weighbearing child for short periods, but I doubt by that stage how interested they would be - why do that when you can jump on a trampoline or run around???
Cylie- I agree with you on that kids can't learn those basic skills they need to use to continue to develop if they are in equipment for long periods of time. However, I still think with normal children and limited use, the equipment was okay. My daughter was allowed to use her jumperoo (we really didn't have any other equipment) when I was getting supper ready....period. I was determined she would spend lots of floor time playing and developing all the necessary building blocks.
And the question with the toe walkers or in-toers....did it develop from the equipment or was there an underlying condition? How much time did they spend in the equipment?
I still feel with "normal" children limited equipment use is fine. Maybe there should be warnings on television that report to only use equipment for 15 minutes per day or some specified number, otherwise it could be detrimental to the child's development. Who wants to develop these commercials?
I think it is Canada and some European countries (though some of our international colleagues may be more informed) that have just banned baby walkers full stop. Both from the injurious nature of them and from the developmental aspect.
I think the benefit that a small percentage of parents that use them in limited amounts when needed is outweighed by those that use them as an extended babysitting tool unfortunately.
Early Weightbearing Toys
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