Evaluation of the Movement and Play Opportunities and Constraints Associated With Containers for Infants

Abstract
Purpose: Containers (eg, strollers, bouncers) are an important part of infants’ environment but may negatively impact infant development and health. This study evaluated movement and play opportunities, constraints, and manufacturers’ developmental claims for infant containers. Methods: Containers were identified through Amazon.com. A content analysis of identified products was conducted to identify movement and visual-manual play opportunities, constraints, and developmental claims. Results: Content was analyzed for 460 containers. Containers varied in their movement and play opportunities; however, most did not incorporate toys and restricted trunk movement, self-directed locomotion, and independent head and trunk control. Containers, especially those with built-in toys, often had claims related to gross motor, sensory, and fine motor development. Conclusion: These findings demonstrate the variability of movement and play opportunities observed across and within categories of infant containers. General recommendations about container use may be less effective than more specific education to parents about selecting and implementing containers. WHAT THIS EVIDENCE ADDS Current evidence: Infant containers such as strollers, jumpers, and floor seats are commonly used by caregivers in home and daycare settings.1,2 Caregivers’ reports of container use indicate that infants spend hours in containers each day.1,3 Although containers are a significant component of infants’ physical environment, their prolonged use has been discouraged by some professional organizations to prevent the negative developmental and health outcomes associated with container baby syndrome (CBS).4 However, manufacturers often make claims about the developmental benefits of their products. These claims, which may or may not align with current literature, can influence parents’ beliefs and purchasing decisions.5 Gap in the evidence: Containers may negatively impact infant development and health by limiting movement and environmental exploration opportunities; however, the opportunities and constraints provided by commercially available containers have not been evaluated. Additionally, the developmental claims made by manufacturers have not been examined. How does this study fill this evidence gap? In this study, we performed a systematic content analysis of the movement and play opportunities, constraints, and developmental claims made by manufacturers of a large sample of commercially available containers. Implication of all the evidence to clinicians: Most containers place young infants in supine or reclined, restrict trunk movement, limit independent support of the head, do not allow self-locomotion, and lack built-in toys. These findings provide insight into potential mechanisms by which containers may result in CBS. Varying levels of movement and play opportunities for containers were observed. The results can inform clinicians and others when supporting parents selecting containers and suggest recommendations for use should depend upon the container rather than being global. Manufacturers of many containers made claims related to motor, cognitive, sensory, and physical development. Clinicians’ awareness of these claims may support education efforts with parents since claims influence parents’ beliefs and purchasing decisions.
Description
This is a pre-copyedited, author-produced version of an article accepted for publication in Pediatric Physical Therapy. The published version of record Alghamdi, Zainab S. MSPT, PT; Orlando, Julie M. PT, PhD; Lobo, Michele A. PhD, PT. Evaluation of the Movement and Play Opportunities and Constraints Associated With Containers for Infants. Pediatric Physical Therapy 36(4):p 458-466, October 2024. | DOI: 10.1097/PEP.0000000000001125 is available online at: https://doi.org/10.1097/PEP.0000000000001125. © 2024 Academy of Pediatric Physical Therapy of the American Physical Therapy Association. This article will be embargoed until 10/01/2025.
Keywords
company labeling, infant containers, infant development, opportunities, physical environment, play
Citation
Alghamdi, Zainab S. MSPT, PT; Orlando, Julie M. PT, PhD; Lobo, Michele A. PhD, PT. Evaluation of the Movement and Play Opportunities and Constraints Associated With Containers for Infants. Pediatric Physical Therapy 36(4):p 458-466, October 2024. | DOI: 10.1097/PEP.0000000000001125