Well this is embarrassing!
The topic of baby walkers comes up on a daily basis in my career. This is mainly because paediatric heath professionals, including physiotherapists myself, have many discussions with parents and carers about why they should be avoided. It is also because many children are coming to see us in physio clinics as a result of using them, be it delayed milestones/walking, injuries or persistent tip toe walking.
What we never intend to do is make a family feel bad about having used a baby walker. The problem that we face is that they are sold as fun bits of kit that help a child to walk – the warnings aren’t as well documented! How are people supposed to know? Also, there will be countless children out there that have used a baby walker with no problems at all. However, we are the people that see the consequences of those that do have problems due to their use.
Here are the main reasons why we feel that physiotherapists feel that baby walkers should be avoided:
They are massively dangerous!
You may feel that these things won’t happen to you or your children but around 4,000 children in the UK alone are injured each year whilst in a baby walker. This can be because of trapped fingers, burns, tumbles down steps/stairs, knocking objects from heights…the list goes on.
They can hinder your child’s development
Many people believe that a baby walker will help their child learn to walk more quickly, but unfortunately they tend to have the opposite effect and delay walking further. The baby walker provides a lot of extra support, which means that the crucial muscle groups and movement patterns are being delayed due to lack of use. The child hasn’t learned to support their own weight at all, only to hang in the seat and scoot along. Children need to learn how to walk from the ground up, building the foundations of strength and movement patterns to allow the ability to achieve the next step, e.g. learning to roll, sit and crawl and allow them to pull to stand by themselves when they are ready.
Using a baby walker is known to cause a persistent toe-walking gait
Tip toe walking is usually a normal variant in a developing walking pattern. This means that not all children do this, but a large number do and this can be a completely normal stage of development that they grow out of. Many children starting to walk can tip toe walk initially, but this should not persist beyond 6 months or so.
There is a definite common link between persistent idiopathic toe walkers and the use of baby walkers. I have my own way of understanding the reason behind this and always share this with the families in physio clinic. When we walk, as adults, we don’t think to ourselves that we must touch down with our heel, push off with our toes and balance while the other leg swings etc etc. It is simply a circuit that was built in our brains when we were learning to walk so that we don’t have to think about it, it becomes automatic. Children learning to walk are still creating circuits of their own and the actions do not come as naturally to them. When have you ever seen a child walk ‘normally’ in a baby walker? Never! They scoot the walker along, the way to scoot is on your toes as you propel the walker forwards. It doesn’t happen with every child but for many, if done enough, this could be a pattern of movement that becomes normal for them.
There are also other researched theories, which I believe all combine towards the issue. The main one is that while the baby is supported in the walker, the upper legs and hips/pelvis become weaker due to reduced use in the support, the lower legs become overused and eventually need to work hard to compensate for the weakness above. We call this ‘fixing’ – overworking to make up for weakness elsewhere.
Once a child has established a toe-walking gait pattern and this has persisted over time, it can be very difficult to treat once the movement pattern is well established. That is not to say that they can’t be treated at all. On the contrary, there are many treatment options that we can use in Physiotherapy, it’s just that it can take a lot of time and effort all round to solve the problem. Obviously, the best treatment is education and prevention.
There are many children out there, particularly those on the Autistic Spectrum, that walk up on their toes as a symptom of their condition, which is usually to gain the sensory input that they need. Most of these children actually NEED to walk like this in order to function. I would look at each case individually and would only treat those that I felt I could help and not hinder.
I hope that you have found this blog helpful in some way. I am happy to assess any children that have issues with their gait pattern so feel free to get in touch.
Christina Peak
Specialist Paediatric Physiotherapist
Sutton Coldfield Children’s Physiotherapy