If Your Child Is Sitting Like This, Here’s Why You Need to Stop Them Now

My daughter’s just over a year old, so there’s really not much she’s doing “wrong” yet. (Trust me, like all of us, she’ll get there.) If she smacks our family pet, it’s less hostility and more that she doesn’t have full control of her arms. If she throws her food, it’s not an act of insubordination but just her method of communicating that she’s done eating. So, when a family member alerted me to something my child was doing that she needed to stop at once, I was taken aback. Especially because, at that particular moment, she wasn’t stealing her playmate’s toys or eating an expensive coaster as she’s sometimes known to do. She was just sitting there.

Turns out, the way she was sitting — with each leg splayed at her side, knees in front and feet behind, to form a “W” shape — was all kinds of bad.

According to a vast majority of physical therapists, there are several key reasons why:

W-sitting limits core strength because it gives kids a wider base of support. Because they don’t have to engage their abdominal or back muscles in this position, kids often prefer it to more challenging, tiring positions, like with legs in front, at their sides, or crisscrossed.
W-sitting causes muscle tightness, particularly in the legs and hips but also knees and ankles.
W-sitting aggravates neurological issues such as low muscle tone, which means when kids aren’t actively using their muscles, those muscles are floppier and softer and have a harder time holding their bodies upright.
What this all means, most therapists agree, is that prolonged W-sitting throughout childhood can lead to a delayed development in gross motor skills like coordination and balance. For those parents hoping to raise a star athlete, this position’s effect on postural muscles can also be cause for concern.

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Why do some kids sit like this? It’s by far the steadiest way for children of all ages to sit, and aside from that innate tendency to achieve the most stability, it’s also been attributed to time spent in infant carrier devices, like swings, bouncy seats, and car seats.

Seeing as my daughter had graduated from infancy, I was immediately concerned that the damage was already done. I had tried my best to limit her time in her baby swing and the oversize, overpriced ExerSaucer that I had bought under the assumption it was actually good for a baby’s development, but here she was, W-sitting at every turn. I had never noticed it until now.

What can be done? Well, the somewhat alarmist recommendation is to get them to stop doing it immediately — that, whenever you see your child W-sitting, you either physically move their legs into a suitable position (if they’re too young to understand) or tell them to do so.

So, with a watchful eye, I adjusted her legs every time she sat incorrectly, and my husband and I instructed our child’s caretakers to do the same. Occasionally I’d correct her, and it’d be fine, but plenty of times, adjusting one of her legs would make her cry and most times, doing so annoyed her to the point that she was no longer interested in sitting and scooted off to go do something else.

She wasn’t the only one getting fed up, and it had only been a week. I dug a little deeper and found that a few pediatric occupational therapists out there don’t view this seated position as a problem necessarily. There’s not much evidence that shows causation. That is, yes, children who W-sit often have orthopedic issues and muscle tightness. But W-sitting hasn’t been proven to be the cause of those issues, which makes one wonder: could tight hamstrings and hip dysplasia lead to W-sitting, not the other way around?

One such unconvinced therapist, Rachel Coley, happens to be the mother to a W-sitter and maintains it’s perfectly normal for kids to sit this way.

She notes that it’s a simple sign of flexibility and aids in fine motor control because you need to assume the most stable seated position possible when engaging in tasks that require “coordinated, controlled movements of the hands and fingers.” Coley also noted that, for babies in particular, W-sitting provides a convenient, “natural transition” from crawling or kneeling to sitting.

However, based on how strongly most certified therapists feel about W-sitting, I’m not taking any chances. I’m going to keep my eye on it, and I’ll encourage other parents who were unaware of this issue to do the same, especially if they have older kids showing some of the negative side effects. But, if my child is having the time of her life smacking two wooden blocks together, I’m not going to spoil the fun if she happens to be W-sitting.

ECV: Keeping the Fetus out of a Breech Position

Management of Difficult Labor

Written by the Healthline Editorial Team on March 15, 2012
Finding the fetus in a breech presentation through ultrasound or by feeling the mother’s abdomen around 20 weeks into the pregnancy is of no important consequence and should not prompt any special concern. Generally the fetus will rotate to a cephalic presentation by term. If, however, the fetus is still in a breech presentation 37 weeks into the pregnancy, it is reasonable to attempt to turn the fetus to a cephalic presentation to avoid the problem of having a breech baby at the onset of labor a week or two later. Though less likely, some fetuses will still rotate spontaneously after 37 weeks. On the other hand, some fetuses successfully rotated by ECV, may flip back before the mother goes into labor.

External Cephalic Version (ECV)

External cephalic version is a procedure for turning the fetus from a breech to a cephalic (head-first) presentation by manipulation through the mother’s abdomen. This procedure is successful in keeping the fetus in a cephalic presentation 50 to 70% of the time. In most medical centers, the protocol for ECV includes the following steps:

obtaining an ultrasound and non-stress test to make sure the fetus is healthy prior to the procedure;
administering a drug, usually terbutaline (Brethine), to relax the muscles of the uterus. This may be unnecessary for women who have had a prior pregnancy;
monitoring the fetus’s heart rate by ultrasound during the procedure;
attempting to roll the fetus forward or backward by lifting and pushing the fetus’s buttocks upward through the mother’s abdominal wall, while guiding the head toward the pelvis; and
obtaining a non-stress test after the procedure, even if it is not successful, to ensure that the fetus is still healthy and tolerated the procedure.
ECV is less likely to work if:

the mother has never had a baby before;
the mother is obese;
the fetus is lying on its back rather than on its side; or
the amount of amniotic fluid around the fetus is reduced.
Women who are Rh-negative, and who are having an attempted ECV should receive Rh immune globulin (RhoGam) if delivery is to be delayed by more than 48 to 72 hours.

If the attempted ECV is unsuccessful, some doctors make a second attempt a few days to one week later, or when placing an epidural block for delivery. Trying to turn the fetus once an epidural block has been placed avoids most of the discomfort associated with attempted ECV and allows a cesarean section to be performed immediately if the attempt fails. If the fetus flips back after a successful ECV, the doctor can attempt to perform the ECV a second time. At this point, labor may be induced while the fetus is in cephalic presentation so that it does not flip back again, which is called an unstable lie.