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My Child Seems to Be Sitting in the W Position—Should I Be Concerned?

As parents, you may have noticed your child sitting in a position where their bottom is on the floor, knees bent, feet tucked under, and legs splayed out to the sides in the shape of a "W." This posture, commonly known as "W-sitting," might seem harmless or even comfortable for your child, but it's important to understand the potential risks associated with frequent or prolonged use of W sitting on a child’s growth and development. 

Why Do Children Choose to W-Sit?

W-sitting provides a wider base of support and a lower center of gravity, making it easier for children to maintain their balance. This stability allows them to focus on activities without the challenge of balancing in more complex sitting positions. 

Is W-Sitting Bad?

It is common and harmless for children to move in and out of the W-sitting position during play, in fact occasional W-sitting is usually not a cause for concern, but habitual or extended use of this position can lead to several potential issues such as:

  • Hip Dislocation: Children with existing hip problems are at greater risk for dislocation due to the strain W-sitting places on the hips and joints.
  • Limited Trunk/Core Strength: The wide stance of the W position reduces the need for core muscle engagement, potentially leading to weaker trunk muscles over time.
  • Impaired Balance and Midline Crossing: W-sitting can hinder a child’s ability to rotate their upper body and perform movements that cross the midline, which are crucial for developing bilateral coordination.
  • Muscle Tightness: Children prone to muscle tightness, or hypertonia, may experience increased tightness in the hips, knees, and ankles from prolonged W-sitting, potentially leading to conditions like walking ‘pigeon-toed.’
  • Postural Problems: W-sitting can contribute to postural issues such as swayback, where the spine curves excessively inward, affecting balance and coordination.

What Are Some Alternative Seating Positions?

To mitigate the risks associated with W-sitting, encourage your child to adopt alternative sitting positions:
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Criss-Cross Applesauce
Encourage your child to sit with their feet crossed and knees apart. This position supports better posture and balance.
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Side-Sitting
If cross-legged sitting is difficult, side-sitting is another option. In this position, knees are bent, weight is shifted to one hip, and both feet are out to the same side. This reduces stress on the hip joints.
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Long Sitting
Sitting with feet forward and back supported helps stretch the hamstrings and keeps hip and knee joints in a neutral position. You can also sit on a pillow or wobble cushion
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Butterfly Sitting
Sitting with the soles of the feet together and knees bent out to the side allows gravity to gently stretch the muscles.
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Kneeling
Encourage kneeling with feet tucked under the bottom as a way to strengthen hip and core muscles. Just be sure the child doesn’t shift back into a W-sitting position.
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Squatting or Low Chairs
These positions can prevent W-sitting during play and encourage a more natural posture.
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Use a Kiddie Chair or Activity Table
Getting your child off the floor can prevent W-sitting. Activity tables encourage playing at a higher level, which can be beneficial for posture.

Fun Activities to Strengthen The Core & Balance

Incorporating fun, engaging activities that build core strength and improve balance can also help discourage W-sitting:

  • Obstacle Courses: Create courses that require your child to use their whole body, engaging in movements that strengthen core and leg muscles.
  • Action Songs: Songs like “Row, Row, Row Your Boat” involve movements that help exercise the hip joints.
  • Hands and Knees Play: Activities like playing with shaving cream, coloring, or assembling puzzles while on their hands and knees are great for building core strength and working out the arms.
  • Crawling Games: Games that involve crawling on hands and knees, such as navigating through tunnels, encourage the use of different muscle groups and promote better sitting habits.
  • Crab Position: Encourage your child to sit in a crab position, with their feet on sliders or paper plates. Have them straighten one leg at a time to knock over a bowling pin or kick a ball, making the activity fun and engaging.
  • Dead Bug: Have your child lie on their back with their arms and legs in the air. You can balance a toy on their feet or shins and encourage them to hold the position. This exercise strengthens both the core and leg muscles.
  • Knee Walking: Have your child knee walk between two tables to build a block tower or move toy pieces. This activity strengthens the core and gluteal muscles and can be made more challenging by pushing a weighted laundry basket.

References:

Michaud, P. A., & Renaud, A. (2001). W-Sitting in Children: What Should the Occupational Therapist Know? Physical & Occupational Therapy in Pediatrics, 21(2-3), 61-76.

Murnane, A., & Gahimer, J. (2005). Pediatric Therapy and Postural Development: Implications of W-Sitting. The American Journal of Occupational Therapy, 59(4), 440-448.

Knudson, S. E., & Galloway, J. C. (2008). Addressing Lower Extremity Postural Control in Pediatric Occupational Therapy. Journal of Pediatric Rehabilitation Medicine, 1(1), 23-30.

Heathcock, J. C., Bhat, A. N., Lobo, M. A., & Galloway, J. C. (2007). The effects of lower-extremity position on motor activity in infants with and without brain injury. Pediatric Physical Therapy, 19(1), 12-18.

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When to Seek Help

If W-sitting is the only position your child uses, or if you notice concerns with their walking, low muscle tone, clumsiness or overall motor development, it may be beneficial to consult a paediatric therapist, such as an occupational therapist or physiotherapist. These professionals can provide targeted strategies to address any underlying issues.
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