I know plenty of babies with reflux who play, digest and sleep in their car seat at home. My reflux baby was fairly content if I held her 24/7. There were times when I did put her down in the car seat because I just had to have my hands free. For example, I did need my hands free for my daily two minute shower. Most of the time, she was in my arms or in a sling/carrier or backpack. My arm muscles became hard as rock and my back ached from the constant bending and lifting. It sure was hard work holding her and I longed to put her down.

An article in the August issue of Pediatrics caught my attention. The article reported on car seat injuries that occurred outside of the car. It is estimated that approximately 43,000 infants were treated in the emergency department for a non transportation related car seat injury between 2003-2007. Approximately half of the injuries occurred at home and infants younger than four months of age were most likely to be injured.

I always thought a car seat was a versatile piece of baby equipment. It certainly was a “must have” item for safe transportation in the car. The car seat always came into my house and doubled as an upright positioner so my baby could be seated when I needed my hands free or upright after a feeding. In addition, the car seat was her first high chair when she started solids. Luckily she was never injured but I can see how easily this could happen. A car seat can tip over if placed on a bed or table. Even if a car seat is placed in a crib, a newly mobile infant can roll out, lean over or become trapped between the car seat and the crib. Lately, I have read studies showing that car seats may increase breathing difficulties in young infants and premature babies. There is also concern that prolonged use of a car seat can lead to spine and back problems and changes in the contours of the head, leading to a “flat head” and bald spot where the back of the head makes contact with the car seat. It is believed that a car seat actually puts more pressure on her stomach, causing more back washing and reflux episodes. So even though upright positioning is favorable for digestion, it needs to occur without keeping her legs flexed.

What if your baby with reflux sleeps in her car seat each night and sits in her car seat happy as a clam after each feeding? My daughter preferred sleeping on my chest while I was semi reclined on a pile of pillows. Maybe that is just as likely to cause injuries or worse than using a car seat. Several of the infant wedge/sling/hammock systems for positioning a baby with reflux have been recalled as well. It is difficult to be safe and practical at the same time.

Here are some ideas to help keep your baby upright and safe in any baby equipment:

·      Ask the Doctor: Ask the doctor for advice on positioning for digestion, play and sleep based in her age, developmental level, height and weight.