Emotional Safety Standards for strollers and car seats?

What is it with baby transport? Why does it make so many of us feel a bit edgy?

This month, the Royal Family’s New Zealand tour began with a public row about the direction that Prince George’s car seat faced.  Last month, Sally Goddard Blythe gave a presentation at the Annual WATCH? Conference, about the importance of movement for babies’ development, but the media headlines focused on strollers.  Last week, my blog about a recent New Zealand study on strollers turned out to be my most popular post ever, with 17,000 people around the world reading it to date. The responses to such stories are wide-ranging and emotive:

• “I have always fought against buggies. Buggies are great for the adults but terrible for the baby.”
• “I am here to totally make fun of these dumb studies because they are always written with a heaping dose of assumptions that all parents are idiots and that we have no idea what we are doing.”
• “How true. It always amazes me when I see a child who should be walking about, sitting in a buggy. Grotesque.”
• “Disgusting that you would forward-face an 8 month old in the car seat. Shame on you.”

Such comments tell us a lot about ourselves. We gain insights about our beliefs about babies and where science is (and isn’t) proving helpful.

Public discussion becomes especially interesting when we learn about one further event that occurred last month: the announcement by the US Consumer Product Safety Commission of new safety standards for strollers.  The new standards have been prompted by 1300 safety-related reports over the past five years, including 4 deaths, 14 hospitalisations, and 391 injuries to American children. These new criteria focus on mechanisms such as hinges, wheels, brakes, locks and restraints, all of which have been involved in accidents.

The Acting Chairman for the CPSC explained the need for the regulations by saying “It is time we put a strong mandatory standard in place…that helps to ensure a stroller ride is a safe ride.”  Brixy (a North American trade association) was one of the many organisations celebrating the new standards, dubbing them “essential for the health and safety of babies across the country”. The story was important enough to make the television news, broadcast by WPRI in northeastern USA.

[youtube https://www.youtube.com/watch?v=-wry75GwrSc]

So in the last six weeks, we’ve been treated to a large dose of international media coverage about infant transport. How effective was that coverage in yielding insights into the emotional safety hazards that modern transport devices carry? I fear the answer is not very effective, given that the term ‘emotional safety hazards’ seems entertaining — even to me.

Why is it so hard for us to collectively contemplate the idea that strollers and car seats could be having an impact on our babies’ emotional development? Here are a few suggestions:

Its not obvious. Emotional development is subtle. We often miss it when its happening. These moments aren’t as blatant as a finger amputated in a hinge or a neck damaged in a car accident.

Insufficient research. There’s virtually no empirical research available on the emotional consequences of infant transport. The topic isn’t on the radar of scientists or manufacturers. In my last blog, I bemoaned that lack of interest and said that I’d had scientific colleagues gently chide me for such ‘trivial’ research interests.

It sounds preposterous. Babies don’t seem to be visibly damaged by transport devices, do they? They still do all the normal things: learn to walk and talk and go to school and eventually get married. So it sounds over-blown and silly to some people to hear that this stuff matters.

Its scary. Alternatively, it sounds scary. If this stuff really does matter, and nobody told you that, then what’s a parent to do? You end up feeling scared and worried and guilty that you might have had a negative impact on your child’s development that you had absolutely no awareness of. That doesn’t feel good. On top of that, you may feel embarrassed, precisely because you are worrying about something that other parents regard as normal. As one contributor to our on-line discussions put it, other people treated her as a bit “precious” when she insisted on a parent-facing stroller.

So what advice is currently given to parents when searching for a stroller or car seat? Here’s a randomly chosen example, from the website of the safety organization Kids in Danger:

• Make sure babies are buckled in when they’re in strollers.
• Avoid leaving babies alone in strollers.
• Avoid overloading strollers with shopping or diaper bags, which can cause tips or a collapse.
• Make sure parking brakes and latches are snapped firmly in place.
• Make sure babies’ hands are away from the stroller as it is folded or unfolded.
• Close leg openings when using the stroller in a reclined position to keep the baby from slipping through.
• Follow manufacturer’s instructions on use and care of the stroller.

The implication is that the only possible stroller dangers come from physical hazards.

What about purchasing a car seat? Here’s Brixy’s list of recommendations about the considerations new parents should make when selecting their choice:

• Style:  Your main choices are between a model that converts from rear-facing to front-facing as the child grows, versus a travel system that snaps onto a stroller chassis and will thus allow you to avoid waking a sleeping baby.
• Fit:  Make sure your chosen model suits your type of vehicle, as the fit is not automatic across all cars.
• Comfort and protection:  Think about the padding and support built into the car seat, because the baby needs to be comfortable as well as safe.
• Budget:  You really do not have to spend a massive amount of money to get a good quality car seat.
• Registration:  Don’t forget to register your purchase with the company so that you can be notified of any recalls or updates.
• Used car seats:  Bad idea.

These are all sound pieces of advice. Nowhere amongst them, though, is there even a hint that a parent would want to be alert to emotional issues that could easily affect development.  These might include length of the time that the baby is strapped into the seat or how lonely the baby might be feeling whilst unable to hear the parent’s voice. Frameworks such as the 90 Minutes Max Rule, advocated by BabyBWell, are far from commonplace.

I was thinking about all of these themes last weekend, as I stood in a museum hall full of families. Lots of young children were running about, with parents clearly grateful for a public space where crying was not a problem. I watched a father with his toddler son, still strapped into the stroller, move toward one of the exhibits. The stroller was a robust and expensive-looking one, and facing outward so that the baby could see all the things of interest around him. Once they had reached the exhibit, the father stopped pushing, then pulled his mobile phone out of his pocket and began texting. The child, who the father couldn’t see because of the stroller’s big brim, began squirming, pulling at the straps, trying to shift his body. He lifted his legs, which were hanging in mid-air, with no foot support, which probably meant the blood supply was being cut off. The toddler’s face contorted with frustrated effort. He gave up. He whimpered. Dad didn’t notice. The baby whimpered louder. Dad jiggled the stroller with one hand, using that distracted rocking motion that is so automatic for parents, still texting with the other hand. When that didn’t work, I watched them walk off, the father still texting and absentmindedly ‘shushing’ the baby from behind.

All parents reading this blog will recognise this scenario. I do not want anyone to feel guilty! Nor do I want anyone to blame this father. He’s not a bad father! He’s a daddy who made the effort to take his little boy out to a museum on a rainy Sunday morning. He’s a modern father, trying to juggle all the things that modern parents juggle. He’s a father with a modern baby, growing up in the modern world that Sally Goddard Blythe was talking about: one where our grown up worries about keeping children safe have gone so far that we are keeping them from learning how to use their own bodies.

When children don’t get enough walking, crawling and tummy time, their language aquisition is impaired, their ability to hold a hold a crayon is undermined, their eventual exam performance is already being subtly shaped. When they don’t get enough cuddle time, their ability to manufacture the calming hormone oxytocin is hampered. When they don’t learn that their parents will respond as soon as they become uncomfortable, they learn that relationships are hard work. I do not believe that that father wanted any of those things for his son. He just didn’t know to pay attention. Maybe he knew but was too tired to remember.

So the question that faces us is: how do we help parents to know? I couldn’t figure out a way to say anything useful to that father. I was afraid he’d feel embarrassed, angry, judged, or simply bemused by this nosy stranger telling him how to care for his own child. I left that baby in discomfort because I couldn’t figure out how to take care of his father’s emotional needs.

I thought maybe I might write to the museum and see if they would work with me on an initiative for encouraging parents to take their bairns out of a buggy as soon they come through the doors. What if public museums made that normative behaviour? This might be one way of getting the message out to parents without causing them more worry or guilt.

Or maybe we should invent the concept of ‘Emotional Health and Safety’. We could put a twist on today’s common parlance. But there’s a little part of me that’s reluctant to go down this path. Such language carries the same connotations of danger that the press love so much. That’s the spin they gave to Sally Goddard Blythe’s presentation, with headlines screaming accusingly: ‘Buggies cause long term harm.’ Such strong headlines led people to feel exasperated, irritated, and vindictive: “Piffle to the entire theory” and “It is just hearsay and not evidence-based medicine. Junk!” and “I wonder how many children Mrs Goddard Blythe has given birth to?”

The Royal Family’s row blew up over the fact that Kate and William had requested a front-facing car seat for 8-month-old George. This orientation is legal in both the UK and New Zealand, although it contravenes the now standard recommendation that a rear-facing car seat be used until the age of 2 years,  in order to guard against whiplash in case of an accident. Plunket, New Zealand’s largest supplier of child health services, took a bashing for agreeing to install the seat in a manner that breached their own advice. But they also made a valid point in their statement about the row: Plunket cannot tell parents what to do; they can only advise them.

Let me throw my hat into this heated row about who should have done what. I have no idea why Prince George’s parents made the decision to place him in a front-facing car seat. What I do know is that they seem to have taken up the option that most parents want for themselves: they want to be as informed as possible and then left to make decisions about what they believe to be best for their baby.

We have to trust parents. What other choice do we have? It is parents who are raising the babies! But most parents do not have the information that neuroscience is now uncovering — information that helps them to understand how babies’ emotional, physical, and brain development are all intertwined. The tone in which that information is delivered is also crucial. It needs to empower parents, helping them to feel curious rather than guilty about their babies. This is an incredibly tricky line to walk, in a world where parents are already drowning in unwanted advice. Sarah Miller tries to capture that sense in her recent piece in The New Yorker,  with a humorous and blunt tone: If parents have to read one more article on parenting, they will go “fucking ape shit”.

But here’s what I really want to say: fixing this isn’t up to parents alone! We create our modern world together. In Suzanne Zeedyk’s World, we would have regulation that required manufacturers of strollers and car seats to provide their employees with regular training in neuroscientific advances. They would not do this under duress, but because they understand that their products are shaping the brains of our children. They would see that this means they have a moral responsibility to get design right. Does that vision sound utopian? I contend it’s not. It is merely an innovative way to meet consumers’ modern expectations that global companies engage with their Corporate Social Responsibilities. 

Right now, most manufacturers don’t realise their actions are shaping children’s brains. They will have a better chance of doing so if you send the link for this blog on to your favourite company, retailer, watchdog or research funder.

What shall we tell them that we would like to see included in a draft set of Emotional Safety Standards?