Bassinet vs. Car Seat Strollers: A Pediatric PT's Perspective on Infant Development

By Tara Liddle, PT, MA, DPT, PCS

As a pediatric physical therapist, I am often asked by new parents about the best type of stroller for their newborn. While car seat strollers offer undeniable convenience, especially in our fast-paced lives, I strongly advocate for the use of bassinet strollers, particularly in the early months. We are discussing the developmental benefits of using a bassinet stroller.  

The primary concern with car seat strollers, especially for prolonged use, is their constrained position on infants. Newborns and young infants need movement. Their bodies are developing rapidly, and they need ample opportunities to explore movement patterns. The confined position of a car seat limits natural movement. It locks the infant into a specific posture, reducing their ability to shift positions, kick their legs, and move their arms freely. Prolonged use, especially out of the car, can restrict the development of core strength, postural control, and overall motor skills.

Newborns are learning to navigate gravity. They're discovering how to use their muscles to lift their heads, push up with their arms, and eventually roll over. These movements are crucial for future motor milestones like sitting, crawling, and walking. When an infant is confined to a car seat, it misses out on these essential movement experiences. The lack of movement can also contribute to positional plagiocephaly, or flat head syndrome, due to prolonged pressure on one area of the skull.

In contrast, a bassinet stroller provides a flat, open space for the infant to move freely. They can kick their legs, wave their arms, and turn their head, all while lying comfortably. This freedom of movement allows them to strengthen their muscles, develop postural control, and explore their surroundings. The flat surface also allows for better alignment of the spine and hips, which is crucial for healthy development.

Bassinet strollers also offer valuable vestibular input. The vestibular system in the inner ear is responsible for balance and spatial orientation. When an infant is lying flat in a bassinet stroller, they experience a more natural and varied range of motion as the stroller moves. This movement stimulates the vestibular system, essential for developing balance, coordination, and spatial awareness. The gentle rocking motion of a bassinet stroller can also be calming and soothing for infants, promoting relaxation and better sleep.

The importance of vestibular input cannot be overstated. It plays a crucial role in overall sensory integration, which is the brain's ability to process and organize sensory information. Adequate vestibular stimulation in infancy can positively impact cognitive development and emotional regulation.

Even pediatric physical therapists understand that car seat strollers are convenient for running errands, navigating crowded spaces, and seamlessly transitioning from car to stroller. They are undoubtedly practical for short trips and essential travel. However, it's crucial to limit the amount of time an infant spends in a car seat stroller. 

For daily walks, outings to the park, or even just strolling around the neighborhood, a bassinet stroller is the ideal choice. It provides the freedom of movement babies need for development. If you live in a city and utilize public transportation, consider a bassinet stroller that has the option to attach the car seat for those times you need to transfer from car to stroller quickly. Many brands offer adaptable travel systems that accommodate a bassinet and a car seat. While many car seat strollers allow for a near-flat recline, they still don't provide the same level of freedom and movement as an actual bassinet. The infant is still somewhat contained and restricted, limiting their ability to fully explore movement patterns.

Another point to consider is the infant's comfort. Bassinet strollers often have softer, more comfortable padding than car seats. This can be especially important for newborns and young infants who spend significant time sleeping. A relaxed environment can promote better sleep and overall well-being.

As your baby grows and develops, their needs will change. Once they have reasonable head control and can sit independently, you can transition to a more upright stroller. However, even then, it is important to incorporate periods of free movement on the floor throughout the day. Tummy time, rolling, and crawling are all essential for developing strength, coordination, and motor skills.

While car seat strollers offer convenience, bassinet strollers are the better choice for promoting healthy infant development. They provide the necessary freedom of movement, vestibular input, and comfort for optimal growth. When using the car seat stroller, keep the time short and make sure to allow for lots of floor time and movement opportunities when you get to your destination.