Achondroplasia: positioning and handling your baby

Babies born with achondroplasia are more likely to develop a small curve in the lower part of the back. This is called a gibbus.

The gibbus will become more noticeable as your child starts sitting up, but it usually improves once your child learns to pull to stand and walk.

Babies with achondroplasia are also more at risk from developing cervical spine cord compression. It is therefore very important to follow careful moving and handling guidelines. Your therapist will provide guidance for moving and handling your baby to minimise any complications.

Positioning and handling recommendations

Make sure your baby’s back and neck is fully always supported when being handled, use a widespread hand to do this. Keep your baby laid flat when carrying them, this will help to support the back and keep the spine straight.

It is important to avoid placing your baby into a c-shaped or slumped posture which may make the gibbus worse. You should therefore avoid using baby carriers or slings. This is something that you can discuss further with your occupational therapist.

When handling your baby upright for winding, make sure you are in a semi-reclined position, supporting your baby’s head and back with your hand. Avoid sitting them to wind.

Do not encourage your baby to sit upright too early as this can make the gibbus worse.

Encourage floor-based play, lying on their back or side position.

Tummy time is vital and your therapist can demonstrate ways to encourage this. This will help to encourage development of head control.

Tummy time on a play mat will help to increase strength in the back muscles. Your baby will learn to push or prop through their arms and raise their head from the floor.

Seating recommendations

It is important not to sit your baby before they are ready. Using a graded approach to sitting will make sure that your baby’s back muscles are strong enough to take the weight of their head on their body and through their back.

It is recommended that you start supported seating around the time your baby begins to wean (take pureed foods). This is usually at around 6 months of age and should be discussed with your child’s therapist.

It is important to choose a highchair or seating that has multiple options for recline. A firm back rest is important to support your baby’s head, neck and back appropriately. Incline should begin at 30 degrees for short periods during mealtimes up to 20 minutes. You can use positioning rolls to fill any spaces either side of your baby and in between the groin strap. This will enable their bottom to sit at the back of the chair, allowing them to maintain a straight spine and prevent a c-shaped posture.

Babies can tire easily when learning to sit, so if your baby shows signs of discomfort, allow them time to recline and rest, before putting them in an inclined position again.

Your occupational therapist or physiotherapist will help to guide sitting incline as your baby develops in strength and ability.

Avoid using baby bouncers or rockers as these are usually not supportive, and encourage development of poor posture.