Is your toddler sitting properly?

When two-year-old Mia Pugliese began pointing to her knees and crying, her mom, Connie Pugliese, a naturopathic doctor, was concerned. She consulted Tema Stein, an osteopath and physical therapist, and discovered improper sitting was to blame. Like many kids, Mia favoured the W position: bum on the floor, legs bent in the shape of the letter W with feet turned out beside her hips.

“Children who didn’t get enough tummy time as babies to develop good strength in the shoulders and back sometimes sit in the W position because it provides a wide base of support,” says Stein. “They can’t stay balanced otherwise.” Since the torso can’t rotate in this position, kids don’t reach across the body to pick up toys and, as a result, don’t develop good rotation, coordination and balance.

Sitting in the W and other improper positions (for example, with legs straight out or bent in the shape of a diamond, or with knees to one side) also puts children at risk for orthopaedic problems. “It can make kids knock-kneed, pigeon-toed or flat-footed, or cause pain in the hips, feet or legs that continues for a lifetime,” says Stein.

Most kids who move into the W position do so for short periods, then naturally shift out of it. But if you notice your child usually sits this way, here’s what you can do:

Encourage “criss-cross applesauce” The cross-legged sitting position is best because it allows the torso to rotate and develop strength, and prevents tight leg muscles. Holding your child’s knees or feet together when he sits down will help him get used to it.

Keep bums on seats Discourage your child from kneeling on chairs, which puts too much pressure on his knees. To keep him from hooking his feet around chair rungs (another form of W sitting), use a booster seat with foot support.

Get help If your child is having pain or difficulty sitting cross-legged, or you notice a problem such as flat feet, consult someone trained in paediatric physical therapy, as Pugliese did. Mia’s knee pain disappeared quickly. Each child is different, though, and you may be in for a longer round of treatment.