On Footrests and Eating

On Footrests and Eating

There is a saying amongst lactation professionals, which I learned from I was studying to become a Certified Lactation Counselor: “Flex the hips to open the lips.”  The context was learning about baby’s motor skill and problems that arise from lack of baby skill, such as a baby who does not latch on well, poor milk transfer from mom to baby, poor weight gain in baby, and mother’s engorgement.  Some of the interventions for babies with poor skill are sensory: provide skin-to-skin contact, provide sensory input to the baby’s mouth by stroking their cheeks and tongue, and applying pressure against the feet.  Tickling a baby’s feet is often recommended and many moms try this, but what they don’t realize is that tickling/touching is different than applying pressure.  Pressure is the application of continuous force, applied uniformly over a surface, by one body onto another body.  Hence, applying pressure on the feet, such that the hips become flexed slightly.

Since that class, I have also learned about a new technique for breastfeeding intervention, called Biological Nurturing (BN), which is a breastfeeding in the laid-back position.  The researcher who coined the term BN, Suzanne Colson, PhD, emphasises utilizing primitive reflexes, such as stroking the top of baby’s foot to help them crawl to the breast, as is the case when mom is leaning back and baby is on top.  Regarding the feet, Dr. Colson states that there is a  “strong foot-to-mouth connection” and when the baby’s feet and body are poorly applied to mom’s body, feeding problems are likely to occur.  Although she is primarily interested in the reflexes on the top portion of the foot, remembering what I had learned in my CLC training, that got me thinking about feet and eating in general.  When I went back to my notes, I noticed that I scribbled that the instructor also mentioned that pressure against feet was good for toddlers too.

Since I had a two year old at the time, I was intrigued by this foot-eating connection.  I noticed that when he was in his high chair (which was a high chair that attaches to a regular chair) he would always lift his feet and keep his feet resting on the underside edge of the tray.  Imagine sitting at a bar, chatting with friends, and your feet are dangling.  It’s not very comfortable.

We bought this type of highchair because I wanted something that could be brought close to the table and was not a separate entity so that our child could feel more included at meals.  I knew that there were more expensive chairs, such as the Stokke Tripp Trapp and others, that provide adjustable configurations from baby to teenager and even adult.  But as an employee of Stokke aptly stated “comfort and ergonomic benefits are not well understood by Americans who have a preconceived notion of high chairs as a single use item vs a chair that grows with the child.”  So true.  And I was also insistent that chair was able to get to the table, but oblivious to the feet-comfort connection.

So I was delighted when we inherited a discontinued high chair by KidKraft, a model that looks very similar to the Stokke Tripp Trapp.  Stokke paved the way for the adjustable ergonomic high chair in 1972, designed by Peter Opsvik (The Tripp Trapp was previously knows as the Kinderzeat), but it has not really caught on until now, especially here in America.

Then we had baby #2.  And although I wanted a new chair, we used the same add-on highchair that we already owned.  But when he was nearing one, he kept struggling to find a place to rest his feet, and he also kept climbing into big brother’s chair.  I have spoken to some Stokke owners about what to do for baby #2.  Some told me that they buy another chair, and build a collection for each child, and some told me that big brother or big sister gives the new baby their chair.  Well that does not solve the problem of dangling feet.

So I was pleased when Stokke provided me with a chair to write this article.  Reading about the history of Stokke, I was not at all surprised to learn that it is a Norwegian company and their slogan is “In the best interest of the child,” since Norway is well-known to have the best maternity and paternity leave in the world.  I also found a class project by a group of Cornell University students (suported by Stokke), in which the students discussed various forms of children’s seating: low chairs with children’s feet touching the floor but separated from the table, high chairs and boosters which raise the child but may not provide lower leg support, and the Stokke Kinderzeat, which provides both.  The students designed a research study:

“to test the claim that the KinderZeat’s footrest provides the “basic stability upon which movement is based” and is essential in “alleviating strain and reducing ‘fidgeting”. To do this we devised a series of tasks to be performed by young preschool children while sitting in the KinderZeat with the footrest, or without the footrest, a condition equivalent to the child sitting in either and adult chair with or without a booster. Tasks were devised to test the various reach capabilities and also the task persistence of young children sitting in these test conditions.”

The results showed that children aged 3-4 were able to reach further when seated in the Kinderzeat, had more stability, and less fidgeting.  The students stated:

”When children sat in the chair with no footrest, they seemed to move more because they had less support for their body, resulting in fidgeting as they tried to get comfortable while performing the task. The body stabilization results between the two conditions also showed a statistically significant difference. Children moved more in the no footrest condition because they were trying to stabilize their lower bodies by wrapping their feet around the chair legs or trying to use the small cross bar beneath the seat, whereas in the condition with the footrest they had a place to rest their feet. “

Although this is a not a peer-reviewed research study, and the students (as am I) may be slightly biased due to the support we received from Stokke, based on what we know about infants and breastfeeding, and what I have seen in my own children, I have become a firm believer that children need a proper footrest when they eat or perform activities at the table until their feet can reach the floor.  I am happy that there are a few other companies that have followed Stokke’s lead in creating ergonomically designed chairs for children.  It is both the application of pressure and the fact that their hips are properly flexed that likely leads to better ergonomics, comfort, behavior, and eating.

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Debra Waldoks

Debra Waldoks is a Registered Dietitian and Certified Lactation Counselor with a Master's Degree in Public Health. She’s an adjunct professor, nutrition consultant, occasional blogger, and most importantly, a mother of two and a wife.

Note: This Perspectives Blog post is written by a guest blogger of DrGreene.com. The opinions expressed on this post do not necessarily reflect the opinions of Dr. Greene or DrGreene.com, and as such we are not responsible for the accuracy of the information supplied. View the license for this post.

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