Is “W” Sitting Bad For Baby’s Hips?

Quick Answer: W sitting is not harmful when it's one of many positions your child uses throughout the day. It does not cause hip dysplasia or long-term orthopedic problems. Only address W sitting if your child sits this way almost exclusively and rarely uses other positions. When W sitting is the primary position, it can indicate decreased trunk strength or lead to muscle imbalances. The solution is gently encouraging position variety, not constantly correcting your child.

Understanding when W sitting matters and when it doesn't helps you respond appropriately without unnecessary worry or constant corrections that frustrate both you and your child.

What Is W Sitting and Why Do Children Choose This Position?

W sitting describes a floor sitting position where a child sits with their bottom on the floor between their feet, with knees bent and legs rotated inward. From above, the legs form a W shape.

Children naturally choose W sitting because it provides a very stable base of support without requiring much core muscle engagement. The wide base and internal hip rotation create stability that allows children to play with toys or watch activities without working as hard to maintain balance.

Anatomical factors influence comfort in this position. All children have some natural inward twist (femoral anteversion) in their thighbone that gradually decreases as they grow. Children with more femoral anteversion often find W sitting particularly comfortable because their hip anatomy naturally positions this way. This typically resolves on its own as bones mature, usually by age 8-10.

The position itself is not inherently harmful. What matters is whether it's the only position your child uses or just one option among many.

Does W Sitting Cause Hip Dysplasia or Orthopedic Problems?

One of the biggest concerns parents hear about W sitting is that it causes hip problems. Research does not support this fear.

Studies show W sitting does not cause hip dysplasia. Hip dysplasia is a condition where the hip socket doesn't properly cover the ball of the thighbone.

W sitting does not damage growing bones or joints when used as one position among several. The hip joint moves through this range naturally during many childhood activities including crawling, squatting, and various play movements.

The femoral anteversion that makes W sitting comfortable typically self-corrects with growth. Children naturally outgrow the bone twist that makes this position feel most stable, and most children spontaneously stop W sitting as frequently as their anatomy matures and their core strength develops.

Understanding that W sitting doesn't cause structural damage helps you approach the position calmly rather than with alarm.

When Does W Sitting Become a Concern?

W sitting only warrants attention when it's your child's primary or exclusive sitting position and they rarely use other options.

Exclusive W sitting can indicate decreased trunk strength because the wide base of support compensates for core muscles that aren't yet strong enough to maintain balance in less stable positions. If your child always chooses the most stable position available, it may suggest they're not building the core strength needed for other activities.

Persistent exclusive W sitting can contribute to muscle imbalances over time. When children spend hours daily in one position, the muscles and connective tissues adapt to that position. This can create tightness in hip internal rotators and potential weakness in external rotators and core stabilizers.

W sitting limits movement variety which affects skill development. From the W position, children have difficulty weight shifting side to side, rotating their trunk to reach across their body, transitioning to other positions smoothly, and developing dynamic balance skills.

The key distinction is frequency and exclusivity. A child who sits in W position for 20% of their floor time and uses ring sitting, side sitting, and other positions for the other 80% is developing normally. A child who sits in W position for 90% of their floor time and resists other positions may benefit from intervention.

What Are Alternative Sitting Positions?

When you want to encourage position variety, demonstrate other options rather than constantly correcting W sitting.

Ring sitting or criss cross sitting has legs crossed in front with knees out to the sides. This position requires more core engagement than W sitting and promotes hip external rotation.

Side sitting has both legs to one side of the body with the top leg crossed over. This position naturally encourages trunk rotation and weight shifting. Encourage alternating which side the legs go to for balanced muscle development.

Long sitting has legs extended straight out in front. This position strengthens core muscles and stretches hamstrings while requiring balance and control.

Kneeling or half-kneeling positions build hip and core strength while allowing children to play at slightly higher surfaces. These transition positions also support development of skills needed for standing.

The goal is variety throughout the day rather than forcing one specific position. Different positions challenge different muscle groups and movement patterns, all of which support overall development.

How Do I Encourage Position Variety Without Constant Corrections?

Constant correction frustrates children and can create power struggles.

Demonstrate other positions naturally by sitting nearby in different positions yourself. Children often imitate what they see, so modeling ring sitting or side sitting during play can prompt them to try these positions without direct instruction.

Make position changes into games. "Can you sit like a mermaid?" for side sitting or "Let's sit criss-cross applesauce like at story time" makes position changes playful rather than corrective.

Limit time in W sitting without making it forbidden. If your child is W sitting, you might say "Let's try a different position for a while" rather than "Stop W sitting, that's bad." After 10-15 minutes in a different position, if they return to W sitting briefly, that's okay.

Choose your moments. If your child is deeply engaged in an activity, disrupting them to change positions may not be worth it. Instead, suggest a position change during natural transitions between activities.

If your child reports pain in any position including W sitting, take this seriously and consult your pediatrician. Pain is never normal and should be evaluated.

When Should I Consult a Physical Therapist?

Most children who occasionally W sit need no intervention. Some situations do warrant professional evaluation.

Consider evaluation if your child exclusively W sits and strongly resists other positions, has difficulty transitioning between floor positions, shows delayed motor milestones alongside exclusive W sitting, demonstrates asymmetrical movement patterns or always sits to one side, or reports pain in any sitting position.

Physical therapy can address underlying trunk weakness that makes W sitting preferable, muscle imbalances that may be developing, motor planning difficulties that make position changes challenging, and provide specific strategies for your child's individual needs.

Early intervention works well when concerns are identified. If your child is 3+ years old and still exclusively W sits despite your efforts to encourage variety, an evaluation can determine whether specific exercises or strategies would be helpful.

Most children naturally diversify their sitting positions as they get stronger and more coordinated. Professional input helps when this natural progression isn't happening.

The Bottom Line

W sitting is not harmful when it's one of several positions your child uses throughout the day. It does not cause hip dysplasia. Most children who W sit occasionally have normal development and need no intervention.

Only address W sitting if your child uses this position almost exclusively and rarely chooses alternatives. In these cases, the concern is not the position itself but rather what exclusive use indicates about trunk strength or muscle balance, and what opportunities for movement variety your child is missing.

Encourage position variety through modeling and playful prompts rather than constant corrections. Most children naturally reduce W sitting as they mature and develop stronger core muscles.

Frequently Asked Questions About W Sitting

Q: Should I ever let my child W sit? Yes, occasional W sitting is fine when your child uses many different positions. Only address it if it's the primary position they choose.

Q: Will W sitting cause my child to be pigeon-toed? W sitting does not cause persistent in-toeing. Some children who W sit also walk with in-toeing due to the same underlying femoral anteversion, but the sitting position doesn't cause the walking pattern.

Q: At what age should children stop W sitting? Most children naturally reduce or stop W sitting by school age (5-7 years) as their anatomy matures and core strength develops. There's no specific age when it becomes problematic if position variety exists.

Q: My child's teacher says W sitting is always bad. Is this true? No, research does not support the claim that W sitting is always harmful. When it's one of many positions used, it's not a concern.

Q: How often should I correct my child's W sitting? If your child uses various positions, you don't need to correct W sitting at all. If they exclusively W sit, focus on encouraging alternatives rather than constantly correcting, aiming for position changes every 10-15 minutes during extended floor play.

Q: Can W sitting affect my child's balance or coordination? Exclusive W sitting can limit practice with dynamic balance and weight shifting. However, children who use W sitting alongside other positions develop normal balance and coordination.

Recommended Reading:

https://publications.aap.org/pediatrics/article/144/2_MeetingAbstract/770/3843/Hip-Dysplasia-is-Not-More-Common-in-W-Sitters

https://hipdysplasia.org/w-sitting-and-hip-development/