When to Move Baby From Pram to Pushchair

As a new parent, it is easy to get a little overwhelmed by the advice on prams and pushchairs. There are so many options to choose from. Your baby is growing and developing at a rapid rate, and their transport needs are changing at the same time. This is one of the most important baby products that you will need to make for your little one, both in terms of cost and how often you will use it. So, it is important to make the right decisions.

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One of the issues that trouble a first-time mum and dad the most is deciding when to move a baby from their pram to their pushchair. Here, we have summarised all the expert opinions to give you a clear timetable to work to. We've included some background information on how you can identify prams, pushchairs, strollers, and all the other ways you could choose to transport your baby.

What is the difference between a pram and a pushchair?

The terminology surrounding prams and pushchairs can be quite confusing. Here we have unpicked the characteristics of each type of baby transport: prams, pushchairs, strollers, buggies, and travel systems.

What is a pram?

Baby sleeping in pram

Prams are a traditional way of transporting young babies. They are designed to meet the needs of newborn babies. Importantly, a baby can lie flat in a pram, which is essential for their health and safety.

Your sleeping baby will lie in a parent-facing position, allowing you to closely monitor them. Some prams allow you to lift the crib part off the frame so that it acts as a temporary Moses basket. Prams often have a soft, comfortable lining and a canopy to protect a baby from the sun.

Also, some prams can be folded flat when not in use, but they are still quite bulky, and you may struggle to get a flat pram in some smaller cars. Some prams can be converted into a pushchair that is suitable for older babies.

What is a pushchair?

Pushchairs are designed for older babies. Even though most pushchair frames will collapse, they are strong and sturdy. The Lightweight Pushchair is a perfect example with a strong aluminium frame that is easy to fold up with one hand. Babies typically face forward because it gives them a good view of the world. However, some pushchairs allow the seat unit to be moved around to face the parents or whoever is pushing the pushchair.

Some, but by no means all, pushchairs have fully reclining seats so that they can be used for a new baby in a lie-flat position. However, this is something that you will need to check carefully. Often, the pushchair description says that it reclines but that is not the same thing as providing a lie-flat position for a baby in the first few months of their life. Always check that they can be used from birth.

You can also use a double pushchair if you have more than two little ones.

What is a stroller?

Mum holding folded stroller in one hand and baby in other arm

Strollers are essentially lightweight pushchairs that are easy to carry around. They are all forward-facing and are designed for older babies who have good head control and no longer need a parent-facing design. Strollers are specially designed to collapse easily and fit into a car boot. It can be very useful to be able to fold up a stroller quickly if you are using public transport.

While some strollers are very simple and lightweight, others are more sophisticated. Take the Baby Jogger City Elite 2 stroller. For example, it has a reclinable seat, forever air rubber tyres, and an adjustable hand bar for the comfort of your baby and your convenience.

What is a buggy?

Balck double buggy

A buggy is just a term that is used to describe both a pushchair and a stroller. A buggy will always be forward-facing. If you have two children, you could use a double buggy. Double buggies can place children side by side or one in front of the other.

Some double buggies, like the Baby Jogger City Mini GT2 Double Stroller, also have reclinable seats, so it is more comfortable for children to spend time in them. You may also want to choose one that has an easy-fold mechanism and a UV canopy for added protection.

What are travel systems?

Baby laying in car seat travel system attachment with white canopy

Travel systems have been around for the last two decades or so. Rather than buying a separate pram or carrycot, pushchair, and car seat (or infant carrier), you could buy the whole lot as an integrated travel system. A travel system has a car seat unit that you can take out of the car and slot onto a frame. This saves you from having to wake up your little one by moving them from their car seat when they are sleeping.

Many travel systems can be used from birth. However, new parents do need to be careful with preterm and young babies because they should not be in a car seat for too long. It is better for them to be in a lying-flat position when they are sleeping.

Added Extras for Pushchairs and Strollers

Back of stroller in room with stroller organiser hanging on stroller handles and groceries in basket of stroller

Some pushchairs and strollers have the option of a separate carrycot that will also fit on the frame. The idea is that you can use the carrycot attachment to create a pram where your baby lies flat during the early months. Then you swap to the pushchair seat unit when your baby is older. This saves you from having to buy both a pram and a pushchair.

Many pushchairs also come with storage baskets and carry-on bags. All pushchairs and strollers have a weight limit, which is the maximum weight that it is safe for them to carry.

Expert Advice on When Babies Can Use Pushchairs

Expert advice is that a baby should lie flat to sleep in the first few months of their life. The first reason for this is to do with head control; the second is connected with breathing; and the third is all about the development of their bones and muscles.

Head Control

Newborn babies do not have the ability to hold their heads in one position. This is called head control. Babies start to lift their heads slightly during tummy time on playmats. It can happen at the age of one month, but in other babies, it starts later.

Then, between one and three months, a baby will start to lift their head up to a 45-degree angle if they are face down on the floor. Over the next three months, their strength and control improve, and by six months of age, most babies will have full control of their heads. Also, your baby will be able to sit up unaided by the age of nine months.

The NHS advice [1] is:

"Pushchairs, also known as strollers and buggies, are only suitable for young babies if they have fully reclining seats so your baby can lie flat. Wait until your baby can sit by themselves before using another type of pushchair."

Breathing

A lot of research has been carried out into the causes of Sudden Infant Death Syndrome (SIDS). As part of that research, it has been discovered that young babies who spend too long travelling in an upright position may develop breathing difficulties. The scrunched up position that they collapse into when they are not flat may not allow them to get enough oxygen.

There is no published guidance that states exactly how many hours 'too long' means. However, the Liberty Trust (a respected charity that offers advice on how to keep young babies safe) says [2]: "Infant healthcare professionals, safety experts, and most car manufacturers recommend that babies not be in a car seat for longer than 2 hours at a time, and they should be taken out frequently."

So, there is no fixed age at which a baby can use a pushchair that does not have a lie-flat seating option; it is more a matter of a child reaching a developmental milestone. All babies are different, and they all develop at different rates. Also, young babies should not travel long distances in car seats.

Spinal development

A baby's bones are very vulnerable, as they are growing at a rapid rate. When a baby is in a lying-flat position, their spine can develop in a natural way.

The concern is that when a baby is not in a lie-flat position, their hips do not turn into their natural externally rotated position, with the femur (thigh bone) correctly positioned in the hip socket. The lie-flat position is thought to be best for the normal development of a baby's hips, legs, and spine.

Harnesses

A five-point harness is essential for pushchair safety. There are five straps that are secured to the pushchair seat and that meet in a central locking system. It holds your baby securely in their seat and does not allow them to wriggle their way out.

Two straps are secured around the shoulders, two around the hips, and one between the legs. Parents just need to make sure that it is fastened correctly.

Take away message on transferring from a pram to a pushchair

Mum kneeling behind pushchair and lowering back of pushchair to lie-flat position

Pushchairs that have a seat that reclines to a lie-flat position and a suitable harness are safe for newborn babies. Many pushchairs are described as 'reclining seat' but this is not the same thing. Always check if the description clearly states that it can be reclined to a flat position and if it is suitable for newborn babies.

Very young babies cannot sleep safely in a pushchair if it does not recline to a flat position. Not only could this be bad for a baby's neck because they cannot support their head, but it could also interfere with a baby's breathing. Your little one needs good head control and must be able to sit upright before they can be transferred from a pram to a regular pushchair.

FAQs

Can a 3-month old use a pushchair?

Three months is a very exciting time in a baby's development. They start to recognise familiar people, grab their feet, and turn when they hear your voice. They can also roll from side to side and keep their heads up when they are in a sitting position. However, they do not have a lot of strength in their neck muscles as yet, and many will struggle to maintain a sitting position for very long.

At this age, it is still important that you are able to put them in a flat position to sleep for their comfort and safety. Therefore, they can only use a pushchair that has a lie-flat position.

What age should your baby stop using a pram?

Once your child can sit without support, they can stop using a pram. After this age, they do not need to lie flat. You don't have to stop using a pram, though, and you may find it useful to lay them flat to sleep for a little longer.

The problem is that your little one will want to see what is going on in the world as they get older. They will struggle into a sitting position, and a suitable harness is vital for your baby's safety. This may prompt you to stop using a pram. Also, most prams are parent-facing, which means that they face the person who is pushing them. This is useful for a young baby because you can monitor them closely and cater to their needs. As your child gets older, they will prefer to face out into the world, which they find very interesting! This is another reason why you may stop using a pram and transfer to a pushchair [4].

When can babies stop lying flat in a pram?

Mum kneeling next to toddler in stroller

Babies don't start to gain head control and be able to support themselves in a semi-upright condition until they are at least three months old. If your baby cannot support their head properly and cannot maintain a sitting position, you should wait a bit longer. Most babies can do this by six months of age.

Why is the lie-flat position important for a baby's breathing?

[3] Research carried out by Bristol University has suggested that placing a baby at a 40-degree angle in a car seat instead of placing them flat causes their heart to beat faster and their lungs to breathe faster. They also had less oxygen in their bodies. Some of this effect may be caused by the vibration of the car, but it is still important enough for the expert to advise that young babies should be in the lying-flat position.

Sources

1. nhs.uk. (2020). What you’ll need for your baby. [online] Available at: https://www.nhs.uk/conditions/baby/caring-for-a-newborn/what-you-will-need-for-your-baby/.

2. The Lullaby Trust. (n.d.). Car seats and SIDS. [online] Available at: https://www.lullabytrust.org.uk/safer-sleep-advice/product-information/car-seats-and-sids/.

3. Bristol, U. of (n.d.). October: child car seats | News and features | University of Bristol. [online] bristol.ac.uk. Available at: https://bristol.ac.uk/news/2016/october/child-car-seats.html [Accessed 3 Jul. 2024].

4. Bradley, S. (2020). When Can Babies Hold Their Head Up? [online] Healthline. Available at: https://www.healthline.com/health/baby/when-can-babies-hold-their-head-up.

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