These days we barely have time to sit still for a minute. Grabbing coffee on the run while chasing around between our children’s extra-mural activities, multi-tasking to get through the daily to-do’s and keeping the balance, always keeping the balance, in the hope of giving our children the best life we can offer. When we finally do sit down with our children and appreciate the opportunity to catch a break, the last thing we think of is that we might be sitting incorrectly! So, grab a cup of coffee (or tea if that’s your thing), sit down with us for a moment and find out why paying attention to your child’s sitting position is part of giving them the best life.

W-Sitting in Children - Medical Support Services

Have you ever seen children sitting as shown in the picture above?

This position is called “M-sitting”. The name comes from the shape that their legs make in this position. If you look at the child’s seated position from above, you will see that it resembles the letter “M”. While some people wonder whether there really is a problem with children sitting like this, others, especially occupational therapists, immediately find themselves wanting to help the child into an alternative sitting position.  

Firstly, M-sitting is not necessarily harmful to a child, but if seated in this position for too long, can create challenges. The sitting position is comfortable, due to our hip’s anatomy, especially for children. Statistics show that M-sitting is linked to an underlying problem in about 5% of typically developing children. Though this may seem to be a small number, it is our job as occupational therapists, to ensure that these children receive the intervention they need to avoid further complications later in life (N. Pates, 2020). 

When we see a child sitting in the M-sitting position, we consider how this position influences the child’s main occupation, play, as well as whether it affects their ability to learn and explore. The M-sitting position creates a large base of support and a lower centre of gravity. This results in less core activation to maintain an upright sitting position. Therefore, a child may prefer this position if he or she has poor core strength. 

M-sitting should be corrected for the following reasons (K. Askins, 2014):

  1. It increases the risks for shortened hip and leg muscles, if the position is maintained for prolonged periods. This can negatively affect a child’s coordination, balance and gross motor skill development. 
  2. It can increase a child’s risk of dislocating their hip (especially if the child has hip dysplasia). 
  3. It restricts a child’s rotation of their upper body when engaging in play. This becomes problematic as it can make it difficult for your child to reach across their body and perform tasks that require bilateral hand use. It can also delay the process of developing hand dominance as your child does not use both hands when playing. This has a direct impact on your child’s school readiness skills like writing skills, coordination, and performance of table-top activities.
  4. It restricts a child’s ability to shift their weight from one side of the body to the other when engaging in a play activity. Weight shifting skills are essential for standing balance and developing gross motor skills such as running, jumping, etc. 
  5. It limits development of strong trunk muscles as your child relies more on their joint structure and wide base support of the legs to keep them upright. This can contribute towards clumsiness. Your child’s school readiness skills may also be negatively affected, such as sitting still for prolonged periods, paying attention in the classroom and sitting with a good and upright posture which is important for writing skills. 

Looking at the facts above, it becomes clear that this sitting position is not ideal. When you see your child sitting in this position during story time, play, etc. you can correct your child by making use of the alternative seating positions shown below to support your child’s development and help them reach their milestones. At first your child might resist these alternative sitting positions, as M-sitting has already become a habit. However, if you are consistent with the repositioning, they will get used to the alternatives. 

Alternative seating positions
Long sittingW-Sitting | Berlin Preschool Learning CenterSide sitting(try to switch sides)
W-Sitting | Berlin Preschool Learning Center
Cross leg sitting
SquattingPrimitive Motor Reflexes & Their Impact on a Child's Function | Blog |  Tools To Grow, Inc.
2-point kneelingW-Sitting | Berlin Preschool Learning Center4-point kneeling
801 Child Kneeling Stock Illustrations, Cliparts and Royalty Free Child  Kneeling Vectors
Puppy prone(lying on the tummy)196,000 A Picture Of A Boy Images, Stock Photos & Vectors | ShutterstockStandingPrimitive Motor Reflexes & Their Impact on a Child's Function | Blog |  Tools To Grow, Inc.
Short sitting on a chair, stool, cushion, or exercise ball✓ Imagen de Alegre niña divertida saltar la cuerda Fotografía de Stock807 Child Sitting On A Chair Clip Art Images, Stock Photos & Vectors |  Shutterstock
Sweet blonde girl sitting in a pillow and reading Vector ImageGirl Sitting Stool Stock Illustrations – 599 Girl Sitting Stool Stock  Illustrations, Vectors & Clipart - Dreamstime

When should you be concerned about your child? The symptoms discussed below could be causes of concern if they persist consistently over a period of time. Then you should consider reaching out to a paediatric occupational therapist or physiotherapist depending on the symptoms that your child presents with (L. Maybin, 2020).

Contact a paediatric physiotherapist if your child:

  1. Often complains about pain or discomfort in their hips and legs.
  2. Presents with an abnormal gait pattern e.g., in-toe (“pigeon-toed” walking).
  3. Presents with flat feet.

Contact a paediatric occupational therapist if your child:

  1. Often presents with clumsiness. 
  2. Presents with delayed gross and fine motor development.
  3. is constantly sitting in an M-sitting position (difficulty to assume any alternative sitting positions). 
  4. Fatigues easily, struggles to sit still, and struggles to pay attention. 
  5. Does not reach their developmental milestones according to the age norm. 

The takeaway: 

Help your child to be more mobile. Let them move from one position into the other, this can include M-sitting, while playing. Each position has different developmental opportunities for them. Try to make transitioning between positions fun by placing the toys at various places that will motivate your child to change positions and shift their weight more naturally.

We would like to encourage you to pay closer attention to your child’s sitting position, help them to become more mobile and break the habit of M-sitting to give them the best life you can. 

If you have any questions regarding M-sitting, please do not hesitate to contact us. 

Written by Chrisné Niebuhr, Bright Eyes Therapy. 

For more information you are welcome to contact us on 083 616 1662 or email us at

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