Medically Reviewed by:The holiday season brings joy, family gatherings, and often long car rides. While we focus on proper car seat installation and safety guidelines, there's another critical aspect of travel that rarely gets discussed: what happens to children's developing bodies during extended time in car seats.
Recent research is revealing something important that might change how you plan your holiday road trips.
The Hidden Impact of Extended Sitting
A 2020 study published in the Journal of Biomechanics examined how different positions affect infant spinal muscle activity. The findings were striking. Researchers found that infants showed the lowest cervical paraspinal muscle activity when placed in car seats compared to all other positions tested, including lying prone, being held in arms, or carried in baby carriers.
Think about what this means. The muscles that support your child's developing neck and spine are essentially "turned off" when they're buckled into a car seat. While car seats are absolutely necessary for crash safety, prolonged time in these devices comes with developmental trade-offs that most parents don't realize exist.
The same research showed that caregivers reported infants spending 43% of their daily awake time in supine-lying baby gear like car seats, swings, and bouncers. Only 12% of time was spent in prone position, where muscle activity was highest. During holiday travel, these percentages can shift even more dramatically.
Why This Matters for Your Child's Development
Your child's spine isn't born with its adult curves. These curves develop gradually as infants gain head control, learn to sit, and eventually stand. Cervical lordosis (the forward curve of the neck) develops around three months when babies can lift their heads during tummy time. Thoracic kyphosis and lumbar lordosis follow as children learn to sit and stand independently.
This development depends on active muscle engagement. When children spend extended periods in positions that reduce muscle activity, we're potentially interfering with this natural progression.
For older children, the concerns shift but remain significant. Research on school-age children has consistently shown that prolonged sitting with poor posture contributes to musculoskeletal discomfort. Children often sit with their trunk, back, and neck flexed or rotated during long car rides. One study found that children spending extended time in fixed sitting positions showed more advanced postural changes, including increased thoracic hyperkyphosis and lumbar flattening.
The Nervous System Connection
Beyond musculoskeletal development, movement plays a crucial role in nervous system regulation. As a HeartMath practitioner, I see this connection daily in my work with children.
The autonomic nervous system has two branches: the sympathetic (fight or flight) and the parasympathetic (rest and digest). During extended car rides, especially stressful holiday travel with traffic and delays, children can get stuck in sympathetic activation. Movement is one of the most effective ways to help shift back to parasympathetic tone.
Research on children's autonomic responses shows that physical activity helps regulate both branches of this system. When children move, they're not just stretching cramped muscles. They're actively supporting their body's ability to self-regulate, process sensory input, and maintain homeostasis.
This becomes especially important when you consider that many children already struggle with regulation during the holiday season due to schedule changes, sensory overload at gatherings, and disrupted sleep patterns. Long car rides without movement breaks add another layer of dysregulation.
The Two-Hour Rule You Might Not Know About
While the American Academy of Pediatrics has clear guidelines about car seat safety, many parents aren't aware of recommendations about breaking up long car trips. For infants, experts generally recommend limiting car seat time to about two hours, followed by a break where the baby can be moved to a flat surface and given time to move freely.
This isn't just about comfort. For young infants, extended time in car seats can affect breathing mechanics. The semi-reclined position can cause the head to fall forward, potentially compromising the airway. Combined with reduced opportunity for movement, this creates a scenario we want to minimize.
What Movement Breaks Actually Do
Research on movement breaks in children shows consistent benefits across multiple domains:
Cognitive function improves. Studies in school settings have found that children are more attentive and focused after movement breaks compared to before. Finnish schools, which incorporate 15-minute breaks after every 45 minutes of instruction, have long understood this principle. The same applies during travel.
Physical regulation occurs. Movement increases heart rate and blood flow, delivering more oxygen to the brain. This supports alertness and learning while also helping children manage the physical discomfort of prolonged sitting.
Emotional regulation strengthens. When children have opportunities for movement, they're better able to manage frustration, boredom, and the general stress of being confined. This can dramatically affect behavior during and after travel.
Developmental needs are met. For infants and toddlers, movement isn't optional. It's the primary way they learn about their bodies and their environment. Every hour spent passively restrained is an hour not spent building the motor skills that form the foundation for all future development.
Practical Strategies for Holiday Travel
Here's how to integrate movement breaks into your holiday travel plans:
Plan stops every 60 to 90 minutes. Yes, this adds time to your trip. But the difference in your children's behavior and your own stress level makes it worthwhile. For infants, aim for every 60 minutes. Older children can typically manage 90 minutes.
Make breaks meaningful. Don't just stand in a parking lot. Find rest stops with grass where children can run, practice animal walks, or play simple games. For infants, lay out a blanket for tummy time or practice assisted standing.
Use specific movement patterns. As a physical therapist, I recommend incorporating movements that counter the flexed position of sitting. Have children reach their arms overhead, do gentle backbends over a stability ball if you travel with one, or practice walking with exaggerated arm swings. For toddlers, climbing on age-appropriate playground equipment at rest stops is ideal.
Include breathwork for older children. Teach simple breathing exercises that can be done in the car during traffic delays and practiced during stops. Belly breathing with hand placement helps children become aware of their breath and activates the parasympathetic nervous system.
Time breaks strategically. Plan stops before behavior deteriorates. If you wait until everyone is melting down, the break becomes crisis management rather than regulation support.
Consider your route. Choose routes with better rest stop options, even if slightly longer. Access to safe outdoor spaces where children can move freely is worth extra miles.
Special Considerations for Different Ages
Infants (0-12 months): Every 60 minutes, remove from car seat for at least 10-15 minutes. Practice tummy time if awake, or simply hold them upright with support, allowing their head and neck muscles to work. If they're sleeping, still plan to stop, even if you just check on positioning and don't wake them.
Toddlers (1-3 years): These children need to move. Plan for 15-20 minute breaks with active play. Running, jumping, climbing (safely), and large motor movements are ideal. Bring a soft ball or bean bags for simple games.
Preschoolers (3-5 years): Structure breaks around specific movement challenges. "Can you walk like a bear? Can you hop on one foot? Can you reach up high and touch the sky?" These directed activities work better than free play for this age.
School-age children (6+ years): Incorporate their interests. If they enjoy sports, bring a football to toss. If they're kinesthetic learners, create movement-based games related to your destination or holiday plans. For children who resist stops, give them ownership by letting them choose the activity.
Addressing Common Concerns
"But we'll never get there." You'll get there differently. Instead of arriving with dysregulated, cramped children who need an hour to settle, you'll arrive with children who've had their movement needs met throughout the journey. The total travel time might be similar once you factor in the time usually spent managing meltdowns.
"My child sleeps the whole way." Sleep in a car seat isn't the same quality as sleep in a proper crib or bed. The position doesn't allow for the postural changes that occur during natural sleep cycles. If your child consistently sleeps through car rides, they may be using sleep as a coping mechanism for the confinement, not getting truly restorative rest.
"I don't want to wake a sleeping baby." For short trips, fine. For extended holiday travel, the two-hour guideline still applies. You can check positioning and airway without fully waking most infants, then allow them to settle back to sleep after ensuring they're safe and haven't been in the same position too long.
The Integration Perspective
As someone trained in both Western physical therapy and integrative approaches including acupuncture and HeartMath®, I see movement breaks as addressing multiple systems simultaneously. We're not just preventing stiffness. We're supporting:
The musculoskeletal system through active engagement of postural muscles.
The nervous system through opportunities for regulation and sensory integration.
The cardiovascular system through increased circulation and heart rate variability.
The vestibular system through changes in head position and movement through space.
The emotional system through opportunities for children to exert autonomy and release pent-up energy.
This is the definition of integrative care. One intervention (movement breaks) supports multiple body systems, creating a compounding positive effect that far exceeds the sum of its parts.
Looking Ahead
Holiday travel doesn't have to mean choosing between safety and development, or between making good time and meeting children's needs. With planning and intentionality, we can do both.
As you prepare for holiday travels this season, consider adding movement breaks to your trip planning alongside your route, snacks, and entertainment. Your children's developing bodies will thank you, and you might find the journey becomes more enjoyable for everyone.
Safe travels.
I'd love to hear how movement breaks work for your family this holiday season. What strategies have you found most helpful during long car rides? Share your experiences in the comments.
For more integrative insights on pediatric therapeutic care, subscribe to my newsletter Beyond Balance. I share evidence-based approaches that bridge traditional physical therapy with holistic practices to support children's development and wellbeing.
