W-Sitting in Children: Is It Bad? What the Research Really Says
W-sitting explained: why children sit this way, what research says about hip dysplasia and posture, when it's a warning sign, and other ways to sit.
For years, parents have been told to stop their children W-sitting: that it causes hip problems, weak core muscles, poor posture and clumsiness. But what does the research actually say? This guide brings together the current evidence and explains when W-sitting is worth checking.
What is W-sitting?
W-sitting is when a child sits on their bottom with their knees bent in front and their feet out to each side, behind them. Seen from above, the legs make the shape of a “W”.
It’s very common in toddlers and young children, and many children grow out of it naturally as their hips change shape and their sitting preferences change.
Why do children W-sit?
- It’s comfortable. Young children’s hips naturally have more inward rotation than adults’ hips, so this position is easy for them.
- It’s stable. The wide base of support means the child doesn’t have to work as hard to stay upright.
- It frees both hands for play, especially on the floor.
What does the research say?
Many traditional concerns about W-sitting came from clinical opinion rather than research. Recent studies have tested some of these concerns directly.
| Common concern | What the evidence says |
|---|---|
| Causes hip dysplasia | A 2020 prospective study of 104 children (196 hips), using hip and pelvis X-rays, found no difference in hip dysplasia measures between W-sitters and non-W-sitters (Rethlefsen et al., Clinical Pediatrics). |
| Damages hips, knees or posture in general | A 2025 systematic review in Acta Ortopédica Brasileira found no scientific evidence to advise against W-sitting in children, and no association with hip dysplasia. |
| Weakens core muscles | Studies have found muscle activation is similar whatever sitting position children choose. |
| Stops children crossing the midline or developing trunk rotation | Not supported by research to date. |
The research is still limited, and most studies look at typically developing children.
When W-sitting is worth checking
-
Usually fine
- Child can also sit in other positions
- No pain
- Meeting motor milestones
- Moves in and out of positions easily
No need to stop it; offer variety
-
Get it checked
- W-sitting is the only way they can sit
- Pain in hips, knees or feet
- Very floppy or very stiff muscles
- Delayed sitting, crawling or walking
- Known cerebral palsy, low tone or hip condition
See a doctor, physio or OT
For children with cerebral palsy, low muscle tone (hypotonia), Down syndrome, dyspraxia or certain hip conditions, a therapist may give specific advice about sitting positions, because these children’s hips and muscles work differently.
Simple ways to encourage variety
Rather than constantly saying “fix your legs”, which can make play time stressful, try offering lots of positions:
| Position | How to encourage it |
|---|---|
| Cross-legged ('criss-cross') | Sing a song or play a game that uses this position |
| Side-sitting | Encourage switching sides during play |
| Long sitting (legs straight) | Play with toys between the legs |
| Kneeling or half-kneeling | Play at a sofa or low table |
| Tummy lying | Great for drawing, puzzles and books; builds shoulder strength too |
| Small stool or chair | Feet flat on the floor at a small table |
Summary
W-sitting is common, comfortable and, for most typically developing children, not harmful according to current research. It’s worth a professional check if it’s the only way your child can sit, if there’s pain, or if your child has low muscle tone, cerebral palsy, a hip condition or delayed milestones. Otherwise, simply encourage a variety of sitting and play positions. Read more about OT for infants and toddlers, toe walking and crossing the midline.
References
- Rethlefsen SA, Mueske NM, Nazareth A, Abousamra O, Wren TAL, Kay RM, Goldstein RY. Prospective study of W-sitting and hip dysplasia in 104 children. Clinical Pediatrics. 2020. Abstract.
- W-sitting in childhood: a systematic review. Acta Ortopédica Brasileira. 2025;33(1). Open access.
- Children’s Hospital Los Angeles. W-sitting is not bad for kids, CHLA experts say.
Frequently asked questions
Is W-sitting bad for children?
Why do children W-sit?
When should I worry about W-sitting?
Does W-sitting cause hip dysplasia?
What are alternatives to W-sitting?
Written by
Payal Mehta, OT
Payal Mehta is a practising occupational therapist and co-founder of Occupational Therapy OT. She writes on pediatrics, sensory integration, and mental-health practice.
All articles by Payal →This article is for general education and is not a substitute for individualized assessment or treatment by a licensed occupational therapist. Always seek the guidance of a qualified professional for specific concerns.
