No matter what position, high or low, loose or tight, it was really uncomfortable. The weight of baby makes the seat dig into your hip or wherever you have the seat positioned. My son is 12 months and 22 pounds, so I cant imagine how much more it would hurt with a child up to 44 pounds sitting on it. The strap that goes around your waist either digs into your hip on the bottom or digs into your ribs at the top. I gave 2 stars because one, I loved the idea of this since my arms get tired when I cSee full review