Babywearing Safety

Babywearing Safety

There are a lot of things to learn when you have your first baby: how to safely use the car seat; how to create a safe sleeping environment or simply how to hold your baby in a safe way.  These things all take time and practice.  Learning to wear your baby safely in a carrier is no different.

There are some specific safety precautions you need to be aware of when wearing your baby.  Many are common sense but others have been discovered more recently from problems occurring for the baby and even from the death of babies.

When you are first learning to wear your baby in any carrier we recommend that you: Practice with doll

  • And your baby are feeling relaxed and content before trying out your sling
  • Take the time to practice with a doll or pillow so you feel confident. Your baby will respond to your confidence and feel comfortable with what you are doing.
  • Use a mirror so you can see what you’re doing.
  • Kneel over a mattress while you practice.

Take these precautions again if/when you learn a new carrying style.

Remember that your baby may not enjoy ‘getting in the sling’ but once they’re in and moving they love it!

Clothing:take layer offDS

  • Remove a layer or two. You and your baby will be warmer when in such close contact.
  • Avoid zips, buttons, jewellery, hair that will interfere with your baby
  • Slippery clothing on you or your baby’s legs, such as rain wear, could cause the carrier to slip or be less secure.
  • If you are wearing a jacket over your baby while carrying them on your front, only zip it up to their neck and not over their head – pop a hat on them if it’s cold.
  • Protect them from the elements with sun screen and covering up or a jacket, shawl, umbrella, or specially made double headed rain jacket.

Safety considerations:

  • Baby carriers are often referred to as slings.  This is a good description as you baby should be ‘slung’ in the carrier.  The carrier should tuck right under and support your baby’s bottom and thighs as opposed to them ‘sitting’ on the edge of it.  This is important for comfort and safety.
  • Wearing your baby on your back when you are cooking or drinking a hot drink is safer than a front carry.  A hip carry may work when your baby is young but as they grow little arms and legs can kick and grab pretty quickly! When you are eating with your baby on your front you maybe able to protect your baby by covering them with a T-towel and drinking your hot drink luke warm.
  • Walking is the safest activity while wearing your baby!  Even when you are walking, be aware that a baby on your front limits your view of the ground in front of you (just like when you were pregnant, for Mums).  Any activity where you could be hurt is not recommended when you have a baby attached!  This includes, among many things, traveling in the car. Use a correctly fitted car seat for your baby.
  • Beware of your baby’s legs, arms and head when you are wearing them.  You will be wider and thicker that you’re used to and a clonk on the door frame hurts!

For the safety of you and your baby use the FITS acronym for optimal positioning –

FITSphoto

  • Firm against your body. Gently push on your baby’s back. Your baby should not significantly move towards you.  Firm up the carrier if need be.
  • Insight, sound or feel babies breath at all times. Your baby’s face must be clear of material with plenty of breathing space. If they are on your back feel their breath on your neck and hear their breathing in your ear.
  • Top of babies head is at the base of your neck. The most ergonomic carrying position is with your baby high on your body. They are also easier to monitor in this position.
  • Support baby’s legs from knee to knee for optimal hip positioning and development and support the natural curvature of the spine. The International Hip Dysplasia Institute 2 is a not for profit trust set up to educate the public about hip dysplasia including Developmental Dysplasia of the Hip (DDH), which is found in infants.  They do not advise any particular baby carrier, but they do explain what contributes to it and what has been found to prevent and treat DDH.  When the legs are supported from knee to knee with knees as high as or higher than the hips, the ball of the femur (thigh bone) fits neatly into the hip socket.  Fig B. As the joints of a NB baby are soft and still developing it is important to support their correct development.
Fig A (not recommended)
Fig A (not recommended)
Fig B (recommended)
Fig B (recommended)

When the legs are unsupported and hanging the ball of the femur is pulling out of the hip socket.  Fig A. It is hard to know whether your baby has a predisposition to DDH unless it is in the family so it is very important for all parents to carry their babies in the correct straddle squatting position.  There are many baby carriers on the market that do not do that and they should be avoided.

Risk factors for DDH: Female, breech position in womb, familial predisposition, environmental factors.

The ‘cradle carry’ is also not recommended.  “Baby carriers that force the baby’s legs to stay together may contribute to hip dysplasia.”cradle carry, 2.

Allowing for the natural curvature of the spine is also important. A carrier needs to fully support a newborn baby, distributing the weight across their body.  The sling should not be overly tight across their lower back as this might cause their back to arch into an unnatural position.  The carrier needs to be firm across the top of baby’s shoulders and support to the base of their neck.  Keeps the airway open and supports the cervical spine.

Tips for carrying an older baby/toddler:What baby can reachDS

  • Be aware of what they can reach.
  • Wriggling toddlers need to be wrapped firmly as they can loosen wraps and slings. Keep an eye on them and check the position of the wrap/sling regularly. Ensure they are secure at all times when putting them on your back.

What to Avoid: Front facing out position. 

This can push the baby’s back into an arch position and often puts all the weight forward onto their crouch.  They are also easily overstimulated.  The parent cannot see their face and may not pick up on the sometimes subtle signs of over-stimulation.  It may only be noticeable when the baby is extremely unsettled later in the day.  They cannot shy away from anything coming at them.  It is difficult to support the full length of their thigh and position them optimally for good hip development.  Use a hip or back carry to allow your baby to see or use the front facing out position for short periods, 15 minutes maximum.

Bag Slings:  A number of babies have died in this type of sling.  See the consumer.org.nz warning

Ensuring comfort for the baby wearer

Along with making sure your baby is positioned safely you need to ensure you are carrying your baby in a way that supports your body too.

  • Having your baby high on your body and close to you is best for carrying.
  • The human body is better designed to carry on your back rather than your front.  Back carries are recommended for heavy babies.  Depending on your carrier you may need to wait until your baby has good head control to carry them on your back.
  • One shoulder carries are an option for people with a single shoulder problem.
  • Torso carries are an option for people who have neck or shoulder problems.
  • For lower back problems carrying high on your back is best.  Carrying low on your front is not good for your back.  Ensuring your baby is snug against you is best for both of you.
  • Cross/spread carrier straps as much as possible for your comfort and safety.  Bend your knees rather than leaning forward.

Breastfeeding in a carrier

It is possible to breastfeed while wearing your baby in a carrier.  However, if you can, take the opportunity to sit down and relax while breastfeeding your baby.  Make sure you and your baby have breastfeeding well established before attempting it in a carrier.  If you’re confident with your baby’s latch you can feed them in a number of positions depending on your carrier and it can often provide some privacy when you’re out in public too. Watch the demonstrations on the video specific to your carrier.

  • You may need to support your baby’s head with one hand when they are feeding.
  • When they are young keep them in view, check them regularly and feel for active feeding.
  • When they have finished actively sucking move them into an upright carrying position.

References:

  1. http://www.bigmamaslings.co.uk/zen-cart/page.html?chapter=0&id=27
  2. http://www.hipdysplasia.org/developmental-dysplasia-of-the-hip/prevention/baby-carriers-seats-and-other-equipment/
  3. http://www.consumer.org.nz/news/view/baby-sling-warning

Further reading:

www.babywearinginstitute.com

Dr Evelin Kirkilionis – http://www.storchenwiege.com/babycarrierresearch.htm

Dr. Eckhard Bonnet – http://www.didymos.de/en/DIDYMagazine/Opinions-and-Photos/Experts-Opinions/Studies-Opinions-and-scientific-papers-Dr-E-Bonnet/

 

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