Babywearing, Safely: A Look at the Carrier Styles

By now, I think everyone who's in the least bit familiar with babywearing and slings has been made aware of the CPSC sling warning and the subsequent recall of 1 million bag carriers by Infantino. (And if you're not aware, either you've been under a rock for the last few weeks or you're without computer access and chatty girlfriends!). I've been overwhelmed by the emails and phone calls I have received in the last 3-4 weeks from various news media sources, reporters, concerned parents, and people hoping to spread the love of babywearing--safely--all looking for answers. Well, actually, one answer, to the question: Is babywearing REALLY safe?

Let me be one of I hope many who will assure you that babywearing is, indeed, safe--with two caveats--when the parent chooses to wear a safe baby carrier, and when they then use that safe baby carrier correctly. Clearly there are styles of baby carriers that are not safe, the Infantino SlingRider being the one that is currently getting the most press. And I may not be the only babywearing educator who hopes to see a few more similar bag carriers being brought to public attention in the next few weeks.

So what styles of carriers are safe? Well, there are four very basic styles of baby carriers-- simple pouches (think: HotSlings), ring slings (which we manufacture here at Baby So Smart), wraps (think: MobyWrap), and Mei Tais (again, another of our beautiful baby carrier styles). And then from these four basic styles of carriers you see a few "hybrids"-- SSC's, Baby K'Tan style carriers, adjustable pouches, etc.

A great deal of what I focus on here at Baby So Smart is babywearing education; more specifically, the "Benefits of Babywearing" classes that we offer and also babywearing safely. I've been working with parents and their infants/toddlers for over 4 years, specifically in regards to babywearing and infant development. And I've been a nurse for the last 15 years, most of my experience being in the pediatric and maternal-child health arenas. One thing that I continue to find over and over again with parents who are just venturing into the world of babywearing (and even with quite a few who have been using carriers for some time), is that rarely do parents actually wear their carriers correctly, or even choose the right size and style of carrier for themselves and their babies. So I want to use the next few posts to talk about babywearing safely using the four basic styles of carriers.

Let's start with pouches. They are the most simple of all the carrier styles, have the shortest learning curve, and have been fairly popular for the last few years. And for sake of simplicity and because they are probably the most familiar of the pouch brands, I'm going to use HotSlings as my example pouch. At least 90% of the local parents that I work with, when choosing a pouch style carrier, choose a pouch size that is far too large for them and their baby. And when I attempt to educate them about how important sizing is when wearing safely, especially when choosing to wear a simple pouch, many of them get frustrated, a bit angry, reluctant to consider that this beautiful pouch that they've recently purchased really doesn't fit them, and because of poor sizing could potentially compromise their baby's safety. Pouches that are too large for the wearer pose several risks: most basic, and least concerning, would be that it can cause back pain or discomfort to the wearer if it is too large; a baby could potentially fall out of a carrier that is too large; and most concerning of all, a young baby can fairly easily slip into the "chin-to-chest" position that is being warned about currently in a pouch that is too large. I've seen it time and time again, mom insisting upon using a pouch that is a size or two too large for her, little baby just curling up inside the dark recesses of a too big pouch, in the dreaded "C-position," little chin dropping onto their chest.

Can this potential compromise be blamed on the baby carrier in this scenario? Absolutely not. As parents, we have to take responsibility to contact the manufacturers of the pouches we use to assure that we are sizing ourselves correctly. Or better yet, if you're in the Greater KC Area, sign up for one of our babywearing classes or contact us for a one-on-one consultation.

So how should a pouch fit you? I've included this photo of a fairly young baby in a HotSlings organic pouch because I think it very clearly demonstrates a very nicely fitting pouch. Note specifically where the baby's bottom is located in relation to the model's body-- baby's bottom is roughly at or slightly above the wearer's navel. This is key to a properly sized pouch. Mom's tend to complain that a baby being worn in a pouch that fits them this way feels "too tight." They often request a pouch that's at least one size larger, sometimes two. But this is how a pouch should fit. Baby should be fairly high on the wearer's body, and they should be fairly tight. The parent should have to work a little bit to get the baby inside the carrier, and then work a hair more to get the baby positioned correctly. If your pouch fits you in such a manner that you can very easily open the pouch, slip baby inside, and then baby slides down to the bottom of the pouch and curls up with pouch fabric covering over his face, your pouch is too large. Period. You need to exchange it for a smaller size.

And I may be alone in this next thought, but several years ago I began to become more concerned about parent's inability to correctly position their infants in their pouch carriers, so I began teaching a slightly modified cradle hold position for people using this style of carrier. Note the baby in the pouch photo above: I'll venture a guess that that baby is roughly 3 1/2 months old-- it appears to have a larger than newborn body and head, appears quite alert, has good coordination (fist in mouth), and appears to have the tone and upper body/head strength of a baby roughly between 3-4 months of age (and a more rigid airway as well). Hence, that baby is perfect in that pouch exactly as s/he is. Now imagine a much smaller, more weak (less muscle tone and strength), probably somewhat sedated (due to maternal pain medication during labor), newborn in that same pouch. The baby's head almost always slips all the way inside the pouch, parents love to pull the fabric of the pouch together to close it over baby's face (think: do we lay baby down for a nap and pull a blanket over baby's face??), weak head and neck muscles do nothing to prevent baby's chin from resting on his chest, and he just kind of ends up "swooning" into the pouch, for lack of a better word.

Because of all of this, I've been teaching a modified cradle hold, as I said, with these littlest of the little babies. When we're done positioning baby in the pouch, their little heads are resting high up on mom's shoulder, face exposed with baby resting his cheek against mom's body, nose and mouth extremely visible, their backs are kept well-supported by the fabric coming down the lateral (or outside edge) of the pouch, and really nothing but their







feet are resting in the lowest part of the pouch. Imagine cradling a baby upright in one of your arms, your baby's head resting high up on your shoulder, cheek laying gently against your upper lateral (outside edge) chest, little bum snuggled into the crook of your elbow, and feet resting on the upper part of your lower arm. I've tried to demonstrate this modified cradle hold in my little diagram, shown above.


Let me end with this tidbit about pouches: these are great carriers, when sized and worn correctly. End of story.

Babywearing and a Bathtub

Tonight, a "guest blogger" steps in to give us his opinion on babywearing. This "guest," my very patient and loving husband, and father to our four children.


I've recently read some articles commenting on the safety of baby carriers. Some articles represent sides clearly against the idea, citing a few mishaps at the cost of a baby's life. While the loss of ANY baby is tragic, what is just as tragic is the interpretation of information (or misinterpretation) leading to unfounded panic and ignorant opinions about the safety of baby carriers.

We've all heard the baby carriers by many different names: slings, wraps, pouches, bags, and on and on. Somehow, the negativity in the articles regarding safety use the term "slings" as synonymous with baby carriers that are compromising, giving the specific Sling a bad rap. I'd like to put in my two cents as a father who was very hesitant about babywearing from the get go.

My wife got into the idea years ago and has become a guru. She chastises me when I don't use the carriers with our children as often as she does, suggesting that I am bad PR. Well, I just take longer than most to adopt a better idea. I will admit that they were awkward for me at the start, but I have tried several different styles, finding my sweet spot with the right carrier and position. I have to say, my favorite and most comfortable to me, is a traditional sling (only one made with the very comfortable and patented shoulder by BabySoSmart.com). It is my favorite because I know how to use it and it works for me. I feel safe with my child in it, though it took some coaching to get me to that comfort level.



Now, back to my point about the safety of slings. Slings are as safe as the person operating them. I would like to make a parallel to a bathtub. More children die by drowning in a bathtub than die from being smothered in a baby carrier. There aren't these freak articles on CNN citing the recall of ALL bathtubs because a parent used poor parenting techniques with the tub. Authorities or ignoramuses don't throw up banners calling for the boycott of bathing a child. You don't stop bathing a child just because a parent neglected their kid. Bathtubs and bathing a child are more dangerous than carrying a baby in a baby carrier. All water can drown a baby, and all cloth can smother a child. I have to say that my wife is safer with ALL her baby carriers than I am at bathing our children. Let me say that a different way; I would sooner trust my wife with your child in a baby carrier than I would trust you to bath my child. Babywearing is like bathing a child; it requires prudent parenting techniques and education. That's right, education. I wouldn't know about not leaving my child unattended in the bathtub if someone hadn't pointed it out to me at some point along the line, despite it being common sense (and I even need reminding, to this day, four children later, as success breeds complacency). Even with a two-year-old, who can sit up in a small amount of water; I'm tempted to walk away with them in the tub sometimes, even just for a minute. And I know from education, that babywearing is just as critical to a baby's health as a simple bath. I'm not going to stop babywearing no matter what people say or recommend based on safety (I'm just going to be smarter about it). So, the next time someone wants to knock all babywearing and all baby carriers for their safety, tell them to stop giving their kid a bath.

Kudos to Baby Bjorn

Most of the time I struggle to find something positive to say about any of the more mainstream front-pack style baby carriers and their respective manufacturers. Recently it was brought to my attention that parents in Australia will have a truly new and improved Baby Bjorn to consider when looking to purchase a safe, or in this case, safer, baby carrier for their baby.

Enter the "Baby Bjorn Comfort Carrier." For those of you familiar with babywearing and the different styles of carriers, you will probably note the major difference in this new Baby Bjorn immediately. For those of you not so intimate with babywearing, let me briefly explain. Look closely at the photo above, paying specific attention to the baby's leg position. Note the nice, wide hip spread. Look familiar? It should, it's the position in which a well-made, correctly worn Mei Tai places a baby's hips. Like this photo of our own Baby So Smart Basic Mei Tai.

I know there has been much to say about hip positioning in regards to the practice of babywearing; I don't want to get into all that here. Suffice it to say that I'm of the opinion that hip position does matter, and if a baby is incorrectly positioned due to the design of a carrier, there is a very real possibility of hip impairment.

This Baby Bjorn improvement is exciting to me because many families are not comfortable trying out a style of carrier they are not familiar with or that they don't routinely see in the major baby supply stores. How often I have tried to counsel parents to consider trading in their poorly designed mainstream front-pack baby carriers for a style of carrier that will support their babies in an anatomically healthy position without success. Now Australian parents will be able to make better choices for their babies when choosing from the mainstream baby carriers.

A word of caution, however. While this new front-pack carrier from Baby Bjorn has the ability to be worn correctly, it also still has the ability to be worn incorrectly. Directly from the Baby Bjorn website in regards to their counsel as to how this carrier can/should be worn: "Carry your child facing inwards with the legs in a normal position" (italics mine) and then they show a diagram of an infant being carried with their legs in what I refer to as a "dangling" position, or in the manner that the other Baby Bjorn carriers position babies. I would advise parents against using this "dangling" position with their infants; the only exception to this would be those babies that are affected by Down's Syndrome. Another word of caution: while the new Bjorn style carrier provides a healthy sitting position for an infant, this still would not be the position of choice for an infant under 3-4 months old. Infants from birth to roughly the 3-4 month mark would be more appropriately carried in the tummy-to-tummy position, with their legs under them, slightly pulled up, hips wide in what can only be referred to as a "frog-leg" position. Here's a great photo of a very small infant in the frog-leg position on a caregivers hip (borrowed from the Didymos website, which is an excellent source of information regarding infant positioning in baby carriers, BTW). Leave the sitting on the bum for the bigger babies, when they are more developmentally ready to be safely seated and not be in danger of taxing little spines in a position their body is not ready for.

Let me end by extending a pat-on-the-back to the manufacturers of the Baby Bjorn style carriers for making this long overdue change. Now let's make them available everywhere, not just Australia.