Thursday, March 25, 2010

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.

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