Carrying your baby in a sling
By Dr Sophie Messager
Babywearing instructor, doula and antenatal educator
A biology research scientist for over 20 years, Dr Sophie Messager 's passion shifted towards supporting parents in the journey through parenthood, following the birth of her first child in 2006. She now works as a babywearing instructor, doula and birth and parenting educator. She has run a local slingmeet group and worked as a qualified babywearing consultant since 2010, as well as running babywearing peer supporter courses since 2012. She has helped over 1000 families to choose and use a sling, and has trained over 70 babywearing peer supporters.
Humans are primates. Primates carry their young with them at all times - they do not leave them in a nest or a burrow. In fact, British anthropologist Timothy Taylor explains that slings were invented over 2 million years ago, and were instrumental in allowing our species to achieve its current brain growth, as it allowed us to carry our immature offspring and carry on with daily tasks. Until very recently in human history (namely the invention of the pram about 200 years ago), babies were carried as a matter of course, including in the Western world. They are still carried in many parts of the world today, and the Western population is rediscovering this ancient tradition. Human babies are "clinging youngs"- they are designed to be carried. They crave close contact with their parents, and display reflexes associated with carrying- they instinctively flex and spread their legs when picked up which helps them cling to the adult body.
Benefits for parents and babies
Benefits for babies
Close to your heartbeat, breathing, smell, voice, touch and warmth –”womb with a view”
Develops a sense of security and trust
Involved in normal life without being centre of attention
More time in a "quiet, alert state" - ideal for learning.
Baby sees more of the world than from a buggy/learns social skills and communication
Regulates temperature, breathing, and heartbeat.
Stimulates balance and muscular strength.
Counts as “tummy time”
Benefits for parents
Get on with the things you want to do
Easier to get around in busy places, country paths, holidays and public transports (no need to carry a car seat, or pushchair into your car, or up stairs)
Gentler for your back than carrying hands free (or than carrying a car seat)
Get to know baby faster and better (read cues)
Help with breastfeeding
Helps with postnatal depression
Helps siblings adjust to new baby
How to carry your baby comfortably and ergonomically
At birth, a baby’s spine and hips are still immature. The spine is naturally rounded, in a c-shape, and not designed to be straight. The spine and the hip joints are still cartilaginous, and therefore fairly soft and flexible .
To support and protect a baby’s developing spine and hips, it is important that the carrier meets the following criteria: It should support the baby's back, hips and back of the head.
To support the back, the carrier needs to allow the baby's back in it natural rounded position, and the fabric should be snug enough so that the baby doesn't slump in a slouched position, especially when asleep (see more about this in the safety paragraph).
To support the hips, the carrier should allow the baby to assume a position known as spread squat, or M position as shown on the picture below-where the baby's bottom sits lower than her knees, and the fabric should support the baby's legs from knee pit to knee pit . This allows for the balls of the hips to sit adequately in their sockets. Rosie Knowles, a GP and babywearing consultant, has written an excellent article on the topic, with very good graphics (www.sheffieldslingsurgery.co.uk/healthy-hips-busting-some-myths)
Finally, the fabric should be high and snug enough to support the back of the baby's head (it should also be adjustable so it comes no higher than this)-this is especially important in newborn babies.
For the reasons highlighted above, it is not recommended to carry your baby facing out in a sling, as it forces the baby's back straight against the wearer's chest, and does not allow the baby to assume the spread squat position (it causes the legs to dangle in a harness like position).
Finally, for the comfort of the parent wearing the baby, it is important that the carrier is high and tight on the parent's body, to avoid causing back strain and displacing the wearer's centre of gravity. As a rule of thumb, the baby should be placed close enough for the wearer to be able to kiss the baby's head.
Issues with most brands of high street "front-pack" style baby carriers
Unfortunately, few of the major carrier brands sold on the high street meet the ergonomics criteria highlighted above. These carriers put a baby in a dangling position, much like sitting in a harness, with all of the baby's weight resting on her crotch rather than being spread from her bottom and her thighs. The baby's back is also forced into a straight position. This type of sling also places the baby too low, with the baby's head at mid chest level. The design of this type of carrier and the low position of the baby are also not ergonomical for the carrying adult and carrying a heavy baby can quickly become uncomfortable.
Different types of slings
There is a plethora of baby carriers available. The range of baby carriers available in the UK falls under 4 categories: Wraps, Meitais, soft structured carriers, and ring slings and pouches
Wraps are long pieces of cloth (4 to 5 metres long) that are tied around the baby and parent.
Stretchy wraps are made a soft, stretchy t-shirt like material. One of their advantages (especially if the fabric contains elastane rather than just plain cotton, this is known as a two-way stretchy wrap) is that they can be left on all day, which allows you to pop the baby in and out easily, which is especially convenient with newborns. Due to the nature of the fabric, many parents find that stretchy wraps are not supportive enough for older babies (6 months onwards).
Woven wraps are diagonally woven cloths, which gives the fabric the ideal amount of stretch and support. They are the most versatile form of carrier available, as they automatically adjust to the size of the carried child. They can be used from birth to toddlerhood and beyond, and can be worn on the front, hip and back and tied in many different ways.
Mei tais are Asian style carriers which consist of a shaped piece of fabric (usually a square or a rectangle) with 4 straps. One set of straps is tied around your waist and the other around your shoulders, the fabric forming a pocket for the baby. They can be worn on the front, hip and back. The size of the rectangle of fabric determines what age range each meitai is suitable for. There are small meitais suitable for young babies, and bigger ones for toddlers available.
Soft Structured carriers
Soft structured carriers have a body is similar to a Mei Tai but the waist and shoulder straps fasten with buckles and clips, much like a rucksack. Because of their structured shape and size, most of them need a padded insert to be used with a newborn baby, up to 3 to 4 months of age, when the baby is big enough to fit the carrier without the insert.. They can be worn on the front, hip and back. They come in baby, toddler, and even preschooler sizes.
Ring slings and pouches
A ring sling is a piece of cloth with 2 rings sewn at one end. The free end is looped through the rings, forming a pouch for the baby, with the tail of the fabric hanging down. They are worn over one shoulder. They are quick to put on but require rigorous learning to get the adjustment right. The rings offer more adjustability than a pouch. Unpadded ring slings are easier to adjust, and the ones made out of woven wrap material are the comfiest to use.
Pouches are also worn over one shoulder. They are made of one folded up length of material which forms a pocket for the baby and is worn over the body like a sash. Unless they are adjustable, they need to be sized for the wearer so the same pouch cannot be used with two parents of very different sizes.
A note about fitting: Slings are very much like jeans or shoes-one style does not fit all. Different body shapes and sizes means that one person's dream sling might be the next person's nightmare one. It is always a good idea to try before you buy (see How to learn to use slings - below).
If you would like to read more about the topic of different types of slings, start here www.sheffieldslingsurgery.co.uk/welcome-to-slings
These guidelines are downloadable as a PDF from www.naturalmamas.co.uk/wp-content/uploads/2012/03/TICKS2.pdf
Due to these guidelines, babywearing instructors usually recommend that the safest position for a baby to be carried is in an upright position. Lying down "cradle" type positions are best avoided with newborns, as it is quite difficult to ensure the position is safe with no chin to chest posture. Upright positions are also more respectful for the baby's developing hips and spine.
Avoid bag style slings
Bags slings are unsafe for small babies as they put babies in a dangerous position (chin to chest) and cover their faces with fabric-both of which carry a risk of positional asphyxiation-The Infantino brand was recalled in 2010 due to deaths in the US, but similar shaped brands are still sold in the UK. To read more about sling safety, see www.sheffieldslingsurgery.co.uk/babywearing-safety
Breastfeeding in a sling
Is it possible to breastfeed in a sling and this is something many mums enquire about, especially second time mums so they can look after their older child whilst nursing their new baby.
Breastfeeding whilst babywearing is not a hands free option as one hand is needed to support baby's neck like you would without a sling. However it can help with mobile breastfeeding and can take weight away from a mother's arms.
Breastfeeding is a skill, and so is babywearing, so please ensure you master both skills separately before attempting to breastfeed in a sling. If breastfeeding in a sling, be particularly aware of the risk of positional asphyxia at all times: , avoid the chin to chest position and make sure that the baby's face is not pushed into the breast. It is probably safer and easier to wait until the baby is a few weeks/months old and can hold his head steady prior to attempting to breastfeed in a sling. (for examples of breastfeeding in a sling videos, see http://thefunnyshapedwoman.blogspot.co.uk/2011/10/milk-to-go-breastfeeding-in-sling.html)
How to learn to use slings
As explained in this article (www.theslingschool.com/2012/04/three-ways-to-learn-art-of-babywearing.html), there are three options for practitioners and parents who want to learn how to use a sling: they can teach themselves, attend a free drop-in like a slingmeet or a sling library, or attend a small group workshop or have a consultation with a qualified sling consultant.
If you or parents prefer to teach yourself how to use a sling, there are many good video tutorials on the Slingababy website www.slingababy.co.uk/#!videos/c16jz
You can find and extensive map and list of both drop-ins and consultants here www.slingpages.co.uk/sling-advice-resources/
Dr Rosie Knowles, a GP and babywearing consultant, has an excellent website, with many great articles about slings www.sheffieldslingsurgery.co.uk/articles/
As a practitioner, you may also decide to train yourself as a peer supporter or babywearing consultant. Peer supporter courses are available from Born to Carry (www.borntocarry.com) and the School of Babywearing (www.schoolofbabywearing.com). Consultant courses are available from three different babywearing schools in the UK: Slingababy (www.slingababy.co.uk), Trageschule UK (www.trageschule.co.uk), and The School of Babywearing (www.schoolofbabywearing.com). This article explains how to choose the right school for you: www.naturalmamas.co.uk/articles/how-can-i-become-a-babywearing-consultant
Where to buy slings
Few high street retailers stock slings that meet the ergonomics criteria highlighted above (although the choice is growing all the time and this is slowly changing). There are many online stores selling carriers, most of which tend to be small "cottage industry" type businesses, which provide excellent customer services. They are listed on the slingpages website (www.slingpages.co.uk/buying-a-sling) Beware of Ebay and non approved online retailers, as there are many fake, poor quality copies of well known brands such as Ergo, Freehand and Moby circulating on the internet. Here is a list of resources to buy second hand slings from www.slingpages.co.uk/pre-loved-slings