Baby Wearing: What is It and How Do I Do It Well?
As we transition into the snuggly weather of fall, we wanted to share this blog written by our team member and baby wearing expert, Dr. Emily Fitzpatrick.
Emily writes: Baby wearing is something that prior to my pregnancy I had not given much thought to. I was aware of its existence, saw parents with babies strapped onto them, but it wasn’t until I was pregnant that I started to really pay more attention to this concept.
The idea of carrying my daughter this way was very appealing to me. I felt that it would be an easy way to keep her comforted while I “did all the things,” from housework to attending street fairs. When she arrived, I found out that this was true!
I also felt that there was something so seamless in this method of carrying, that it felt natural to me, and the same seemed true for my daughter who would take great naps this way.
I felt that it helped improve my postpartum mental health, as I was easily able to be close to her, all the while staying involved in the tasks that served me.
It turns out that it benefitted her as well!
Here are some great benefits of baby wearing:
- The skin to skin contact promotes a stabilized heart rate, improved breathing, decreased crying, and improved sleep
- Promotes responsive feeding and positively supports breastfeeding
- Increases parent-child bonding
- Promotes healthy skeletal development, as it serves as prevention and/or treatment for hip dysplasia and plagiocephaly (flattening of the head), as well as supports spinal development
But before I became a frequent “wearer,” I struggled to know how to get started, because once I started to look around, I noticed so many different contraptions being used to secure babies (and even toddlers)! Then I started to look on the internet, and the options expanded and expanded…
So while prepping for my baby shower, I began to look into what device would be the best fit for me. Naturally, I started reading online reviews and found most of them to be less than helpful.
The majority of feedback were short things like, “Works great,” and “Baby loves it!” or “Hurts my back,” and “Can’t figure it out.” I then went to the store and tried some on. It turns out this is tough to do because, well, I didn’t have a baby with whom to try it out!
Then I put my “PT” hat on and decided that reviews just won’t do. I need to figure out WHY one carrier would be superior to another, based on the 3 criteria that meant the most to me: Which is the safest, which will enable proper bone development for my baby, and which will promote good body mechanics for myself?
I’ll save you some midnight Googles and internet rabbit hole journeys by telling you what I learned.
As it turns out, it’s not so much about the product, but the application of the product! So no matter what device you choose, be sure to apply the following information.
#1 Safety
First and foremost always read the manufacturer’s instructions for proper application of any babywearing devices. Be sure to look for weight and age restrictions and/or model specific guidelines to ensure that the chosen product is right for the baby in your life.
- TICKS Guidelines
These guidelines can and should be applied to all carriers with children of all ages.
They promote airway, sleep, and developmental safety.
T- Tight to chest and properly supported through spine
I- In view at all times
C- Chin up off of the babies chest to promote an open airway
K- Kiss! Baby is close enough to kiss the top of their head
S-Supported back and thighs.
- So….where do I put the baby?
If you’ve been gazing around you’ll see a variety of positions that babies can be worn, here’s the break down on why you may choose or choose not to use one of the following positions:
To Face In or Out?
-Wearing a baby facing towards your chest is the only formal recommended position for babies from 0-4 months of age, according to the American Academy of Pediatrics (AAP). This is due to insufficient head control of the baby during this time. Since a baby can not yet keep their head up on their own, we need to offer support of our chest to prevent a baby’s head from falling forward and restricting their airway.
-Between 4-6 months, babies may be turned to an outward facing position IF they have quality head and neck control, meaning that the baby can support the weight of their own head and turn side to side and up and down without fatigue for prolonged periods of time.
-The formal guidelines for the outfacing position is that, despite a child’s age, if you choose to carry in the outfacing position, time spent here should not exceed a 30 minute duration. This is due to the excess weight bearing this positioning places on the baby’s developing spine and hips. Short durations to satisfy baby’s desire to interact with the world around them is great, but anything more is a no go.
**NEVER allow an outward facing child to fall asleep in this position. Sleeping in this position causes the head to fold forward (bringing baby’s chin to chest) and closes off their airways, which can lead to suffocation.
On my front or my back?
- The formal recommendation from the AAP is that all babies aged 0-6 months should be carried on your chest to enable proper vigilance of unrestricted airways. Babies in this age range are at higher risk for suffocation if they are unsupervised by placing them on your back to carry.
- Once your baby reaches 6 months, they may safely be carried on your back if they can sit unsupported independently! The achievement of this developmental milestone is essential to ensure that the baby has sufficient strength to maintain the head position (up right) required to decrease the risk for suffocation. Many individuals enjoy this positioning as the baby gets bigger, and eventually they may be too tall for you to see over their head!
**babies should never be carried on the back facing out, no exceptions!
#2 What will promote proper bone development for baby?
A little background here. Bones grow and develop under pressure, aka through weight bearing. Within the first year of life, babies reach developmental motor milestones, such as rolling, sitting, and crawling, which aid in their overall development in so many ways! One of which is to aid in proper bone development.
Bone development encompasses so many things, from spinal curve to hip socket formation. For example, babies spend about 0-4 months (give or take, as each child is different) on their belly and back. Next, they begin to partake in sitting. The weight bearing demand placed on their body is very different in these two positions, and therefore, the growth and development of their bones are very different.
Each stage is a building block for the next, so a big no-no is interrupting the natural progression of these by placing babies in positions outside of a developmental window. This is important to keep in mind when thinking about how we support our babies when wearing, and choosing positions that support their growth!
Side note: If you have any concerns about your child meeting and/or progressing through developmental milestones, talk to your pediatrician and seek help from a pediatric physical or occupational therapist.
If you’re local to us, join us in person at one of our baby and me classes to engage in age appropriate play, as well as learn tips and tricks to support the little ones in your lives to achieve all of their milestones! To join use click livelaughpoop.setmore.com
So when I looked into which carriers promote the optimal bone growth, it turns out they all do equally well as long as….wait for it…. the baby’s positioning is correct!
Let’s dive further into proper child positioning here:
No matter how you are wearing (in vs. out facing or front vs. back) the following should always be instituted.
- “M” positioning at the hips (see photo below for Beesley’s demonstration!)
What this entails is that the baby’s entire thigh is supported with fabric and their knees should be equal to or (ideally) higher than the hips. This makes the “M” shape. With baby’s knees being the peaks of the letter and bum as the valley. This places the hip sockets in optimal position for proper development.
*The only caveat to this hip positioning is that if the baby is still in “physiological flexion.” If this is the case, then you may place them on your chest with knees tucked in towards their chest, and support the entirety of their body with the carrier material.
- What is “Physiological Flexion”? It is referring to the position your baby assumes via reflex. So, when you lift the baby up in the air, if their knees tuck up towards the face and the spine assumes a C curve, this is physiological flexion. This is most common during periods of birth to 4 weeks old. Be sure that babies’ airways are open, and breathing is easy in this position.
- Feet should be free of fabric restrictions. Let those piggy toes out and about! This ensures that the feet are unweighted to prevent premature weight bearing on baby’s legs. This also help support proper hip development.
- Support the spine. Fabric should completely cover the baby’s back to ensure proper support for the spine curvatures.
#3 What will promote good body mechanics?
AGAIN, this is a trick question, because the answer is YOUR strength, and existing posture is what will promote good body mechanics. But… there are a few things to look for in my professional opinion.
First off, what are body mechanics?
“Body mechanics” is a term used to describe how a body is moved during daily activities. This encompasses movements from walking, lifting, bending, and yes, carrying! Engaging in “good” body mechanics is when you move your body in a supported and safe fashion.
To create a safe and supported foundation, you need adequate strength to accomplish tasks. So when I say that it’s your strength and posture that promotes quality and pain free use of any baby-wearing device, it’s because you’re the one carrying the baby’s weight! The device is used to help evenly distribute the baby’s weight along your body, it’s not doing the work for you. If your core strength is decreased, or if your posture is already less than ideal (which lets face it whose isn’t), back pain can occur.
In addition, engage in some simple core strengthening and postural support exercises. If you need extra help with this, reach out to a physical therapist!
An amazing opportunity to learn and practice these basics is by checking out our Baby and Me Workout Class! Join our mailing list or follow ups on IG (@practicallyperfect.pt)!
Here are some things to look for in a device to enable your body to carry that baby to the best of your ability!
-Choose a device where the baby can be held at the center of your body, as opposed to off to one side. Placing a baby on one hip creates an unequal distribution of weight, causing half of your body to do more work than the other. Operating like this for prolonged periods of time can cause muscle imbalances, which can lead to postural changes and potentially pain.
-Choose a device that is adjustable to your body type. Picking a device that is easily adjustable is important to ensure that it fits you properly. If you cannot adjust the width or height of a device, this may promote poor posture while wearing.
-Choose a device that spreads weight evenly along a wide surface of your body. These devices may wrap around the entirety of your torso/back or have multiple straps, as opposed to a single strap or sling style.
At the end of the day, baby wearing is meant to be comfortable, safe, and mutually desirable. Don’t force a product or positioning on yourself or your baby. If either of you are uncomfortable, be sure that the fit and position is correct, and then slowly work your way up to increased wear time. Start with just 5-10 minutes, and then work your way up to longer periods of time if desired!
