Baby carriers may be used for short-term purposes during transport or occasional parental activities. It is the opinion of the International Hip Dysplasia Institute that periodic short-term use of a baby carrier is unlikely to have any effect on hip development.
In contrast, there is evidence that carrying a baby on the mother’s body (or father’s body) is likely to influence hip development during the first six months of life when the baby is carried for many hours each day for purposes of bonding or infant care.
The purpose of this educational statement is to provide information about healthy hip development to guide manufacturers in the development of optimum designs for infant equipment, so parents can make appropriate choices about the devices they use for their babies. Parents and caregivers are encouraged to choose a baby carrier that allows healthy hip positioning, in addition to other safety considerations. When babies are carried, especially for prolonged periods of time, the hips should be allowed to spread apart with the thighs supported, and the hips bent.
Babywearing can be beneficial for both baby and parent, but as with other baby products, it’s important to use baby carriers with safety in mind.
Whether you’ve already started babywearing or you’re an expectant parent and only think about buying a baby carrier, here you will find all information on how to make babywearing a safe activity for the baby and you.
As you may have already known, babywearing can be very useful. It’s practical if you have more than one child, it helps parents to take care of household chores when you need to prepare a meal, as well as for going out on your own for example to the mall or getting through crowded places like the airport.
Moreover, using a baby carrier may soothe a fussy newborn or help the baby with reflux. When you’re carrying the baby on your front, he feels the movement of your body, of your belly – which works kind of like a massage for his belly. It may help with colic.
Newborn baby remembers your moves, your heartbeat from the time when he was in your womb. That’s why babywearing can be very soothing for the infant – he can feel similar to the way he felt in your womb during these 9 magical months. It also helps to regulate a newborn’s body temperature.
And of course, babywearing also has emotional benefits, both for the baby and caregiver – it gives a sense of closeness, security and love.
All of that sounds inviting, but if you want babywearing to be favourable for you and your baby, it requires a bit of knowledge and practice. Only when you’re familiar with baby carriers safety rules, babywearing can be beneficial, comfortable and enjoyable for you and your little one.
My Baby Nursery has the biggest range of the best baby clothing. Check it out here.
Baby Slings Throughout History
Baby carriers have been around for thousands of years. Prior to the early 1900s, parents worldwide used a variety of long cloths, shawls, scarves and even bedsheets to snuggle up to their babies and get the chores done. Baby-wearing wasn’t something “special” or different, as it is perceived today in the Western world; it was a necessity. Mum had to work incredibly hard and didn’t have time to stop and entertain the baby, so the baby just came along for the ride. Even today, many traditional types of carrier are still used in developing countries. However, this is usually restricted to indigenous communities where baby-wearing is normal, a necessity and a way of life.
In his book, The Artificial Ape, British pre-historian Timothy Taylor, from Bradford University, claims that increased brain size was made possible by the invention of the baby sling. He says the baby sling was a development that enabled slower growing, physically and mentally immature offspring to survive and flourish. In other words, he determines that the task of building a large brain retards physical growth.
Before the invention of the baby sling, dated by Dr Taylor to at least 2.2 million years ago, when human ancestor head size suddenly began to increase, physically mature infants were more likely to survive because caring for slower-developing, immature babies was difficult, uneconomic and often dangerous. Mothers holding their infants were more vulnerable to attack from predators or other humans than those using baby slings.
Baby Carrier Dangers
Putting a Baby in a “C-Shape”
The first consideration for proper fit, per Raspa, is to ensure the child isn’t forced chin-to-chest, which doesn’t allow him or her to straighten out. In such a position, there’s a risk of cutting off the airway. “Anything that would keep the baby from breathing,” he says, should be avoided. When carrying, notice any squirming while visually assessing for your child changing colours. Both, he says, are clear warning signs. You want your child to have room to lengthen.
Strapping a Baby in Too Tightly
While your child can be forced into a position where he or she can’t breathe, being held too tightly to you can also pose risks. Once you’ve ensured that your child isn’t forced into a C-shape, check to see that he or she isn’t being forced into your chest or back, which can also pose a risk for suffocation. The same warning signs from the previous point apply.
Not Accounting For Temperature
When the summer sun is out, provided you’ve got a well-fitting sling, your baby should be fine: Babies can raise their core body temperatures quite a bit. A degree or two is not an issue. Of course, freedom of movement and a clear airway is key. However, if a baby is sweating excessively or turning red, it’s time to remove your child and get him or her into the shade to cool down.
Letting Baby’s Legs Hang Straight
We want the baby’s hips to stay in a position up close to their bellies in a ‘W’ kind of situation, referencing the natural splay open from the groin when a child’s knees are drawn up. While it may seem counterintuitive, you actually want the child’s butt pulled toward the belly, with the legs bent and naturally falling open. If his or her legs hang straight down, your child is at risk for hip dysplasia, which is a deforming of the socket joint, to which those less than six months are especially prone. Find a carrier with a wide base or ensure your wrap sits wide over the bottom and extends to the backs of the knees.
Hip Dysplasia: a “silent Condition” That Can Be Missed
One of the problems underlying the conflicting baby carrier messages is that while pediatricians catch about 95% of hip dysplasia in infants, “there are definitely some who slip through the safety net of examination.
IDHI describes hip dysplasia as a “silent condition” because babies aren’t in pain and can usually still learn to walk. What we may never know is whether the hip problems went undetected or whether the condition developed after birth.
Signs of hip dysplasia may include: asymmetrical buttock creases, audible hip clicks or pops during a hip examination (though snapping sounds can be normal), limited range of motion when spreading hips, swayback, and exaggerated waddling limp or leg length discrepancy while learning to walk. Parents with questions should consult their doctor.
If hip dysplasia treatment is delayed beyond two years of age, it’s more likely to lead to pain, waddling, and decreased strength. If left completely untreated, osteoarthritis and other hip deformities can occur in young adulthood.
One in 100 infants is treated for hip dysplasia, while one in ten is born with hip instability. Hip instability in infants, for the most part, tends to resolve spontaneously without any dysplasia. Females make up 80% of hip dysplasia cases, and infants are 12 times more likely to have the condition when there is a family history of the condition.
Carrying Baby Properly: Tips for Preventing Non-Congenital (after Birth) Hip Dysplasia
Outside the womb, an infant’s risk of developing hip dysplasia or dislocation is highest during the first few months after birth when an infants’ joints stretch out naturally. Breech babies (born bottom first) may need even more time. Natural stretching that occurs during birth can cause the “ball” of the ball and socket hip joint to be loose. If infants’ hips are forced into a straight, stretched out position, the ball can deform the edges of the socket or slip out of the socket, causing hip dysplasia, according to IHDI.
And that’s where proper and improper baby carrying practices come into play.
“If your kid has healthy hips, it’s not an issue, referring to short-term (up to 2 hours) carrying practices. “It’s just that we don’t (always) know if they have healthy hips or not.”
However, carrying an infant improperly — with straight, tight legs — for hours on end daily is “definitely detrimental to hip, adding that when the Navajo nation tightly swaddled their infants on papoose boards, they had a 30% incidence of hip dysplasia.
The best position for infants’ hips involves the hips spreading naturally apart, to each side of a baby carrier or caregiver’s body, with hips and knees bent as the thighs are supported. Hips should move freely, as opposed to forcing them together.
IDHI encourages caregivers to choose baby carriers that accommodate healthy hip positioning. It has found these products to be “hip-healthy.”
Healthy hip habits are similar to other healthy habits of exercise, proper nutrition and adequate rest. These are goals that we hope to achieve, but we shouldn’t be too hard on ourselves if we don’t achieve them all the time, every day.
Healthy and Unhealthy Hip Positioning
According to Price, the natural position for the baby’s hips is the ‘M’ position, and carrying infants inward-facing toward the caregiver’s face for six months is best, as opposed to outward-facing away from the caregiver’s face.
As far as placing the baby somewhere in between the “M” shape and straight legs, Price said that researchers don’t know much about the safety of these intermediate positions.
If your baby has risk factors, is loose-jointed or was in a breech position or if the family has risk factors, then there may be a good reason to be a little more cautious when carrying.
My Baby Nursery has a wide range of the best baby prams for you to choose from.
Basic Safety Rules for Babywearing
Whether you want to carry your baby in a wrap, ring slings, mei-tai, soft structured carrier or other types, there are few basic rules that you need to follow.
There is the TICKS Rule for Safe Babywearing checklist, prepared by The British Association of Babywearing Instructors. It makes it easier to remember the safety rules.
TICKS Rules should be followed regardless of the type of the carrier and baby’s age.
There is also an ABC checklist made by Babywearing International. On their website, you can read more about safety rules and see useful pictures on how to position the child in a carrier.
A – AIRWAY – Check the baby in the carrier often and monitor the baby’s breathing. Make sure the baby’s airway is always open. It’s most easy to do when the baby is in an upright position. Baby’s chin should be off the chest (there should be enough space for one or even two fingers under the baby’s chin). Baby’s nose and mouth cannot be blocked by anything; the air should circulate around the baby’s face easily. You should always be able to see the baby’s face. Moreover, the baby’s head should be close to your chin so you could kiss it just by tipping your head forward.
B – BODY POSITIONING – The carrier should provide appropriate support for the baby’s neck and back. Ideally, the baby’s knees should be higher than the bottom, and the legs should be in spread-squat position (M-like shape), and the carrier should prevent the baby from slumping. Thighs and bum should bear a baby’s weight. It is recommended to carry infants in a vertical position. If you want to nurse the baby in a carrier, try the cradle or horizontal position but return to the vertical position as soon as you have finished breastfeeding. If the carrier allows the baby to rest in a natural, ergonomic position, it is also more comfortable for the wearer.
C – COMFORT – Don’t forget that the carrier should feel comfortable for you and the baby. If you’re not confident about your carrier, you should keep a spotter nearby, in case you need some help.
Moreover, regardless of the type of baby carrier you’re using, check it frequently for any damages or signs of wear like worn fabrics or loose stitching, which may decrease its safety quality. If you notice such things, consider contacting the manufacturer.
Suppose you’re a babywearing-beginner practice using and adjusting the carrier with a spotter or at least over a bed/couch until you feel confident about it. It’s important especially with wraps that require learning how to make a secure tie, as well as using a baby carrier on your back.
Ergonomic Position: Frog Position
Lots of parents often ask: “Are baby carriers safe for baby hips?” The answer is actually quite simple: if you carry the baby in the proper position, it supports good hip development or even may prevent the baby from hip dysplasia and dislocation.
Now you may ask what the proper, safe position for the infant in a baby carrier is. The position of the baby’s hip in a healthy way to promote natural hip development.
According to the International Hip Dysplasia Institute, the healthiest position for the baby in a carrier during the first few months is the position called frog position, spread-squat position, straddle position or jockey position (they are all the same, these are just different names).
In this position, the baby’s hips naturally fall or spread apart to the side, the hips and knees are bent, and the thighs are supported. Hips movement is not blocked. Moreover, hips should not be forced together. Such a position encourages normal hip development. You should use this position when you carry the baby (whether in a baby carrier or your arms), especially during the first six months of the baby’s life.
The newborn’s legs should be in an M-like position. They can be inside the carrier or outside but always supported from knee to knee, with knees higher than a bum. The arms should also be inside the carrier, but as the baby gains neck control, you can put the arms out.
Also, the infant back should be naturally rounded. Don’t use a carrier that forces the baby to straighten his spine too early. As the baby grows, his neck control develops, and his spine strengthens naturally (usually between 6 and 12 months).
It’s important to check if the back panel is at an appropriate height and gives proper support, according to the baby’s age.
If the baby carrier is used properly, the newborn baby should maintain a natural, safety position:
- Hips and knees bent
- Knees higher than the bottom or at least at the hip level (M-liked shape, bent at 110°-120° angle)
- The straddle should be at about 60° and gradually should increase up to 90° as the baby grows
- Baby’s feet rotated to the outside
- C-shaped spine (baby’s back is naturally rounded after birth) and baby’s head supported by wearer’s chest – Thanks to that weight of baby’s head doesn’t burden his spine, and each vertebra is protected, and the wrap/sling/carrier well supports the whole spine
Never position the infant into an artificially upright position and don’t force his spine, hips, and knees to straighten too early.
Some types of baby carriers and other equipment may interfere with healthy hip positioning. Such devices include but are not limited to baby carriers, slings and wraps. These devices could inadvertently place hips in an unhealthy position, especially when used for extended periods of time. Any device that restrains a baby’s legs in an unhealthy position should be considered a potential risk for abnormal hip development. It is also important to assess the size of the baby and match the device and carrier to the size of the child so that the hips can be in a healthy position during transport.
Parents are advised to research the general safety and risks of any device they wish to use. When in doubt, we recommend involving your primary health-care provider in any further decision-making that may be medically relevant. Looking for the best tables and chairs for baby playroom? Look no further. My Baby Nursery has you covered.