Choosing a sling

How to Choose a Sling

I have met thousands of parents over the years, wanting help with choosing a sling. It’s fantastic to support them in their desire to carry their child close, with all the great things this will bring the whole family. For many, they can feel utterly overwhelmed by the huge range of options on offer (see here for a quick introduction to carrying, and here for a quick overview of the major types of sling).

Very often, they will ask me what I would recommend.. and this is a very hard question to answer, one that I usually respond to with more questions! Everyone’s choice of carrier is unique for themselves; and their initial choice will often change as they try things out.


Initially, when it comes to choosing a sling,

many people will look for a carrier that isn’t especially expensive, to see “if they get on with carrying.” Others will pick something that has been marketed by a mass-manufacturer in mainstream stores or at trade shows as being the best option available, or will choose something for the specific features listed, such as the ability to carry a baby in multiple positions, or being described as “the best”. Some may have been given carriers by their friends from several years ago (often hardly used “as it just didn’t work for us”), or bagged some ultra-cheap ones on Ebay.

This can sometimes lead to problems, as such carriers may not have been specifically designed to work with parent and child anatomy and can thus often be uncomfortable after only a short time. They may be worn too loose or baby may be too low, causing back pain from the strain of the carrying or the hunching that can ensue (as well as potentially posing an airway risk). This can lead to a belief that that baby is too heavy or that the parent isn’t strong enough (neither is usually true!) and carrying journeys come to a premature end. At this point, those who want to make carrying work for them will often look for support from someone like me to find something that works. Of course, some parents will come straight to us right at the start!

A good carrier should be comfortable for both baby and parent. It should support baby safely, protecting their airway and allowing easy breathing, in just the same way as when you hold them upright on your chest in your arms.

A good carrier should hold baby in the anatomically appropriate spread-squat position that respects infant and child spine physiology. Carrying in this fashion is usually much more comfortable and allows longer duration of sling use than in-arms or in a poorly fitting carrier. (Do remember to build up your carrying muscles day by day. It is exercise and gets easier with repetition, just like training for a race.)


People end up choosing their main carrier for many different reasons – and each individual will have different priorities, which will lead to their own personal choice. When I am asked what I would recommend myself, I often describe a bar chart like the one below, which shows just how variable things can be, and what suits me won’t suit them. Some people will prioritise comfort and longevity over pricing and simplicity; some value customisability and appearance more than pricing or resale value, everyone is different. People may end up choosing alternative carriers that they had originally envisaged, based on their “list of requirements”, due to how the sling feels for baby and parent when it is fitted.


This is why one “size does not fit all” and why many of us in the sling world use an analogy of shoe fitting, jeans or wedding dresses when it comes to trying a carrier. Everyone ends up with something difference. Cheap shoes bought over the internet often don’t fit your feet and can cause blisters. Jimmy Choos, Louboutins or Doc Martens really do not work for everyone, however desirable or pretty or cool they may be. What works for your friend, or for a large number of enthusiastic sling owners on the internet, or an experienced sling professional may not work for you. Current trends or famous brands don’t equate to an instant “perfect fit” and no one carrier can claim to be “the ultimate” or “the best.”

Trying a few things out before you commit yourself to a purchase that can feel expensive is very useful, and it is often worth spending more on a good quality carrier that fits you well, to ensure you and your baby are both comfortable and that it will last for some time. Many people find, however, once they have the right sling, it gets used daily, and the cost per use per day comes down to pence. Don’t be tempted to buy an extremely cheap carrier that may well be a fake (Ergobaby is the best known carrier to have been counterfeited) – always ask for proof of purchase from an authorised retailer when buying second hand. Your child’s safety isn’t worth the risk. Buyer beware!


Once you’ve recognised the benefits of carrying as comfortably as possible, how do you begin to choose?

I highly recommend visiting your local sling library to try out several options; there will be someone there with training and experience to help you navigate the choices. Some people will have a “shopping list” of requirements for their ideal carrier, based on what they have read online or been advocated by a friend or an internet group. Of course, such recommendations can be helpful, but a one-size-fits-all approach rarely works in practice. Every baby-parent dyad is unique, with their own personal stories that influence how they stand, how they carry, how they prefer to be held, for example, and particular features that seemed desirable on paper may not feel quite right in person. If you think your other half is likely to carry too, do bring them along to try things themselves; it is very hard to guess what will work.

For example, some people will love the feel of thicker, more padded waistbands, while others will find them bulky and restrictive. Some will prefer straps that cross over, others find this can ride up to the neck. Some find rucksack style straps hard to do up. Some inserts are simple to use, others more complex, many don’t like inserts at all. Some people find meh dais and woven wraps more comfortable than carriers. It is generally a good idea to have an open mind; you may be surprised to find some things work much better than you had imagined, while others just don’t feel quite right.

Bulky carriers may not necessarily equal greater support or comfort for everyone, and too much bulk can be unhelpful for some. Knowing how to achieve good positioning and how high and tight to have a carrier are very effective tools for successfully distributing weight comfortably.

A good sling librarian or peer supporter will be able to show you how to position your child, as well as tips and tricks that can make things much easier (such as how to put on fiddly straps, or how to make sure your stretchy wrap is tight enough, or how to ensure your ring sling feels secure). Sling libraries are fantastic resources.

Choosing a sling

It is worth being aware that knowledge about sling safety and best practice positioning is improving all the time. Older carriers and older brands may have instructions that are no longer part of current safety guidelines; feeding and sleeping positions in slings are often out of date. Do check with your local sling professional if you have any concerns at all, they will be only too pleased to support you and your child.

Your sling should bring you and your child great enjoyment and should not cause you pain or be uncomfortable. Furthermore, as a family’s familiarity with slings grows and as their baby gets bigger, their choices can change. They may move from things that are especially designed for small babies, or carriers that are as simple as can be, on to things that they find increasingly versatile and comfortable. Babies may wish to change how they are carried, desiring greater visibility, for example. Each parent may have different shapes too, and families may decide to have different carriers for different situations (eg a simple buckled carrier for use on a school run or on a muddy day, or a woven wrap for a long sleep-inducing walk, for example). There are no “perfect” answers, but options that end up being the best choice for the circumstances.


sling safety matters sling safely

Sling Safety Matters - How to Use a Sling Safely

Sling safety matters. Carrying our children in a sling safely can be one of the most precious experiences we ever have as parents or caregivers. There really is something very special about the bond that builds from keeping your child close.

However fantastic it may be, it must be done safely, for your baby’s health and your own. As parents of small babies and bigger ones, one of our greatest priorities is to keep our children safe. A good, correctly fitting sling can be a very helpful tool for this; keeping a child safe while daily life continues.


Sling use for very young babies (birth to four months)

This is becoming increasingly popular around the more developed world; a practice that has in fact been universal for thousands of years. Families that live in extended communities or “villages” are usually able to share well-honed, tried and tested knowledge down the generations and provide easily accessible advice and support. This kind of local support is much harder to come by in our more fragmented societies, which means we often turn to books or the internet to fill the gaps in our knowledge and provide us with reassurance we are doing it right. Unfortunately, sometimes these sources of information are out-of-date, incorrect or even dangerous, and can lead to problems with the use of any kind of baby equipment. Manufacturer instructions can be slow to be updated with new “best-practice” guidelines and YouTube videos not made by professionals can often be misleading and miss out important information.

Many carriers on the market hold babies very low down and loose, which will allow young bodies with little muscle tone (especially during sleep) to slump and end up with nose and mouth pressed against fabric. They often talk about “head support” but use rigid high backed panels that tip baby’s large head and chin forwards onto their chest. This is not wise or responsible.

Very few manufacturers advise about monitoring baby’s temperature in baby carriers; which is important, as overheating is risky.


Why bother with a sling at all if there are any risks?

There are many benefits to using a sling with a very young baby; in fact. many hospitals use them in the practice known as “Kangaroo Care”, and there is much evidence to suggest this skin to skin contact between mother and newborn (especially premature babies) can confer great benefits to both.

The baby gains assistance with their physiological regulation of breathing and heart rates, temperature control is improved, and the contact helps to establish breastfeeding and promote more rapid growth compared to babies who are not held as close for as long. Furthermore, the baby will feel more secure in their developing relationship with his caregiver, due to the time spent in close contact.

The caregiver may find that he/she is able to bond with her baby, due to the increased release of oxytocin, and post-natal depression may be reduced. Being able to be “hands-free” can really make a difference to a family’s ability to get around with their new baby, keeping them active and engaging with normal life.

The key is to know how to use the sling in a safe and secure way, just as you may practise learning to ride a bicycle, or drive a car. Familiarity and practice make perfect. All baby equipment should be used safely, and it is an unfortunate fact that sometimes things are not fit for purpose, or the instructions that come with equipment are inadequate. Babies should be able to breathe easily, be at a comfortable temperature, and held in positions that are healthy and beneficial for them.


How can I ensure I am using my sling safely?

A good sling should mimic the natural, in-arms upright position for carrying babies, ensuring the caregiver can see and sense the baby at all times, and thus able to be quickly aware of and rapidly responsive to any changes.

I see a lot of parents with newborn babies wanting to learn how to use a sling, and the photos and the position diagrams here are the first thing we look at.

in arms M and J shape

Babies grow in tucked positions, and after birth, they tend to maintain this gentle curve to their spines for several months due their lack of muscle tone or strength to their head and neck and upper torso. It is not till they are older that they have the strength to hold their spine in a straightened posture. It is not till they can crawl and stand and are  beginning to walk that their muscles and ligaments hold the spine in the more adult S shape. While babies are young, holding them in their naturally adopted tucked positions is both comfortable for them and also more comfortable for you. As they grow and begin to develop their strength and clinging ability, their needs will change.

Young babies who are seated in the “squat” position or the M shape (looks like a J shape from the side) will have a broader, more stable base to rest on than a narrow perch. This position, with the curve mainly at the base also helps to keep the chest flat against the parent’s body and thus in an expanded position for good airflow.

babywearing safety
10 FAQs

Babies under 3 to 4 months are most at risk of airway compromise when chin can sink onto their chests; so a good carrier will hold baby’s chest snugly against yours to keep the chest cavity uncurled and the chin off the chest. It is important to ensure no slumping and that there is no fabric over the face and there is a good air supply. Babies have a disproportionately large occiput (the back of the skull) and a short neck, along with lower muscle strength and co-ordination compared to adults. Rigid surfaces behind the back of their heads tend to push the skull forwards so chin sinks onto chest and can obstruct airway. This is is why upper back and neck support (no further up than the earlobes) is so important, rather than using headrests which can be risky.

Stabilising a child’s body with a broad base and good upper back and neck support is key in the early months.

This also applies to car seat usage; rigid shells with a hard back holding babies at 40 degree angles can also push a baby’s chin onto their chest and is why it is not recommended for newborns to sleep for long periods in car seats.

Babies should be dressed appropriately to ensure they do not get too warm; people are often surprised how quickly everyone can warm up when in close contact. Please do not use thick, furry or padded snowsuits and dress down. You can always add more layers over the top.

Respectful, anatomically appropriate positioning


ABC is the basic first-aid mnemonic, which can be adapted for safe sling use.

AIRWAY is vital. Babies’ heads are heavy and it takes time for their muscle strength and tone to develop enough to hold up their heads and support their own airways; until then, it is our job as parents to be as caring and careful as we can. A baby’s head should be resting against the caregiver’s chest, with the windpipe straight, not curled over. A good guide is at least two fingers being able to fit between baby’s chin and his chest. Air should be able to circulate freely and the face should not be obscured by fabric, or buried within cleavage. Baby’s cheek can rest against parent’s chest, and hands should be accessible to the mouth for sucking if needed (and not trapped down the side of the sling)

BODY POSITION is important to protect the airway as well. The upper body should be supported against parent’s chest, to ensure no slumping (this is why carriers should be tight, to make sure that babies do not roll up into a ball). The pelvic tuck into the M shape with knees higher than bottom will help support baby’s back as well as being very comfortable. The neck should be supported where possible to avoid backwards lolling but the back of the head should never be tilted forwards (see the image above – babies have a larger occiput, shorter neck and less-strong neck muscles than adults). The pelvic tilt and using a rolled muslin cushion (to rest below the earlobes) can be helpful if babies resist head support. See the diagrams above for the correct shaping.

COMFORT comes last – I would rather see a child in an uncomfortable carrier that was safe, than fast asleep slumped into a tight ball or folded over in a cradle carry, however comfortable it is. However, you and your child are likely to enjoy and appreciate a carrier that is pleasant to use, fits well and does not cause back pain. Here is some advice about how to choose a carrier. Comfort also covers the baby’s temperature; too hot is a problem, so please layer your baby carefully and do not over-dress them.

In summary, the safest position is an upright one that meets the TICKS guidelines – Tight, In View, Close enough to Kiss, Keep Chin off the Chest, Supported Back.

from Babywearing International
from www. babyslingsafety.co.uk

I would never recommend any kind of lying- down position in a carrier, especially where the back of the head is bent forwards to compress the airway and a child is thus not able move its head freely to clear any blockage. Bag slings, ill-fitting pouch slings and other slings used badly can be risky.

Breastfeeding is usually safest done in upright positions for this reason, and a child who falls asleep feeding in a sling should always, always be brought back into this safe upright position, to protect the airway. Babies should never be left to sleep in a cradled position inside a sling; this can be dangerous.

sling safety matters sling safely

What about older babies beyond the early weeks and months when they are developing more control over their bodies?

As babies grow, their needs and abilities change. A baby who can maintain their own airway independently will expect more freedom and will show you this with wriggling and turning. Their wild jerky movements are how they practice muscle control and learn coordination. Movement is important, babies should be given the opportunity to explore their bodies whenever possible. Parents and carers will need to find a happy balance between the need for safe and comfortable transportation, a place to sleep or feed, and their baby’s need to move. It’s worth being aware that prolonged, unchanged positioning isn’t good for anyone and even adults are being encouraged to move every 45 minutes. Children’s bodies are still growing!

Try to change positions, try in arms carrying, swap with other carers, use a buggy, to give children a variety of experiences and positions.

Top Tips

Position matters

  • Your child must be able to breathe safely in the sling. Their chin should not be touching their chest (a good guide is a space two finger-widths or more) or lolling back too far. (Try it yourself! Can you swallow your saliva with your chin too close to your chest or lolling all the way back?)
  • To ensure no slumping, position your child correctly against your body, chest well against yours, and bring the carrier over your baby as you hold them. This video will help you to ensure no slump.
  • A child whose bottom and legs are well supported from knee to knee in a “spread squat” or “M position” is in a more stable position and will be less likely to fold up or slump over.

Know your sling and know your baby

  • Always familiarise yourself with your carrier before you use it for the first time. Ensure you have a good idea how to use it. Some people like to practice with a teddy bear near a bed and with a mirror to see what is happening.
  • Always check your carrier before use for any wear and tear, that all component parts are present and fit for purpose (eg is the chest belt in place? Are any buckles in the right places and not broken, are the seams are intact?)
  • Check your baby is willing to be carried. The only “unsafe” carry is one with an unwilling baby. If baby seems unkeen, can you establish why? For example, is he hungry? Is she wet or dirty? Does he have reflux or does he find certain positions uncomfortable? Does she want to do something else? Is he too hot or cold? Is she in pain? If he or she cries in a sling, read here about some of the many other reasons a baby may express distress.

Dress appropriately

  • Ensure appropriate clothing – the sling may add additional warmth, so layering is a good idea.
  • In cold weather there is a temptation to wrap up extra warm but this needs to be done with care. Too-warm babies are less likely to wake if their breathing slows. Don't be tempted to over-dress!! You can always add more layers over the top if babies really are cold.
  • Many people find baby leggings, gloves on strings, well fitting hats and tie-on warm booties to be especially helpful in the chill. Thin layering is key.
  • Read more about the risks of snowsuits here.
  • Don’t forget to ensure your baby doesn’t get too hot in the summer; protect your baby from sunburn and to keep well hydrated in warm weather.
  • An useful tip, if you dress your baby in a bodysuit with feet, is to choose a larger size than for ordinary wear, as the fabric will ride up a little with the sling and may squash tiny toes.

Keeping Safe in the ColdKeeping Safe in the Sun

Be alert at all times

  • It is important to be aware of your child at all times; if you feel something is different, check! Some people like to carry a small pocket mirror so they can check on children riding on the back.
  • It is wise to consider what physical activity you wish to do while babywearing; will it hinder your awareness of your child in the sling or hamper your ability to deal with any problems? Your baby will be at a height in the sling and may be able to reach for unexpected items – awareness and attention is vital.
  • Be very cautious when engaging in any form of exercise or dance with your baby in the carrier; many manufacturers do not recommend this, and there are risks with young babies and untrained class leaders. Read more about slings and exercise here.
  • Your sling is NOT a substitute for a car seat, and you should not sleep while carrying your baby.
  • Do not carry your baby facing out in a carrier before 3-4months, and avoid letting them sleep facing out. Be responsive to their needs and turn them back to face you when showing signs of weariness. Choose a carrier that will be comfortable for their spines.


Get help and support

There are many, many sling communities in the UK, sling consultants like myself who offer one to one sessions where you can look through the options and practice using a carrier safely, sling libraries with trained peer supporters where you can try out slings and get some advice, and sociable sling meets that will serve a “village” purpose for parents to share their growing knowledge/personal journeys and offer support. Don’t rely on books/pamphlets/the internet – be armed with education and take advantage of the experience you will find in your local resources.
If you are unsure, do find your local sling professional at the Sling Pages – we are always happy to help.


Breast and Bottle Feeding Safely in a Sling

Carrying babies is a wonderful way to encourage successful and more long-lasting breastfeeding, as the frequent skin to skin contact and the building of loving relationships help to stimulate oxytocin release.

Oxytocin release (which stimulates let-down) becomes conditioned to the mother’s experience and emotions; the touch, sight, smell or cry of her baby, as well as thoughts of her baby and the natural rhythm and expectation that baby will be hungry soon.

A sling that allows ease of access to the breast encourages responsive feeding, helping the harmonious nurturing relationship to flourish.

Mothers can go about their daily tasks or care for older children while their child’s need for nurture and nourishment can continue uninterrupted. This is normal human behaviour.

If the mother is in distress, unwell, or struggling with postnatal depression or anxiety, her feelings will inhibit oxytocin release and have an impact on breastfeeding. Close physical contact with her child as well as effective emotional support can help a feeding relationship to recover.

A comfortable baby carrier can thus be an excellent solution for a breastfeeding mother and baby who have had a complex start. This can be especially valuable after a difficult labour and birth or a prolonged separation for medical reasons.

The carrier can help create a safe space for the dyad, keeping them close together, allowing them to heal each other, encouraging the hormones of love and bonding to flow. This has a positive impact on breastfeeding.

If breastfeeding comes to an end, the baby carrier can preserve the growing relationship by keeping mother and baby in close contact and help it to continue to blossom.

 

There is always more of a risk to safety when combining breastfeeding with babywearing and it must be done well. Here’s my guide to safe breast and bottle feeding in a sling!

I meet a lot of pregnant ladies in the course of my varied roles, and many new mums, and one of the questions I am most frequently asked is “Will I be able to feed my baby in a sling?”

It’s an important question to deal with, as it crops up so regularly, and for some, is one of the criteria for choosing the right sling for their needs. The simplest answer is that, “Yes, many parents are able to feed their babies in slings, from the breast or from the bottle.”

But this then leads to other vital questions…

1. “Why might you want to be able to feed in a sling?”

2. “How can you keep your baby safe while feeding?”

3. “How can you make feeding in a sling as easy as possible?”

4. “What slings can be helpful for feeding?”


1) Why might you want to feed in a sling?

Most commonly, mums of more than one child find being able to feed the baby on the go very useful. This is especially so if they are feeding responsively, as recommended by the WHO, and have an older child who needs their parent just as much. Quite often, they will have had some experience of breast or bottle feeding already, and may be very familiar with their sling, and will be “old hands” at combining the two skills.

Mums of older children who can feed quickly in a sitting upright position may also find a sling an invaluable and very convenient tool for getting on with daily life.

For mums of small babies, it may be that the sling will be useful to carry their child to a place where they can be taken out to feed in peace and comfort. For others, being able to have baby partly supported with the sling and with one arm may allow a “third hand” to work on achieving latch, and can prove very useful for facilitating feeding. For others and once feeding is established, it can allow some simple multi-tasking rather than being pinned to the sofa.

On the whole, it may help to consider each element as a separate skill to master – how to feed, and how to use the sling, and learn how to combine them safely, however, for some, the sling can actually be an aid to achieving latch. Practice will, of course, be needed, like with every new accomplishment!

2) How can you keep your baby safe while feeding?

All the basic rules of sling safety apply when carrying a baby. The TICKS guidelines and the ABC reminders are below. However, there are different considerations needed with feeding in slings (as baby may not be close enough to kiss, for example). As always, protecting the airway and ensuring breathing is unobstructed is of paramount importance.

Babies, on the whole, are obligate nasal breathers. This means that they find it much easier to breathe through their noses than their mouths, for the first few months of life, and it is essential that noses are kept clear of any obstruction. This is why babies may struggle more than older children with mild respiratory infections affecting the small nasal passages. It is also why they are able to feed for prolonged periods of time without needing to delatch for mouth breathing, and why babies with snuffly noses find it harder to feed.

Therefore, while a baby’s mouth is engaged with the process of sucking and swallowing, his only patent airway is his nose. It is important for the carer to be consciously aware of any potential obstruction, either external (from sling fabric, or breast tissue, or clothing ) or internal (neck bent over too far) and able to rectify it rapidly when required.

how do i keep my baby safe in the sling
from www. babyslingsafety.co.uk
from Babywearing International

Whether feeding upright, or slightly reclined, the safest positions are…

  • those in which the parent is actively engaged and frequently checking on their child, and able to recognise any changes

  • those that ensure a good air supply at all times with no fabric over the head and chin off the chest (check you can fit two fingers underneath if you are unsure)

  • those in which baby’s head is aligned with their spine and only turned slightly to one side if needed

  • those in which baby’s back and occiput (lower part of the back of the head) are appropriately supported

  • those in which baby’s knees are above the bottom and hips are flexed (bent upwards)

  • those that ensure that a baby who has finished feeding or has fallen asleep is returned to the most optimal upright position to keep airway supported and open.

The choice of best position will vary from person to person, depending on the individual circumstances, however, the majority of successful “on-the-go” feeding is done in the upright position.

In my opinion, the greatest risk comes from breastfeeding in positions where baby is held face inwards towards the breast, with sling fabric pulled up over the back of the head, so the face is pressed firmly into breast tissue or the child is curled over into a ball.

Please note this dangerous position is not the same typical gentle reclining in-arms “cradle” positions where the head is well supported in the crook of the elbow and the chin is not on the chest. This is the most common breastfeeding position, with a sling adding a little support, almost like a cushion or a hammock, to take some of the weight off the supporting arm and give you one hand free.

What should a feeding carry look like?

Baby’s head should be completely free of fabric, being supported by the sling up to the nape of the neck, able to latch and delatch as needed. Their lower body should be well supported from knee to knee, either by wrap fabric well and snugly tucked up between your bodies, or a well tied/securely buckled waistband. Both of baby’s arms should be positioned around the feeding breast or bottle, just as if in arms, and the head should not be at an awkward angle.  Feet should be free of fabric and baby should be comfortable and easily able to reach the nipple. If baby is able to achieve a good latch from this position, he/she should be able to feed if ready. Some practice may be needed for both of you!

Feeding in slings is more risky if you have a snuffly baby who is needing to delatch frequently for some mouth breathing, and finds herself unable to do so as her head is not free to pull backwards for a little extra air.

Babies should never be left to sleep in feeding positions as their disproportionally heavy heads can too easily droop or be folded over, with subsequent obstruction of their airways.

**Please remember that loosened slings with longer tails can present a trip hazard if you are feeding on the move.**

 

In general, it can help to think of the sling as a third hand to help support baby in position while you work on achieving a latch. Many people manage to feed happily and safely in slings, once they are armed with good information, and know what to watch out for. It usually works best with older children, too. If you feel unsure about feeding your child in your carrier, do get in touch with a professional who can give you some one-to-one help and advice.

A hip carry may work well (with a wrap/ring sling/cross strap buckle carrier/meh dai).


3) How can you make feeding in a sling as easy as possible?

For breastfeeding, think about ensuring easy access for your baby. Your choice of clothes can make things a lot easier. Loose fronted tops that can be easily moved out of the way, pulled down or lifted up, or those that open and close with zips or poppers, rather than buttons can help. Many mums swear by a combination of a loose shirt that can be lifted up/pulled down with a stretchy camisole or vest underneath that can be lifted up/pulled down. Such layering often provides good cover, if required. Bras that are easy to undo one handed (while your other hand supports baby”s head) are also helpful. Some mums find latching on more successful if they lean forwards slightly to bring the breast up to baby’s mouth, and many need to hold their breast up with one hand for the duration of the feed. Hoods can help with providing some discreet coverage, but remember that temperatures inside slings rise quickly if air cannot circulate freely, and carbon dioxide levels in rebreathed air are raised.

4) What kind of slings are good for breastfeeding in?

It is usually possible to feed a baby in most slings, with a bit of care. I don’t think there is really any such thing as hands-free feeding, as one hand or arm should always be on your baby to provide support, especially before they have excellent head control. But one hand free is better than none! Breast size, shape, flexibiliity and nipple position varies from woman to woman, and from stage to stage in the breastfeeding journey, so each dyad will need practice to work out which height works best for them. Larger breasts may prove more tricky for some.

Please remember that baby’s back and occiput should be well supported with no curling over and his chin should not be resting on his own chest, and once finished feeding, baby will need to be returned to his previous snug, upright and close position, by adjusting the sling appropriately.


Feeding in Stretchy Wraps

There are many different ways to feed in a stretchy wrap. Some methods are safer than others. On the whole, stretchy wraps are mostly used with small babies in the classic upright “hug hold” also known as the “pocket wrap cross carry”. It is these young babies from birth to four months who have the greatest risk of airway obstruction, so it is worth visiting your local babywearing consultant to get some advice and support if you can. I can’t stress enough how important it is to ensure your baby’s back and head is well supported, but still able to move freely to create an effective latch (and delatch), and that baby’s face is visible, not covered with fabric and their nose is clear. Once the feed is over, baby MUST be returned to the previous snug, close, upright seated squat position. There should NEVER be any fabric behind the back of baby’s head.

The video shows how to use a stretchy as a breastfeeding aid. You can see how baby is in the classic tummy to mummy position as the fabric is removed.

I usually advise parents to see their stretchy wrap as a breastfeeding aid. It can add a layer of extra support and spread some of the weight to the non cradling shoulder, and allow a short period of moving around while their child is feeding. It is not hands-free.


Feeding in ring slings

Ring Slings and upright feeding

From a good seated squat position, the pouch can be gently and slowly loosened by lifting the uppermost ring up carefully, so that baby is lowered slightly down your body. Ensure that the loosening is equal across the width of the sling so that baby’s upright seated squat position is maintained. Bring your child to the breast up so he is able to latch on without twisting his neck.

  • Bottle feeders may not need to lower their baby as much, but some loosening will help to ensure baby does not have to twist his head to the side too much for teat access.

 

.

Ring Slings and slightly reclined feeding

From the snug seated squat position, loosen the fabric slowly and carefully to lower baby just a little.  Lean forwards slightly and support baby’s upper body with one hand. Gently recline your baby into the waiting crook of your arm as you bring his far leg around to your front so both legs are together. Ensure the pouch of fabric is well tucked up between your baby’s side and your tummy so he is resting as if in a hammock, slightly turned towards you, bent knees above bottom, feet outside the carrier, with his head and neck resting on your arm. Adjust his location in this position so his mouth is able to reach your nipple – it should look and feel just as if you were holding him in your arms to feed. Keep the top rail of fabric under baby’s neck, do not pull it over his head.

  • Bottle feeding is similar, but baby’s head will be facing the ceiling.


Feeding in Woven Wraps

Woven wraps and upright feeding

Carries such as the Front Wrap Cross Carry and its variants can be easily adjusted for feeding. The knot at the back (or side) can be loosened just a little, with the resulting small amount of slack worked equally and evenly back along the fabric so baby is sitting in a lower pouch with mouth above nipple, but still snug and supported, and in the spread squat position. The whole carry can be moved slightly across to one side or the other, and the baby can then be brought to to the breast. It is easy to switch sides.

Hip carries (especially those with slip knots) are easy to feed from one side.

Bottle feeding is similar, but baby may not need to be lowered quite as much, and may need a little more space at the top edge for the bottle to be accessible without baby’s head having to turn too far.

feeding with a bottle in a woven wrap

Woven Wraps and slightly reclined feeding

This works best with carries that do not have cross passes under baby’s legs, so baby can be gently tilted to one side to rest on your feeding arm. The FWCC can be partially untied so the long tails are hanging down over the shoulders and baby is sitting just in the horizontal pass. He can then be carefully gathered to one side with his far leg brought round to the front, his body turned to face the parent, bent knees above bottom, feet out and head and neck resting on your arm. Adjust his location in this position so his mouth is able to reach your nipple – it should look and feel just as if you were holding him in your arms to feed. Keep the top rail of fabric under baby’s neck, do not pull it over his head. The long tails are usually best left loose as retying them will mean you are not in control of baby’s head during the process.

  • Bottle feeding is similar, but baby’s head will be facing the ceiling.



Feeding in soft structured carriers

Soft structured carriers (mei tais, half buckles, full buckles) and upright feeding

This can work well for bigger babies who have some head control. Baby should be in the carrier at the height she would normally be carried, with back and legs comfy in the seated squat position. To feed, slightly loosen the waistband gently and lower it a couple of inches and retighten, then loosen the side buckles or ties one by one to lower baby to the required position. One side may need to be loosened more than the other as baby feeds from that side. The breast can then be brought to the mouth. It is usually easy to switch sides with the straps being adjusted each time to allow baby to move. Baby’s back and occiput should be well supported with no curling over and his chin should not be resting on his own chest.

  • Bottle feeding is similar, but baby may not need to be lowered quite as much, and may need a little more space at the top edge for the bottle to be accessible without baby’s head having to turn too far.

Once finished feeding, baby will need to be returned to the previous snug, upright and close position, by adjusting the sling appropriately.

breastfeeding in a Mamaruga Zensling

So in summary.. “Can I feed my child in my sling?” The answer is a resounding YES YOU CAN, from newborn to toddler, in lots of positions, from breast and from bottle. The key to doing it well is to ask questions about how to do it safely and empower yourself with knowledge to make a choice about how you wish to feed and then practice. It’s all about the AIRWAY! Do ask your local sling professional for some support…. – and enjoy!

 

Some further reading;

Seven Reasons Why Carrying is Great for Breastfeeding Mothers (Jess Hippey for Oscha Slings)


carrying in the heat

Summer Slings and Keeping Safe in The Sun - Carrying in the Heat

Summer slings and keeping safe while carrying in the heat is a hot topic among regular sling users. Carrying in warm weather can be hot and bothersome!

“Can I carry my baby in this heat? We are getting way too hot with our sling!” is a question I am asked many times in the few warmer months we get in the UK. Babies are warm little creatures, and in the summer humidity, they can feel like hot-water bottles on your chest. Many parents worry and stop using their slings in the summer as they don’t enjoy the sweatiness and stickiness that can come with hot-weather babywearing, and then miss the closeness. Sometimes children insist on being carried, so you get hot anyway, or pushchairs aren’t an option.. so what is a parent to do?

First of all, don’t worry. You won’t overheat your baby by carrying him.  Women have been carrying in the heat for generations, in far hotter climes than the UK, they carry their children daily and come to no harm. The body is able to thermoregulate appropriately. However, there are a few things you can do to make the experience more pleasant for you both.

carrying in the heat, summer babywearing

1) You and your baby need to be safe in the increased temperatures.

  • Keep well hydrated. Baby needs to replace all the fluid she is sweating out – don’t underestimate her need to drink or breastfeed in warm weather. Take frequent breaks from your summer activity to check on your child and allow this re-hydration. Breastfeeding mums will need to increase their own fluid intake to compensate for the higher milk demand (breast milk becomes more watery and thirst-quenching in hot weather, amazing!) and everyone will need to drink more. Exclusively breastfed babies can get all their fluid requirements by frequent feeding and are unlikely to need any other fluids if they are feeding well. Bottle fed babies may well need some cool boiled water in addition to their formula. Sweating actually helps to cool the body down, by using the heat beneath the skin to evaporate the moisture. The better hydrated you are, the easier it will be to provide sweat. Adults are better able to thermoregulate than small children, so you can actually help to cool your hot child down by skin to skin.
  • Think about the clothing you’re both wearing. Layers of clothes trap air, and therefore can keep heat in in cold weather.. so in hot weather, wear less layers on yourself, and reduce your child’s clothing too. Natural fabrics tend to be cooler – pure cotton, linen, bamboo allow breathability more than man-made fabrics and tend to cause less stickiness. The sling counts as layers of clothing, so take that into account.
  • Protect your child from sunburn and windburn. Muslins can be draped over exposed legs or heads – but they are very thin and babies may still burn through them if not careful. UV protection covers from Snooze Shade can help for buggies. Hoods can be a mixed blessing in hot weather, as they can trap warm air when closed, thus increasing the temperature inside the carrier and reducing the flow of air around. A light, tie-on broad brimmed hat with neck coverage is often a better option. Clothing can help – lightweight long sleeves can add protection. Some slings provide mechanical protection from the sun, and some have UV protection features as well. Suncreams are an important part of caring for your child’s health (especially if they fall asleep and you are distracted.) Please check your sun cream is appropriate for your baby’s age and skin. Parasols can provide some shade.
  • Cooling aids can be helpful. Some people will place a cool, damp muslin between their bare skin and baby’s, for coolness (others will use dry muslins to wick away sweat). Handheld fans can be very useful to blow cool air around. Sometimes people will use cool-packs to lay against skin every now and again, for brief periods. (I think this is safer than using freezer blocks in carrier pockets next to baby skin. Frozen peas against an ankle begin to hurt after a few moments, and babies may not be able to communicate the source of their discomfort well enough.) Splashing cool water can provide some relief… and regular breaks from the sling in the shade should be part and parcel of ensuring everyone is comfortable.
  • Choose the time of day you use your carrier and consider other means of transport.  It may be useful to just use your carrier in the cool of the morning or for evening strolls rather than carrying in the heat of the midday sun. Parasols may offer some shade as you walk along. Some parents and children may dislike the sweatiness that comes from close contact in slings and may therefore feel cooler with in arms carrying, or in a pushchair. If you use a buggy do make sure that the seat itself isn’t hot from the sun and that you allow plenty of fresh air inside the chair as temperatures can rise very quickly indeed. The sun cover may indeed keep the sun off but can also trap heat and carbon dioxide due to the reduced air circulation, which can be dangerous for children. The Snooze Shade offers a safe way to protect babies in buggies

Such measures may go a long way to making you and your baby feel a lot happier in the sling that you have.

hot weather babywearing and feeding
carrying in the heat warm weather
carrying in the heat

2) Use your current carrier in a way that is more appropriate in hot weather

Please note that each suggestion may not work for every situation. If you are unsure and would appreciate some more help, do get in touch with your local sling consultant/library for some support! The Sling Pages has a comprehensive list of such resources.

Stretchy Wraps

  • When stretchy wraps are used with the classic pre-tied Pocket Wrap Cross Carry, it is best to have three layers across baby. This is because the elastic nature of the sling does not provide enough support with only one layer, and two cross layers can be easily divided by a baby pushing away or arching backwards. If you want to use your pre-tied stretchy in the PWCC or a hybrid stretchy carrier with just two layers, ensure the cross passes are well distributed from knee pit to knee pit and up to the neck on both sides, be well aware of the risks and be vigilant of your baby’s movements, especially if you are likely to be distracted.
  • You could try using a thin gauze scarf in place of the third layer of hybrid stretchy carriers.
  • Front double hammock carries and hip carries (two-layers) are an option. They can be harder to master.
  • Seated sideways carries may reduce the body surface contact.
  • If you are using an old-style stretchy wrap folded in half (six layers), try using it unfolded (three layers).

Woven Wraps

  • Try single layer front carries to reduce the number of layers over baby, such as a kangaroo carry which can have open sides.
  • Try hip carries to reduce the amount of fabric around your body.
  • Try high back carries (this may reduce surface area contact).

Ring Slings/Mesh slings

  • These are often cool anyway. Try a seated sideways position to reduce the amount of surface contact.
  • Try a back carry or a torso carry which may feel cooler.
  • Fold the shoulder fabric that is cupping your shoulder over itself a little to reduce the coverage across your upper back. Flipped shoulders can also help with this.

Meh Dais/Half Buckles

  • Try using your meh dai with the passes unspread across baby’s back (ensure the bunched up passes are not too tight and rubbing into his knee pits) to allow some airflow at the sides.
  • Try a hip or back carry.

Buckle Carriers

  • Try a hip carry, if your carrier has this functionality.
  • Try a back carry if your baby is able to sit unaided (enough upper body strength).

carrying in the heat
carrying in the heat

3) Try a carrier that is more suited to the weather

Your local Sling Library may have a few options you can try out for carrying in the heat – it is always worth investigating to see what works for you and your baby comfort-wise. Sometimes hiring for a holiday may be cheaper than buying a new sling!

Stretchy Wraps

There are several lighter weight stretchy wraps available which will feel cooler than the heavier, thicker brands. Bamboo is breathable and cooler, and look at how thick the fabric is before you buy. Stretchies are wonderful for little babies but need a minimum of two, ideally three layers. Some hybrid carriers have mesh panels which can reduce warmth.

Woven Wraps

Lightweight wraps (usually those with a lower density (the g/m2) are cooler and lighter than thicker and heavier ones) can be very useful. Gauze wraps are thin and cool and good with smaller children. Thin cotton wraps are also an option – but may not be as sturdy for bigger children. There are many supportive, lightweight , breathable cotton wraps around and some brands make special lightweight cotton blends with special fibre types for strength (eg “ice cotton”).

ice cotton wrap

 

There are thick and thin versions of almost every combined blend of woven wrap available,  so it is worth doing some research into the thickness and density. Traditionally, linen, hemp and silk are used to add strength and sturdiness to the softness of cotton, and can be lovely lightweight toddlerworthy wraps, but some blends can be thick and warm. 100% linens are often cool and supportive, and loose weaves can be airier than dense ones. Some people find merino blend wraps cool in warm weather, as the breathable wool wicks moisture to the surface to be carried away.

Learning how to use a shorter wrap may be another way of reducing the amount of fabric wrapped around your body.

There are a few mesh wraps around, such as the Fil’Up, which can be very cool to use.

Ring Slings/Mesh Slings

Ring slings or mesh slings like the MiniSling are a great option in warmer weather, as they can be quick to take on and off and only cover half of your body. They are single layer slings, too. Again, like any woven wrap , the fabric involved can make a difference to its warmth. Lightweight muslin ring slings, 100% linens or thin but strong cotton/blends  are a good option here.  Be cautious about buying thin ring slings from eBay or from non-recognised retailers. There are mesh water ring slings which can be useful in the water, but can also be a little sweaty in dry, hot conditions due to the fabric used. Simple pouches can be a good option as well, if used safely in an upright position, and there are several mesh carrying aids like the Suppori and the Tonga which can help take some of your child’s weight and remain cool. Carrying aids are not hands free, however.

Meh Dais/Half Buckles

Sometimes these can feel warm, if there are multiple layers of fabric in the panel or if the fabric used is thick and dense. Sometimes lighter weight meh dais/half buckles can work well, tied in ways that allow airflow at the sides or with straps not spread across the whole of the parent’s back.

Buckle Carriers

Some buckle carriers are designed for hot weather use, either in the lightness of the fabric they use, the lack of padding, or their design (mesh panels etc). Some people will find rucksack style carriers less warm than cross strap carriers, as there is less padding across the back (when used in front carries). Solarweave fabric is useful and some carriers make a feature of their UV resistant fabric too. Some carriers have lightweight mesh panels or less padded straps, or thin waterproof fabric . Those with thick padded waists may feel just as hot to wear as their standard counterparts.

     

In summary, yes you can carry your baby in hot weather, there are many things you can do to make it more enjoyable for both of you. Be mindful of your baby’s comfort and be careful of both your needs, and you won’t go far wrong!


fuss about facing out

The Fuss about Facing Out

family in spain sunnyOne of the most common “controversies” in the babywearing world is the “fuss about facing out” that is, the issue of babies being carried in facing out positions. This means babies being held with their backs to their carer, facing the world, rather than facing the person who is carrying them. Opinions vary widely among manufacturers and parents and even among professionals. Many babies do very much enjoy being held in positions where they can see the world, so why all the fuss? Is there any need for a fuss at all?

What are the advantages of world-facing?

Babies do enjoy seeing the world, especially once they are a little older and have mastered head control and wish to be more involved with their environment, rather than sleeping or snuggling in as they did when they were very little. Curiosity often coincides with increased motor co-ordination and greater periods of awake and interaction time. This is often the point at which families begin holding their babies in positions that give them greater visibility. Instinctively, they tend to support their little ones in very gentle positions that still ensure good hip and spine support; cradled in arms with chin off chest, or held in semi-seated positions with back curved against parent but hips held in flexion, as if sitting in a bowl.
These positions protect the natural anatomical curve of the immature spine and do not straighten it uncomfortably.

As babies grow, their muscle strength increases and fatiguability decreases, alongside greater coordination and gross motor skills. This allows slowly improving head and neck and upper back control (with less drooping or wild flailing) as their spines gradually begin to uncurl. Furthermore, as their focal length improves and visual acuity rises, the world becomes very interesting! There are stages in baby development when babies seem to arch away in arms a lot; this may be related to a desire to see more, but may also simply be attempts to hone upper back strength, in preparation for turning skills and rolling over. This is very common around ten to twelve weeks. Babies may also arch when they are tired, if they have reflux, if they are frustrated.

In-arms holding is responsive, which is the key issue; if baby makes a protesting movement or noise, the carer responds and moves the baby to help it to become calm again. Also, parental arms get tired and baby is easily moved to another position, this may often be on the shoulder facing parent again for a while. Such reactive carrying in-arms, with changing facing-in and facing-out positions, is of great benefit for honing development and also to encourage learning about the world from a safe and comfortable position.

This all sounds great, so what’s the problem with using a sling for this?

What are the hazards of facing out?

It is important to remember that young babies are not ready for prolonged and intense interaction with a very sensory-overloading environment; they have not yet learned how to process the bombardment of information their brains are receiving. They have not yet discovered how to “filter out” the irrelevant for a more focused look at the world, (a skill that we take for granted) so this can be very tiring. Being able to turn away from the noise and bustle and fall asleep (to process information) is important. A facing-out carrier holds a baby in a fixed position for a prolonged period of time. The duration of this time is entirely dependent on the parent; they are unable to see their baby’s face to pick up early cues of tiredness or distress or breathing difficulties, and they are less able to feel subtle shifts in baby’s body signalling discomfort or a need to change positions. Babies can easily be left in carriers for much longer than they would be held in arms.

Babies are intensely social creatures and learn to regulate and control their emotions from interaction with their parents and watching their faces. Social referencing (also known as triangulation) is very important in the first year and well into the second. A child will often decide how to react to a new experience after it has looked to its carer; it will be less likely to touch something dangerous if the carer reacts in an upset way. Potentially scary experiences can defused by turning the head to see a parent remaining calm, or to receive comfort and reassurance, and vice versa. In a structured carrier worn facing out, it isn’t as easy for a baby to twist around to see the parent’s face for reassurance or to be able to seek comfort.

Many pushchair makers now include parent-facing positions as standard, as this is believed to encourage and improve language skills and bonding. (It is worth noting that there is no formal evidence to suggest that our children are any slower at language acquisition than previous generations who did not use facing-out means of transport, however, anything that promotes bonding and communication is to be encouraged.)Sleeping

Furthermore, the world-facing positions do not provide any safe sleeping positions (all respected manufacturers say babies must be turned around to sleep; this is often missed in the small print) as there is no head support in this carry. A heavy head that is unsupported by a parent’s chest will droop forwards, putting baby’s chest under slight compression and pressing the chin downwards, potentially compromising the airway.

This is why the majority of respected sling manufacturers suggest that babies under 4months should not be carried facing out. Before this, babies simply are not developmentally ready.  Beyond this age, they should not be held in carriers facing the world for longer than twenty minutes to half an hour or so. (Some manufacturers say facing out from 3 months up, some say from 5months up). I think it depends on the child’s personal developmental stage and there should really be no rush.)

There is also the issue of hip and spine positioning in facing out positions. Most facing out in slings is done with “narrow-based” carriers, as very few high street options offer wider, more ergonomic seats that protect the gentle curve of the spine and promote healthy hip development in the world facing position. Most babies find their backs are held in straighter positions than ideal, with their legs hanging straight down from their hip sockets in this narrow shaping. While there is no formal evidence that choosing a narrow-based carrier will cause any harm to a baby who has healthy hips with normal sockets, there is a small percentage of babies who do have developmental hip dysplasia that are missed at their routine checks. These babies will benefit enormously from the ergonomic seated M shape position that allows their joints to be held in the optimum angles for healthy blood vessel growth and nutrient provision, and often this positioning is all that is needed to correct mild cases of hip dysplasia. It is worth weighing up the risks and may be better to choose a carrier that holds a baby more optimally if you decide to face baby out. Additionally, it is more comfortable for a person to be seated on a broad based hammock shaped chair rather than perched astride a narrow padded beam, and babies are no different.

Print

Carrying a baby who is sitting high up against the carer’s body with the centres of gravity closely aligned is much more comfortable than carrying one who is low down, far away, and suspended from the carer’s shoulders. The parent’s body does not form part of the support structure of the carry when facing out, so much of the work of carrying has to be done by the upper body, rather than the core postural muscles. Centres of gravity diverge further when held facing out in narrow based carriers. Put simply, carrying facing out in this style of carrier is often uncomfortable.

Ok, so what can I use to carry my curious child optimally?

It is common among parents who are considering using a sling to look for options that offer world-facing positions. This position is what is often seen in the media and is widely advertised; it may be more pleasing to see happy babies looking directly at the camera rather than away from it, which can be better for marketing purposes. As it is so visible, it becomes the “norm” and carriers that offer this option are often perceived as “better.” 

Pao

Many parents believe that babies need to be given the opportunity to face the world as much as possible for the stimulation, rather than looking at their parent all the time. Sometimes this belief can be be a marker for low self-esteem in a parent; that they just aren’t interesting enough, when in fact, for many well-attached babies, their parent is their most beloved sight. This is especially true if parent and baby are attuned and the parent is responsive and communicative and able to engage happily in play with their baby. Babies are often able to pick up on unhappy or uneasy feelings in parents and can be reflexively resistant to close contact, creating a negative spiral. Lots of in-arms carrying, skin to skin, and just time spent together can be very helpful with this.

Sometimes babies may begin to resist being carried in their parent-facing positions – they may have come to associate the sling with sleeping which they don’t want to do, and they may want to be able to see more. 

JUNOlo-16
To achieve a good view while the child remains parent-facing, and ensure access to the world, try carriers with broadly angled straps that don’t get too close to the face can be very useful, or ones that can be tied carefully for good visibility. As children grow in co-ordination, they need less head support and often enjoy having their arms out of carriers (with the panel reaching up to the armpits for safety and support.) It is surprising how far a child can turn round to see when they can move their shoulders! 
JUNOlo-38Hip carriers and ring slings will hold a child “off-centre” or laterally on the hip, for a great vantage point, and they will still be able to turn towards their parent for conversation or rest. Back carrying can be another very useful way for a curious child to see the world coming towards them. Most structured carrier makers will suggest sitting-up age to be the most appropriate time to begin to think of this option, and it is not hard to do on your own. Your local sling library or consultant (www.slingpages.co.uk) will be able to help you learn.

If you have a baby who is developmentally ready for facing out in a carrier and has stable hips, then I think it is just fine to give it a go! Your local sling library will be able to show you some options and talk you through which may be the most comfortable for you. Trying the carrier out first for a period of time at home is very useful to see if it really does work for you before you buy; advice from the internet is no substitute for real life trials.This period of “fussiness” doesn’t usually last long, as babies grow in co-ordination they are happier and many babies who once resisted facing in are very content a few months later in a carrier that is more comfortable with greater longevity.

In summary, facing out can be a great deal of fun for parent and child, if done sensitively and thoughtfully, with consideration to the child’s anatomical development and comfort; look for those carriers that take your baby’s comfort as seriously as yours. Try to pick a carrier that will hold baby optimally for most of the time, some come with specially designed bucket seats and others will widen for facing in and back carrying.

Age-appropriate facing out for those who enjoy it is great, when done safely! Your local sling library can be found at www.slingpages.co.uk.

 

ten FAQs FFO
ring sling

Carrying while Pregnant

Is carrying while pregnant safe? Many mothers wonder if they can safely continue to carry their children while pregnant with a new baby. For many, having established a close bond and finding the carrier they use of great value for comfort and practicality, they are keen to carry on carrying, both to meet their child’s needs for contact and for their own enjoyment.pregnant connecta

“I knew that I needed to make the most of carrying my girl before her sibling was born as things were about to change for all of us. She needed me too, so I carried her as long as I could during my pregnancy. Her weight balanced out my bump and actually made my back pain more manageable by being corrective.” Jody

Other mothers may not have a choice, especially if there will be a small age gap between siblings and the older child is not yet walking reliably, or if he becomes worried by the impending changes to the family structure and needs extra closeness and reassurance. Sometimes it is just necessary.

“My little girl is very strong willed so if she wanted up for a carry while I was pregnant, it was simply the path of least resistance . There were a few times when she was poorly, others when she was tired or I simply had things to do. It was all about practicality and doing whatever made my day a bit easier.” Lindsay

It is worth reflecting on the fact that women around the world have, for many generations past, carried older children on their bodies while pregnant, so it is certainly possible to do. In societies where babywearing is a part of everyday life, child-carrying is traditionally shared around large families, with older siblings carrying younger ones, or close family members taking their turn, to lighten and distribute the load around the community. Women in more Westernised societies may feel much more isolated and unsupported by their local communities, so they may need to be able to carry their own children for longer periods and more often than in traditional societies.

Babywearing in pregnancy is indeed possible for the majority of women, if they are in good health and there is no medical reason to avoid lifting loads. Those who are already well used to carrying their toddler frequently will find it simple to continue; their body strength and tolerance has grown in pace with their child’s weight and little may need to change until the bump is large.

“We needed to walk the dog and I wanted to be able to go to the dog trials and carrying was much more convenient than a buggy. My body was used to carrying, so we just carried on!” Lucy

Those who are new to carrying (and looking for a solution for an uncertain or distressed older child) may find it more of a challenge, just as if they had a new job which required sudden frequent heavy lifting. In these circumstances, it would be wise to get some support from your local sling professionals to find out which slings will work best for you and be comfortable. They can help you learn how to get your bigger child up into a carrier safely without straining yourself, and be able to work with you to find solutions. Once equipped with an appropriate sling, it is wise to stick with carrying for short periods and gradually increase the duration of use. This all helps to build up endurance until pregnancy is well advanced.

big kid with bump

First Trimester

The maternal body undergoes several changes during pregnancy which can have an impact on the type of carrying women find comfortable.
In the first trimester, symptoms such as Photo by Alicia Petresc on Unsplashnausea or lower abdominal discomfort can have an effect on how much a woman feels able to carry; pressure around the stomach can feel intolerable. Fatigue and low back pain can take its toll as well, and changes in blood volume can cause lightheadedness or dizziness. Such symptoms may make carrying children uncomfortable or even inadvisable and medical advice should be sought. It is important for women to listen to what their bodies need and be responsive; changing which carrier they are using, changing position frequently, or even not carrying at all for a while. Medical advice should never be ignored.

All being well, however, most carriers can be used in early pregnancy; there is no need to fear that the growing baby will be squashed by waistbands, for example. On the whole, the carrier that has been used up until a mother discovered she was expecting again can continue to be used while baby’s body is still small and mostly contained within the pelvic brim. Front carries are still fine to use and hip and back carries are also appropriate.

This may be a good time to begin learning some new carries or investigating other slings in preparation for an enlarging bump. At this early stage, the toddler’s weight is still being distributed around the mother’s body and it is not resting on a bump, so there is time for both parties to begin initiating change whilst still being able to enjoy front carries.

If there is any discomfort from abdominal pressure, altering the type of carry can be very useful; front carries that don’t use a waistband could be considered, as could hip carries or back carries that avoid any central abdominal pressure. Meh Dais (and their variants) and woven wraps will offer high back carries in this circumstance, and can be tied in ways that have no knots around the middle at all (for example, “tying tibetan or candy cane”). A carrier with a waistband could be moved low down to settle around the hips (as long as the carried child remains snug and close enough to kiss with an uncompromised airway), or moved higher up nearer the ribs, whichever feels most comfortable.

Second Trimester

As a growing bump begins to have an impact on a mother’s shape, moving to hip or back carries may feel much more comfortable. Front carrying may become awkward as the child will be very high and it is best to avoid a heavy toddler’s weight sitting on top of a bump.

front carryHip carrying (with adjustable buckle carriers, meh dais, ring slings, other one shouldered carriers, or wraps) can become a fantastically useful option for many for quick up and downs; many parents carry toddlers loose in arms on their hips in daily life (usually with frequent changes of position and for short durations at a time). A sling may add a little bit of support if used well but it does not mimic in-arms carrying as most the weight of the child is now borne by a single shoulder rather than the spine and lower body. It is very common for people to find themselves mis-aligned with hip carries, leaning towards the side the child is sitting on, finding their shoulders and upper body rotated, and experiencing a lot of pulling strain on the ring-shoulder. Trying to fit a big toddler on the hip in a very lateral position (to avoid sitting on a bump) may also mean that shoulders are out of alignment with each other, as one shoulder has to be held behind the central plane to fit around the child’s body, putting a rotatory torsion on the spine.

Those who love ring slings and other hip carriers have often already learned how to minimise these alignment issues with familiarity and experience, and can always benefit from being reminded!

It is worth being aware that prolonged hip carrying in pregnancy may also have an impact on the pelvis and its stability, especially as ligaments begin to soften and loosen in preparation for birth. If you begin to experience any discomfort with carrying (if not related to inexperience) then it is sensible to check your posture to make sure your spine is not twisting, try frequent switching of sides, reduce the duration of carrying, and see your local specialist for support. Some women suffer from Symphysis Pubis Dysfunction and may find hip carrying inadvisable.

13627241_10100708599629694_3550257905670810259_nBack carrying is a good solution for many; there is more space on the back for a bigger child, enabling close contact without putting any pressure on the enlarging bump. The maternal body may be able to balance the front and back loads better with a more equal pull on the weightbearing axes from the two directions, however, as the load grows, the strain will increase and some women will choose to stop carrying sooner than others, or reduce the duration of sling use.  The carrier on the back should be used in such a way that the child is held snugly and as close as possible to the mother’s centre of gravity, and needs to fit well to help with weight distribution. The core muscles of the abdomen and lower back/buttocks as well as the joints of the spine and hips and knees are having to work harder than usual; any pain or soreness during carrying, or stiffness and aching afterwards should encourage a woman to assess whether it is appropriate to continue. Asking a sling and carrier consultant for help may be very useful; to assess if the type of carry is the best one, or if it is snug enough, or if an alternative carrier would be of benefit. 

Logistically, waistbands may begin to become difficult to fit above the bump and may no longer be as supportive due to the changing angle of the band and how it functions when distributing weight around the pelvis. It is up to the individual to decide when the waistband is no longer the best option. At this stage, carriers with floppy soft waistbands that will mould around the mother’s shape, or no waistband at all, may be more useful. Meh Dais with flexible waists that can be carefully tied, or podaegis or onbuhimos or woven wraps tied in such a way that the carry has  no waist at all may be very helpful.twin bumpThese wraparound carriers focus mainly on binding a child’s body as close to his mother’s as possible so that they share a space. These can be tied gently above bump, or spread around the chest and shoulders, taking the weight much more on the mother’s upper body.

candy cane chest belt to avoid tying round the middle

Learning how to do this well and comfortably may need practice and building-up of strength due to the new position and a local sling professional can help.

3rd triThird Trimester

In this last part of pregnancy, the maternal body is now carrying a significant extra load every day; movement may feel more cumbersome and the mother may wish not to carry any more than she has to. Furthermore, the levels of relaxin hormone increase significantly; ligaments and tendons soften and become more elastic. This helps the pelvic outlet to widen ready for delivery and also loosens and softens the intercostal muscles and ligaments between the ribs to allow expansion of the chest diameter for the growing baby. These changes will all affect load-bearing and every pregnant mother will vary in what she feels able to do; each successive pregnancy will also affect carrying ability.

kathy

In the third trimester, high, supportive back carries with soft slings tend to work best; woven wraps in multiple layer carries or supportive single layers are useful, as are meh dais and their variants, as well as the waistband less onbuhimos, all of which keep toddler weight high, snug and central, minimising any uneven pressure on the pelvis and spine, and also balancing out the weight of the bump. Carrying may be only for short periods, and hip carries are best kept to a minimum.

3rd tri

Once baby has been born, the maternal body will take some time to recover from the huge changes of preparing for labour; and then the process of labour and birth themselves. It may be some time before a mother feels well and strong enough to begin carrying her toddler again; the pelvic floor and stretched abdominal muscles need time to re-tone and strengthen. For this reason, many experienced professionals will advise post-partum women to consider carrying just their newborn for the first few weeks and months, and then begin to carry their toddler again in front carries before they consider re-starting back carrying. Methods for getting a heavy toddler on the back will need to be considered; swinging and scooting methods may place inappropriate strain on still-recovering ligaments and muscles. This will of course depend on individual circumstances; back carrying may be preferable to pushing heavy buggies. Tandem carries may be necessary from an early stage, and it would be wise to visit your local sling professional to get some support with carrying two children in this way if you are not experienced.



Carrying in the Postnatal Period

lindsay 10days

Is carrying in the postnatal period (in the early weeks after a baby is born) safe?

Babies want to be held close from the very moment they enter the outside world; they crave contact and many will spend their first few days and weeks sleeping in their parents’ arms and feeding frequently, enjoying this close interaction.

Pregnancy can be tiring and uncomfortable for many, due to our changing bodies and habits. We are no longer an upright species but a sedentary one, to our great anatomical and physiological disadvantages; chronic pain is a significant problem for increasing numbers of people in our society. Symphysis Pubis Dysfunction can be debilitating for pregnant women, and there is a growing belief that many women’s bodies are frequently not in the optimal condition to carry a child and thus take much longer to recover from pregnancy than our forebears. Ligament softening and laxity (from the hormonal changes preparing a body to deliver a fetus) can take some time to resolve fully especially if there has been pre-existing back pain and poor posture, and breastfeeding may prolong the effects of relaxin.

Labour, while exhilarating and empowering for some, can be exhausting for others, especially if prolonged. The recent historical practice of lying down for delivery is in marked contrast to how most women around the world across history and cultures have given birth (upright, squatting or kneeling). The natural birth movement and the emergence of doulas to support women with their delivery choices mirrors a growing desire to get back to our ancient human roots, which may also encourage speedier recovery from labour and birth.

Women are becoming prouder of their bodies and what they have achieved; bringing forth life. As a friend of mine once said, how can you ask a butterfly to return to being a caterpilllar? Women's bodies are designed to carry and nurture children before birth and after. Here is a photo of one mum carrying her newborn in the early days after birth, proudly showing her post-partum body. martha RS

The rate of caesarean sections (both planned and as emergency) is high in Western society, currently between 20-25% of births in the UK (with some regional variation). A caesarean section is major abdominal surgery and some recovery time from this is to be expected, and varies enormously from woman to woman, depending on the reasons for the operation. Women are advised to avoid heavy lifting, “carry nothing heavier than your baby”, and not to drive for at least six weeks after birth. Scars can be uncomfortable and slow to heal for some, and some may experience abdominal pain for a while afterwards. Babies may come early and be very frail for several weeks.

Therefore it is not surprising that many mothers worry that after labour and birth, they may not be strong or well enough to carry their newborns in their arms for prolonged periods. Many will have toddlers at home needing the reassurance of their mother’s loving arms to help them cope with the newcomer’s arrival. Paternity or parental leave is often short; in a few weeks mothers are often required to manage at home alone.

Carrying your child in the postnatal period is important.

The early weeks are vital for bonding and attachment, providing continuity and security, promoting breastfeeding and helping to reduce depression. So yes, we should carry our babies somehow after birth. This doesn’t need a sling; people can hold their babies while sitting down and while reclining just as much as while they stand and walk around; it is the closeness and the contact and the skin to skin that promotes bonding and oxytocin release that matters. It helps to shape baby's brain, and also has a positive effect on yours! Furthermore it can be a great way to ensure any older children still feel connected to you, as your hands are free.

 

Carrying a newborn baby can be very healing if birth has been traumatic or there has been previous bereavement.

“"I had a tiny baby (4lb5oz) and experienced a traumatic birth, I suffered with PTSD. At times this meant I was very anxious and wanted to keep my baby close to me to be sure she was safe. I started with a stretchy wrap when P was just 3weeks old. I truly believe babywearing strengthened my attachment with her and helped me to cope every day." Anon

There are some garments of clothing that can be worn in hospital or in the early weeks after birth; mimicking the practice of putting a tiny newborn down the front of the shirt. Some of these garments (known as skin to skin tops or kangaroo care clothing) are designed for keeping baby skin to skin to the parent while reclining, and are not hands-free.

carrying in the postnatal period
Others are a little more structured (at least two layers of stretchy fabric) and provide enough support for baby that a parent can be hands-free and walk around, similar to a stretchy wrap. These can be most useful in hospital environments for their coolness and simplicity. (in the UK the Vija Design range is the most commonly used).

Please note that if your baby is premature or very small (under 6lb) it is wise to seek the advice of a specialist baby-carrying consultant; many "newborn" carriers, including some stretchy wraps will not provide enough support without guidance on how to use for these babies with special needs.

Breast and bottle-feeding can cause back, neck and shoulder pains, as can prolonged periods of one-sided carrying (which can also affect the pelvic floor and the symphysis pubis.) Being alert to the body’s signals of discomfort and acting on them to frequently redistribute the strain is of great benefit in building up tolerance and strength.

As women recover their strength and are able to do more each day, their mobile carrying abilities will grow too.  As womens’ bodies settle back down after pregnancy, with appropriate pelvic floor toning and correction of posture and alignment, carrying will become easier. Furthermore, as baby gets bigger and heavier, the parent’s muscles will adapt to the gradually increasing weight and become more toned day by day, the more often they carry.

“Much of my pre-pregnancy life was spent in the mountains, and carrying my babies after their birth helped me get back in touch with my "home". It enabled me to very gradually and gently regain some fitness away from busy streets, and felt like less strain on the scar area than pushing a double buggy uphill.” Carissa

twin stretchies
Twins in a stretchy. Image shared with permission

Keeping a baby’s weight high, snug and central will encourage loading across the large weight-bearing axes of the body, thereby preventing strain on muscles, ligaments and the pelvic floor, and avoiding abdominal pressure. Lifting a baby to the chest should be done carefully, with knees bent and upright posture maintained, and pelvic floor and core muscles engaged and active. Most types of carriers will be possible to use after a vaginal birth, and it will be a very individual and personal choice which. On the whole, most babies enjoy the gentle all-around pressure of carriers that can mould softly around them and be reminiscent of the uterine walls they have just left; and carriers that distribute weight widely across the parent’s upper body will be more comfortable. 

If you have a sling that makes your back ache, please visit your local sling library or consultant for a fit check (often a few tweaks make all the difference) or to try an alternative. Cheaper carriers from supermarkets/Ebay often work much less well than better designed carriers and therefore last much longer. "My baby is too heavy for a sling" is usually an issue with the sling not fitting/not being well designed.

Carrying after a Caesarean

post CS
Leaving hospital with baby after a section. Image shared with permission
NICU
Skin to skin in the NICU. Image shared with permission

This is also very possible, and it could be argued, perhaps more important post section than after a normal non-instrumental vaginal delivery, depending on how the individual feels after the surgery. Achieving skin to skin as soon as possible is ideal,  for promoting oxytocin release and bonding.  This is vitally important after a section, especially if it was emergency and traumatic, thereby interrupting many of the biofeedback mechanisms around bonding. It is also important if the section was planned and baby was thus delivered before the biological hormone cascades of labour and birth were able to begin. There can be a strong tendency for women who did not have the birth experience they wished for to feel robbed and deprived of an important part of their baby’s arrival. The subsequent feelings of sadness and grief, or disappointment or that they have let themselves or their baby down somehow, however untrue, can significantly hamper the forming of attachment bonds and play a part in later postnatal depression or other mood disorders.

Mothers who experience this are very likely to find that skin to skin contact and frequent close touch and carrying extremely useful; the process of initiating and mantaining contact and loving touch often acts as a catalyst for the oxytocin release; this positive feedback mechanism will encourage loving feelings to develop despite the less than “perfect” start and get bonding well under way.

As soon as surgery is safely over and a well baby can be given to its mother, skin to skin can begin; resting on the mother’s chest under a blanket, inside a shirt or with kangaroo care clothing. Women are entitled to this skin to skin and should insist upon it; baby does not need to be washed or the cord to be cut before contact is achieved; the sooner the better.

Once mother is ready to move around and carry her child in her arms she can; she is advised to carry nothing heavier than her baby. Some women will choose to use slings immediately, if they feel ready (especially if they are already familiar with slings and feel confident with their use), others will wish to wait, especially if they feel unwell or are in pain. If the mother is confined to hospital and alone for parts of the day and wishes to move around, she may find the sling will help her to feel safer than carrying her baby loose in arms while she is still a little unsteady.

“Having a sling for carrying was very useful, as much easier and less painful than carrying in arms (less stress on abdominal muscles).  It was great for bonding, especially since we were having trouble with breastfeeding.” Rebecca

The key factor is to avoid any carrier from irritating the wound or putting pressure on the abdomen. Double layer kangaroo-care shirts or other soft carriers such as stretchy or woven wraps, high-carrying waistband-less meh dais or buckle-tais and ring slings in frontal tummy to tummy carries, may be options to consider. Baby’s legs should ideally be tucked into the M shape, and this will also help to avoid feet kicking against a still tender wound. As the scar and any abdominal pain heals, carriers with more structured waistbands will become more accessible.xmas connecta

General tips about post-partum carrying (including fitness classes)

Post CS connectasarah hatBaby carrying in the post-partum period is possible, if done in a mindful, responsive way, and can actually help promote recovery.  Holding a baby close in the anatomically correct position so that their weight is well distributed through the large weightbearing axes will tone muscles and improve posture more than pushing a pram with a strong forwards lean. Being able to go for gradually longer and longer walks with your baby in a soft and comfortable sling will rebuild strength and release endorphins which are natural feel-good hormones.
Participating in postnatal recovery programmes can be useful; however combining carrying and exercise/dance is usually best done with great caution as not every provider will have adequate knowledge about postnatal recovery (pelvic floor and diastasis recti issues) or about the rate and speed of each woman’s individual recovery from birth. Many may have no specialist knowledge about safe sling use or how to protect a baby from sudden shaking movements, as well as how to avoid overloading still-recovering tissues with certain stretching or weight-bearing activities with the extra load of a child in a sling. Walking with a baby in the sling, ensuring good alignment and posture, gradually increasing the speed and duration, is usually enough exercise for most women in the early months. Please do not rush; pelvic floor dysfunction is very very common (14 million women in the UK are known to have an issue, and many many more never seek help and remain undiagnosed). Leaking is NOT normal or to be expected. If you are unsure if your pelvic floor is recovering normally, please see your GP.

Read more about babywearing fitness classes here.

Using a sling allows families to settle back into the normal rhythms of daily life.

Often, older siblings are uncertain about the new addition to the family and uneasy about their place in it; they may need extra reassurance with the birth of a new baby. They may wish to return to their mother’s arms and be close to her body, for reassurance and reinforcing of the attachment bond.walk after birth

Toddler carrying after birth

“During the intense post-birth bonding period with D I began to use a couple of wraps that had been favourites of R (the new big brother). It almost felt like a betrayal! But one afternoon, R asked if he could come up for a front carry in his favourite wrap, something he hadn't done for ages, and we twirled round the lounge together laughing while my husband cuddled the new baby. I think that was a really healing moment for us and let my eldest know he still had an important place in my arms too.’  Emma

However, toddler carrying after birth is much more of a challenge, especially if the pelvic floor is weak and there is diastasis recti (separation of the abdominal muscles from the stretching during pregnancy). Please seek help if your floor or core are weak.

tandem Many specialists would suggest it is wise to wait until any pelvic floor/diastasis recti issues have resolved and the mother is functionally strong before beginning to carry toddlers again; this will of course vary widely from woman to woman. Generally those mothers who are well used to carrying toddlers will find it easier to resume carrying than those beginning for the first time, and front carrying may be the most suitable position (rather than hip or back carries, to avoid straining still-healing tissue). Sitting down cuddles may be wise for a while!

Involving the whole family!

The post-partum period may be a great opportunity for other caregivers in the family to share the carrying and begin the bonding process.  Whole families thrive when children are kept close; it spreads the load of child care around. Partners can carry their newborns, or their older children to provide reassurance.

“Carrying our eldest son (3) enabled my wife to give her attention to our new baby. It gave us much needed daddy and son bonding, at a time when he was feeling insecure with the arrival of the new baby.” Mal

Remember, it is the closeness and contact that matters; in arms carrying is as valuable as using a sling, and the shifting of your growing baby around your body as your muscles tire will help to rebuild your strength and endurance. Sharing the carrying with other members of your family will help to strengthen relationships and reduce the strain on your own body too.

family


Carry Me Daddy!

“Dear Daddy


When you hold me I feel happy. You are strong and I am safe in your arms. The more time I spend with you the more I trust you, and the more I can let you look after me when Mummy isn’t here.

I love to hear your breathing and the sound of your voice rolling around in your chest. I can hear your heart beating and it steadies me. I can hear you best when I am close to you. I love it when you look at me with your proud eyes, it makes me feel good. I feel loved.

I love being carried on your chest where we can chat till I am ready to snuggle contentedly to sleep.
I love my rides on your shoulders and on your back. The world is so interesting from up high!

I love the games we play and the way you make me laugh till I have no more breath in my body. I love it when you hold me on your lap to read to me. I love it when you hold my hand.

Carry me Daddy, while you still can!”

In-arms carrying and all other means of close and regular contact (such as noisy physical play) is of enormous value in building bonds between fathers and their children. 1 in 4 children lack strong attachment relationships, and slowly our society is recognising the need to address this. In arms carrying can be hard work, and a good comfortable baby or child carrier can make this much easier. Babywearing dads are becoming more and more visible, which is great news for families and for our society.

There can be a common myth that is only mothers who bond with their children in depth, and that the changes in her brain with parenthood are unique to her. This isn’t the case, fathers’ brains are also deeply affected by their caring role and they form strong, lifelong connections to their children if they are closely involved with their young baby as they grow. Bonding can be encouraged in many ways, not just though feeding the baby (which is another common myth). Babywearing is one tool for developing a deep relationship.

Here are some fathers talking about babywearing, what it means to them and why they do it!

Mohamed

Babywearing! How are you faring? Are they still staring? As a father of twins who liked getting things done, there was only so far my two hands could take me when I had two babies to hold. I was hesitant at the science behind stretchy slings when I was first told you could carry more than 1 baby in them, the picture shows how quickly that evaporated into pure elation and joy. "I've got my hands back!" I remember thinking. That was the start to an awesome journey where there was nowhere I couldn't go with the twins. Beyond the physical strength which babywearing gave, I feel like it helped me show my girls that no matter what, I was able to lift them and raise them above whatever it was they were facing and give them a different view while still supporting myself. Why are you fearing if all you are doing is baby wearing?


Read more


Perinatal mood disorders

Perinatal Mood Disorders and Carrying

The prevalence of Perinatal Mood Disorders (pre and post-natal depression, anxiety and post-traumatic stress disorder) is increasing in Western society as it is increasingly fractured and isolated, with a decreased sense of local community and shared care. The birth of a baby is often an overwhelming time for both parents, especially when also faced with the expectations and demands of a fast-paced culture that often judges people by their apparent productivity and appearance. As a GP, I see many families struggling with these conditions that are often diagnosed, and keeping babies close may play a part in surviving these illness, mainly due to the closeness with your child, rather than the choice of sling.

Postnatal depression is on the rise – affecting at least 10-15% of new mothers (with many more sufferers (and fathers) never being recognised to have the condition). Anxiety and PTSD are also worryingly common. Parents are encouraged to put their babies down as much as possible and regain their old lives; babies are expected to learn independence as quickly as possible and stop relying on their parents for their every need.

This approach to caring for children is very new in human history and runs counter to attachment theory, which suggests that the human infant thrives on responsive parenting and close contact.

Read about Ruth’s experience of antenatal depression here; for the rest of this post we will focus mainly on postnatal depression (PND).

What is Postnatal Depression?

Postnatal Depression is a depressive illness which affects between 10 to 15% of new mothers. Many more are never diagnosed with this condition, which can become a very significant issue in the functioning of a family. It is often poorly managed by health care providers, and can be misunderstood by the community and dismissed as “just the baby blues” or “tiredness.” It is common for sufferers to feel very alone and unable to explain just how they feel and why it is so difficult to endure. Prenatal depression is also experienced by many new parents, and postnatal anxiety and Post Traumatic Stress Disorder are also commonly experienced pre and postnatally.

Sad woman

Why is it so common?

Western society is increasingly fractured and isolated, with a decreased sense of local community and shared care. Depression is common in our culture, for reasons not clearly understood, but partly due to the way we live. The birth of a baby is often an overwhelming time for both parents, especially when also faced with the expectations and demands of a fast-paced culture that often judges people by their apparent productivity and appearance.

Before parenthood, people’s identities are often based on their roles and responsibilities in life; work, friendship circles, hobbies and interests. After a baby arrives, this often changes dramatically, sometimes in unexpected ways, and for many, the huge change in the pace of life and the loss of control can be very difficult to deal with. “The burden of conscious responsibility with no let up and the unusual and unexpected degree of fatigue can make a mother feel desperate about whether she can survive and how she will manage.” (Kennell & Klaus) This is the role that community used to play; supporting and carrying each other’s burdens as part of a committed and close-knit group of people who lived together, an experience that few parents enjoy in the West today.

What does it feel like?

Common words used to describe PND are guilt and inadequacy.

“The worst part was the guilt I felt about crying every day when I had a beautiful new daughter.”

“It isn’t about not loving your baby but about feeling overwhelmed with responsibility and unable to cope.”

“My head can feel empty and I have no thoughts.”

“It is just so hard to face another day of feeling totally unlike myself, missing my old life, unable to enjoy this new one.”

Fathers suffer from depression after birth too.

“The first few weeks were the hardest and I would just sit and cry. I felt like this shouldn’t happen to me, I should just be taking it on the chin and getting on with it. But the truth is, I felt alone and without the support of my wife, I would’ve been a lot worse.”

Many parents with PND feel a sense of dissociation and detachment from the child they want to love so much. 

“It isn’t about not loving your baby but about feeling overwhelmed with responsibility and unable to cope.”

Caring for people with PND is hard.

“PND is the scariest and loneliest place on the planet and puts a terrible strain on the whole family.”

“My husband felt helpless because he knew something was wrong but I wouldn’t admit it and shut him out. All he could do was try to look after me and be there when I finally admitted it. It caused a lot of irrational arguments.”

perinatal mood disorders
Perinatal mood disorders

What can I do?

If you are suffering, or think you may be suffering from perinatal mood disorders, first be reassured that you are not alone and the vast majority of people with it survive with few long-term ill effects.

Here are some suggestions that may help.

Get help where you are.

Tell your nearest and dearest how you really feel.

“I found the hardest bit was to admit that I wasn’t coping, even when it looked like I was, I was fine on the outside but was a complete mess on the inside.”

Many women testify how supportive their partners and families and close friends are once they understand – ask them to help with the basic jobs of daily life; cooking, cleaning etc. Help them to see how useful you will find it when they listen to you with acceptance and without judgement, and how their understanding when things go wrong is vital. Guilt is a large part of PND and many kind people may inadvertently add to this burden.

Get help from your local health care providers.

This may be your GP, your midwife, your health visitor, your local SureStart centre. The quality of care from these resources can vary enormously. It can help to write down on paper how you feel in advance and what you think you need (validation, formal counselling, CBT or medication, for example) and take it with you to appointments. Continuity of care is great, if available; a HCP who listens and cares can make a greater difference than one who fires questions and is keen to tick boxes and prescribe medication at once.

“Guilt and lack of confidence are so typical of PND and my HCP was essentially validating those feelings even though objectively I was doing a great job!”

Be armed with information (e.g. if you wish to carry breastfeeding, sertraline is safe in these circumstances). The Breastfeeding Network is a valuable resource. If you are not satisfied with the care you are receiving, find different care.

Get help from your local non-NHS resources.

These can be very useful, such as HomeStart (a befriending service) and local PND groups. A postnatal doula may help, and there are many national helplines and resources (see below)

Get help from online social resources.

There are many forums and parenting groups full of people who know how you feel, and will listen and share. Being among people with the same values and parenting beliefs may be a source of great encouragement. Equally, avoid too much time online.

Get out!

It can be very hard to actually get out of the house when struggling with dark thoughts or hopelessness, but it is worth the effort involved. Even a walk down the road is a good start, and encourages release of endorphins (the natural feel-good hormone). Arrange to meet some friends, and ask them to encourage you to come. Try to make a plan for most days, and be kind to yourself if you decide on a pyjama day instead. Try to arrange some time to spend alone with your other half, to remember who you still are, as well as parents.

Get nourishment.

Good quality food, drink, exercise and sleep are vital to your own health and sanity, as are times to enjoy the things you used to. Dress well in bright mood-enhancing colours. You are still a person and your own needs should be met as much as your child’s. Some people make use of night-time carers to allow some much-needed uninterrupted sleep.

Get past your birth story.

For many women, recovering from birth takes a while, especially if it was not the hoped-for experience. The NHS Afterthoughts service and counselling can help if you feel a sense of grief.

Get a sling or carrier.

Keeping your baby physically close is well known to stimulate the release of oxytocin. Oxytocin is a hormone that is closely related to bonding and attachment. It is released during labour and breastfeeding, and, crucially, during skin-to-skin contact and social interaction. It has an important role in encouraging nurturing feelings and a sense of belonging, and reduces anxiety and depression by affecting cortisol release.

Babies who are in close contact with their parents have been shown to have a corresponding higher level of oxytocin than their non-carried counterparts; which subsequently helps to reduce baby’s own stress levels and improve their sense of secure attachment; their needs are met at the point of request. Calmer babies are easier to care for; win/win.

The soft touch of close skin to skin contact reduces the release of cortisol, the stress hormone, via C afferet fibres affecting receptors in the hypothalamic-pituitary-axis. Stroking has been shown to reduce pain responses.

Modern life is fast-paced and for many, constant carrying of ever-growing children can be difficult to achieve, or uncomfortable after the travails of birth. This is where the practice of using a sling, (sometimes known as babywearing) can be of great value. A soft sling that allows you to keep your child close to you, (thereby stimulating the release of oxytocin and reducing cortisol), and helps your baby to relax and sleep in secure comfort may make a huge difference to your life and your feelings and help you to feel that you can cope. Anxiety may settle a little as you know your little one is safe next to you. 

“The sling brought us back to an almost pregnant-like state, with him a part of me, listening to one another’s cues. He was calmer for being close to me, which made me feel more confident, which brightened my mood. Leaving the house felt less daunting so I got more exercise and again increased my confidence. I talked to him more, whether he was awake or not, and he became my son rather than a tiny scary stranger.”

“My favourite thing in the whole world, that never fails to calm me or lift my mood has been cuddles with my baby, particularly skin-to-skin. For me, there is no antidepressant like it.”

“When she was in her pram I felt completely removed from her and her world. I was just an accessory, she was a job to do and I was irrelevant. Using a sling finally helped me bond properly with her and made a massive difference to the PND.”

Many slings are extremely comfortable to use, and can be very practical indeed. It is possible to learn how to feed discreetly in a sling, allowing you more flexibility about being out of the house for the day with your baby.

Slings give you and your baby the freedom to be on the move together, rather than feeling stuck; to go out into the world for a walk or go shopping without struggling with the complexities of a pram. Movement and exercise are vital to wellbeing; and using a sling safely can help your body recover from birth and become stronger.

Slings can be beautiful and colour therapy can help to lift the mood. Learning a new skill can be therapeutic, and many parents find a great sense of community among other sling users both locally and online. This can help with feelings of isolation, especially if you have chosen to parent differently from your family or your peers.

help my child cries in the sling

 Get a sense of perspective.

What matters in these early months is you and your baby. It does not matter what other people think; the house does not need to be pristine, you do not need to impress people with how well you are taking to parenthood. I have heard many women describe how they “are falling apart on the inside”.

“I thought because I wasn’t suicidal or not looking after things that it couldn’t be PND so held back for a long time from accepting it and getting help.”

“I found the hardest bit was to admit that I wasn’t coping, even when it looked like I was, I looked fine on the outside but was a complete mess on the inside.”

Get confident again.

Reflect on what you have achieved so far and use that to build self-belief. Learn to trust yourself, be an instinctive parent – and you will fin that as you encourage others, you will find yourself lifted too. Some people find going back to work can be very helpful; the chance to use skills again and have adult interactions once more can be a great boost to self-confidence.


slings and prams and guilt

Slings and Prams and Guilt

“I have a confession to make. I like my pram; sometimes I choose it over my sling. Does that mean I’m not a real babywearer?”
“I feel guilty if I pick the pram for days out when I know the sling is so beneficial.”
“I feel selfish if I use the buggy, but sometimes my body needs a break.”

Slings and prams and guilt often seem to go hand in hand; as if there wasn’t enough guilt involved in being a parent in the first place.

I hear phrases like these from time to time, and while I am delighted that these families have discovered the good things that come from using a carrier, I feel sad that guilt has started to creep in, and that divisions are developing. There is more than enough guilt in the world for parents; how they choose to feed, how they choose to dress their children, and now it seems, how they choose (or don’t choose) to carry. I am really keen to prevent any “mommy wars” regarding carrying from springing into life, so here are my answers to this sort of situation.

Carrying DOES matter. Carrying your child is an important and necessary part of the “fourth trimester” early months of life, it is part of the essential bonding (imprinting) process whereby attachment is created. Secure attachments with a loving caregiver are the bedrock of future positive mental health and the springboard into healthy emotional relationships in later life. For young babies, loving touch and holding are one of the major means of providing this sense of being loved and being secure. Few of us are able to resist the urge to hold our crying children, to provide them with relief and to be their safe space, it is instinctive in us. We should all spend a lot of time holding and loving our babies and allowing them to learn to love us back.

However, modern life is demanding and society encourages us to think that early independence is desirable; that children should not “hold us back.” It is important to care for all members of the family; baby, siblings and parents equally; and this is where using a sling can help. A baby needs to be carried; a sling will allow this to happen while life can continue around them. A sling can mean the childcare can be shared with other adults, a sling will allow a parent to get out and around without the need for lots of equipment.

That said, there are many ways to keep a child close without the need to use a sling 24 hours a day. In-arms carrying, cuddly play, breastfeeding, bedsharing, piggybacks, reading stories with baby on your knee and so on are all ways to be in close contact. It is indeed vital to keep up with regular close contact well into the 2nd year and beyond as our children’s brains are still learning about love and attachment – it’s an investment in their future mental health. However, once babies begin to take control of their own bodies and learn how to move they need the freedom to do so.

Prams and buggies are a perfectly valid, convenient and useful way of transporting your child around and there is no reason to feel you are disadvantaging your child by using one instead of the sling today, or depriving her of something, especially if she can see you and remain in communication. You can meet her needs for closeness some other way later in the day. There is no reason to “ditch” the pram if you find it helps you in your parenting. A pram is (like the sling) a tool for getting around and carrying things, and may be easier in many circumstances, just as a sling can be easier in others (eg public transport, busy shops, off-road exploring). There are many ways to carry other things when your baby wants to be up; special bags that fit around the sling.. or a buggy!! Many families use and love both types of transportation, choosing what will suit the situation best.

Some children may just prefer the space of the pram; this is not a rejection of you, but may just be an expression of their personalities or their wish to explore what they can do with their limbs. It may be that your little boy feels too hot in the carrier that you have, or just fancies a change! Your toddler may also enjoy being able to see the world from a different perspective. If your baby loves the pram and doesn’t want to go in the sling today (assuming of course it is a comfortable and well fitting one – see here if your baby seems to hate the sling), that’s just fine. You are being responsive to your child; there is nothing to feel guilty about.

Sometimes YOU may just prefer the pram over the sling, especially if you are feeling a little claustrophobic or touched out, or just tired. Maybe you have two children, or more, and the buggies are the best option!

We don’t live in the same supportive communities these days and it can be hard for one (or two) people to shoulder the load of responsive parenting alone 24hours a day, we all need a break sometimes. “Villages” of old would share the carrying/ feeding/ entertainment more widely, which provided a much better balance of life than many of us are able to find today. If you want to use your buggy, use it and enjoy it, you can cuddle your baby later (or you may have already used the sling today.) Do not feel guilty that you are not being the best parent that you could be.

Do not feel guilty if you feel you just can’t carry today. There is no such thing as a perfect parent and social media sharing doesn’t present a true picture of people’s lives; it can look like others are using their carriers hour in hour out, day after day from their photos, but these don’t show the in between hours or days where the sling is not in use (and the pram is!) Sometimes prams are an expression of our personalities too, just as the carriers we choose can be…

snowsuits scarves slings and safety carrying in the cold

All safe and responsive carrying is good

; the sling you choose to use is not important, as long as it is safe and comfortable. A buckle carrier is as valuable as a mei tai or a woven wrap or stretchy or a ring sling. Even brands of buckle or wrap is irrelevant; what matters is that you and your child are together, in close contact, safe, and enjoying each other’s company, or sleeping in contentment.

If you are a sling user, this is a great opportunity to avoid creating a culture of guilt and judgement. The parents you see using a pram to quieten a crying baby may well have found this works better for sleeping than their sling. The mum you see pushing a pram in crowds may feel her baby is safer inside the pram than being bashed by passers by in a sling. A parent carrying a heavy toddler in their arms after a melt-down may well have chosen not to use their sling today. iIt is important to be kind and recognise that one moment is not a whole life, and we do each other a dis-service if we unintentionally spread the message that either prams or slings are superior, or if we stare and make comments about others that could be overheard.  All safe slings are of great value, and we should be cautious about what message we send to the new parents around us.

I’ll finish by reiterating that carrying IS important. We should all carry our babies and spend as much time in close contact with them as we can, be that in a sling, in arms, hand holding and so on. We should try to carry our children as much as possible, as there are many good reasons to do so. That does not mean that we should feel guilty if we choose to use prams or buggies as well, or if we choose to use one kind of sling over the other.

Oh, and of course it is fine to come to a sling meet/sling library session with your pram! And no, you definitely don’t need to feel embarrassed if you see me out and about and you are using your buggy!