mother and infant wondrous thing

The importance of soft touch for healthy infant development

A huge amount of work has been done in recent years to understand the role of soft touch in how babies' brains develop. Here I summarise the major points in one page! It has been a great privilege to visit the Affective Touch conference in Liverpool and all the ACE-Aware Nation events in Scotland (with Nadine Burke-Harris and Gabor Mate) and to see all this research coming together.

Soft touch changes the DNA and the brain

  • it switches certain genes on and off, thus affecting cortisol receptor expression and therefore modulates the stress response. This was shown by Michael Meaney and his team; rat pups who were licked and groomed frequently by their mothers became high-licking mothers themselves. The DNA methylation of these high-licking rats and their offspring were different from low-licking rats. When a pup from a low-licking mother was fostered in a high-licking nest, this pup became a high-licker, and was found to display the same DNA changes. Behaviour had altered the expression of these genes, and these epigenetic changes persisted into the offspring. 
  • Soft touch reduces anxiety and pain, thought to be via effects on the HPA axis, parasympathetic system and oxytocin release.
  • Deep pressure (as in hugs and massage) is also thought to play an important part in social touch, activating brain regions highly similar to those that respond to C-tactile stroking.
  • Neonatal studies have shown the impact of soft touch (skin to skin) on improving long term neurodevelopmental outcomes, as they are thought provide a scaffold for the developing social brain.
  • Soft touch and holding is know to help with regulating and stabilising cardiovascular parameters in premature babies and a good case for babywearing as a positive intervention has been made in a study in one NICU.
  • There are positive long- term effects of supporting early mother-baby close contact. The "Family Nurture Intervention" studies suggest that at age 4-5, the intervention arm showed more healthy autonomic regulation

 

Soft touch also affects the hormonal systems of the body.

  • Oxytocin is well known to be released by skin to skin tactile contact, as well as visual, auditory, olfactory stimuli, and works to promote further social interaction. Close contact stimulates release of this important hormone of bonding into both halves of the dyad (usually mother and baby).
  • Oxytocin reduces stress and increases a sense of wellbeing and connection, and it has been proposed that regular skin to skin contact can shift the overall balance of the neurohumoral system away from sympathetic activation (stress, flight/fight) towards the parasympathetic/oxytocinergic system (calm and connection). With what we know about the effects of prolonged stress and cortisol release on health, this is encouraging.

It is clear that there are major benefits to the frontal closeness that babywearing in the early months and years can bring!


Further reading

Skin to Skin

Epigenetic programming by maternal behavior, Nature Neuroscience volume 7, pages 847–854(2004) Meaney et al

Lick your rats!

The Dual Nature of Early-Life Experience on Somatosensory Processing in the Human Infant Brain, Current Biology Vol 27 Issue 7, P1048-1054 Maitre et al

Babywearing as an intervention in the NICU  Advances in Neonatal Care: September 29, 2020, Williams et al

Longer term effects of nurture on mother/child regulation Clin Neurophysiol Off J Int Fed Clin Neurophysiol. 2014;125(4):675-684, Welch et al

Why Oxytocin Matters, Kerstin Uvnas-Moberg, 2020

Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contactInfant Behavior and Development, Volume 61, November 2020, Uvnas-Moberg et al


Top FAQS

These are the most common questions about babywearing I am asked, in a single helpful list!

Just click on the links to read the relevant blog posts, some are kindly shared from others

Firstly; some of my most popular articles:

Do the babywearing “rules” really matter?

Babywearing and infant mental health

Babywearing and the mother-baby dyad

.

Secondly, I get this query daily. “Can I use your infographics to support families?” ABSOLUTELY! Everything on this website was created to help families with children to feel close and connected. Please credit me appropriately and link back to my website/social media (facebook, instagram)

Here is the link to the infographics (eg the Fourth Trimester/Build a Happy Brain/Why Carrying Matters/Skin to Skin posters and much more)

Carrying in different circumstances

Can I sleep while my baby sleeps in their carrier?

How do I carry more than one child at a time? (Coming soon)

How can I carry safely in hot weather?

What good summer slings are there?

How do I keep my baby warm while carrying in the cold?  (ie can I put them in a snowsuit?)

How do I keep myself and baby dry when babywearing in the rain? (Coming soon)

Carrying adopted or foster children

Can I carry my child if I am disabled? (Coming soon)

What if my child has a disability? See this link for a stories from families living with a range of specific conditions.

What if babywearing just isn’t working for me?


Skin to skin Skin to skin pic soft touch babywearing

Skin to skin contact brings long lasting benefits

Skin to skin contact, also known as "kangaroo care", is one of the simplest yet most effective practices to help babies and their carers make the transition to life as a new family, supporting the development of essential bonds.

Skin to skin kangaroo Care carrying matters

It is a major part of helping the baby to adjust to life outside the womb; the “fourth trimester” concept, and is highly important for supporting mothers to initiate breastfeeding and for carers to develop a close, loving relationship with their baby.

What exactly is skin to skin?

Here is the Unicef definition.

It is usually referred to as the practice where a baby is dried and laid directly on their mother’s bare chest after birth, both of them covered in a warm blanket and left for at least an hour or until after the first feed. Skin-to-skin contact can also take place any time a baby needs comforting or calming and to help boost a mother’s milk supply. Skin-to-skin contact is also vital in neonatal units, where it is often known as ‘kangaroo care’, helping parents to bond with their baby, as well as supporting better physical and developmental outcomes for the baby.

Why does it matter?

Outcomes for babies and their parents are better when kangaroo care is offered, especially with premature or low birthweight infants. A collection of studies examined outcomes for mothers and healthy newborns and concluded that there were clear benefits for physiological development, breastfeeding outcomes, emotional wellbeing. Other studies are helpfully summarised here, showing enhanced bonding and attachment, and likely a direct impact on infant development by contributing to neurophysiological organisation and an indirect effect by improving parental mood, perceptions, and interactive behaviour.

skin to skin
skin to skin

The major benefits of skin to skin care can be summarised in these images (thanks to Vija UK).

How is this thought to happen?

At birth, the neonatal brain has two critical sensory needs; smell and contact that is warm and soft. (Dr. Nils Bergman). Frequent skin to skin contact meets these needs in abundance, allowing the brain and the body to begin the process of adjusting to the outside world optimally, forging a pathway from  the baby’s amygdala to its frontal lobe. This connects the newborn’s emotional and social brain circuits. Mothers also need early uninterrupted contact with their babies to fire up their hormonal response; that is, the release of oxytocin that helps breastfeeding and bonding to get going. Oxytocin and soft touch build connection and empathy, helping people to connect and care about each other. Studies suggest that an hour a day of skin to skin in the first 14 days is enough to derive long lasting benefits.

The mother’s body remains the baby’s natural home for many months after birth, and a policy of zero separation at birth is ideal for creating the conditions that allow new families to thrive. Fathers (and other primary caregivers) also benefit from skin to skin contact and this should be encouraged.

Kangaroo care

The impacts of this early contact are long lasting. Feldman et al in 2014 showed that kangaroo care “increased autonomic functioning  and maternal attachment behaviour in the postpartum period, reduced maternal anxiety, and enhanced child cognitive development and executive functions from 6 months to 10 years.”

Skin to skin is clearly a fantastic thing; and the best thing about it is that the close contact in the early hours, weeks and months is normal human instinctive behaviour. It is free and effective; and should be available to all new families.

Simple wraps or specialised “kangaroo care” shirts can offer a more prolonged time skin to skin, and allow a parent/carer to move around, however it is the close contact itself, not the tool, that matters here!

What if I couldn’t do skin to skin with my child?

Not every parent/carer has the opportunity to experience skin to skin, for a wide range of reasons. This can be a source of sadness and concern, however, there are many ways to bond with your baby and help them to form secure attachments. Skin to skin is one very helpful practice, but it is not essential for relationship forming.

Your ability to bond with your baby is not determined by your birth experience, whether or not you were able to offer kangaroo care at birth or later, how you feed your child or where they sleep. It doesn’t depend on your gender or your family set-up. Relationships form by experiencing a sense of connection and love. Children learn how to love by being loved. Playing, talking, cuddling, snuggles, reading to your baby, bathing them, being responsive and present are the things that matter.


Using a newborn insert with a buckle carrier tutorial

Some buckle carriers require an insert for use with newborns, as the panel is too tall and wide for a small baby. The insert raises baby up inside the panel to ensure they remain close enough to kiss with an unobstructed airway. It also creates a narrower seat for baby to rest on, while preserving the M shape and hip health.

Follow the steps to ensure a safe and snug carry; the time spent preparing really pays off when baby is put in, meaning it will feel more secure right away, and less fiddling and adjustments will be needed later.


front carry with a close caboo

Front carry with a Close Caboo photo tutorial

The Caboo is a great option for those who enjoy the snuggly feel of a stretchy wrap but prefer a little pre-structure. This front carry with a Close Caboo photo tutorial will get you off to a flying start.

Follow the steps to ensure a safe and snug carry; the time spent preparing really pays off when baby is put in, far less fiddling and adjustments!

 

Read more about carrying newborns in stretchy wraps or Close Carriers here.

Read more about sling safety with young babies here, and our guide to stretchy wraps and the hybrid carriers like the Close Caboo here.


Babywearing Theory, Safety and Peer Supporter Training

I am a Carrying Advocate and Babywearing Peer Supporter trainer, working under the Born To Carry banner. (This is a training provider of excellence in babywearing skills, bringing together some of the most experienced babywearing teachers and facilitators in the UK). I have trained hundreds of peer supporters. These range from interested parents who want to volunteer or help their own friends, massage therapists, early years providers, health care professionals (health visitors, midwives, doulas etc) and those who want to set up their own local sling libraries.

During the pandemic, much learning has had to move online, and my training courses are no exception.

There are two courses available.


The first is a comprehensive introduction to babywearing theory and safety, which will give an excellent grounding for becoming an advocate for carrying behaviour and how slings can help promote health and wellbeing. It also provides an in-depth introduction to the major types of carrier and how to use them. This is open to everyone, and can be completed at your leisure. There are short tests of your knowledge as you proceed through the course and a final assessment to complete the course for a certificate.

  • This will suit many people who wish to enhance their knowledge and understanding, become evidence-based babywearing advocates, be able to signpost to local libraries with more confidence, and are not planning to offer in-person support to families on a regular basis.
  • This course is not timed, and can be done at your own schedule and to your own pace.
  • Please be aware that this course is not a Peer Supporter course and the certificate cannot be presented as such.
  • This course is not sufficient on its own for anyone planning to offer any form of movement classes with babies in slings.

The second is a practical peer supporter training session, currently being delivered online in small groups, via Zoom. This practical session focuses on actively supporting new parents with hands-on-help, and is required to become a Peer Supporter. Regular dates for these sessions will be available for individuals to sign up for. The theory and safety course must have been completed before doing this section.

  • These sessions can also be arranged for a single group who want to focus on a particular need (such as health care professionals only, using one type of carrier) or for a group who wish to learn together. Please contact me to arrange this.
  • Satisfactory completion of this course and the assessment will generate a certificate of competence as a Babywearing Peer Supporter.

The courses are purchased separately, to give as much flexibility as possible.


Introduction to babywearing theory and safety – online course, £40

  • Welcome Module.
  • Why Carrying Matters Module/Fourth Trimester Module.
  • Introduction to Basic Babywearing Safety.
  • The Role of the Peer Supporter/Consultant.
  • The Different Types of Slings And How To Use Them.
  • Special Circumstances.
  • Assessment Module (to confirm learning)

Peer Supporter Practical Session (to be done in person, or via video link), £55 per person, half a day.

  • Assessing skills in using the main types of carrier
  • Learning how to support others and troubleshoot effectively.
  • Assessment Module (via the Born to Carry website) to ensure receipt of information and ensure the high standards of training from the Born to Carry organisation are met.

Reduced cost places are available for certain priority groups, read more about that here and how to apply.

Enrol onto the Theory and Safety Course (£40)Contact me for dates for the Practical Peer Supporter Training

I’d highly recommend any enthusiast to attend this course. I found it thoroughly enjoyable and look forward to being able to use this new knowledge to help more parents discover the benefits of babywearing, as I have.
R.T.


FAQ

Do I need to do both modules?
It depends what you need from the training. If you wish to be a Peer Supporter, yes, you will.

Can I just do the online theory and safety course?
Yes, this will generate a certificate of competence in babywearing theory and safety, which may be all you need. You will have a good grounding in why babywearing is so useful, based in evidence, a solid understanding of how to keep a baby safe in the major types of sling and be able to advocate and signpost to further resources.

I want to support new parents to choose a good sling, and become confident in putting their slings on, or set up a sling library. What modules do I need?
You will need to do both the theory and practical modules, as this is what Peer Supporters do!

I want to offer classes for new parents and their babies with slings as part of the class. Is the online module enough?
No. You must do the full Peer Supporter training. This online course will not be enough on its own, as hands-on skills and careful planning of classes are needed. Adding any movement with a sling beyond walking increases the potential for harm. Babies and their caregivers’ wellbeing should be the primary concern for such classes, and they should not be placed at risk by inadequate training.

Do I need to do both the online and practical modules at the same time?
This is up to you! Some people will opt to do the theory modules at their own pace, and then decide if they want to do the practical modules. If you wish to do the full course, it will help to have the online theory fresh in your mind before you come to the practical session. You must have completed the theory before the practical session.

Can I have a practical session tailored to the specific need of my group (eg neonatal nurses, health visitors or for dance classes, etc?)
Absolutely, you can do the online theory and safety course and then have your own group practical session with me, please get in touch to discuss your needs. Please be aware that I am a working GP and can only offer a certain number of practical sessions per year.

The Carrying Advocacy Peer Supporter Course has several aims. One is to understand why carrying matters so much in the vital task of building a happy brain – we look at some of the neuropsychology and biochemistry behind it all. Slings can help to facilitate this. Another is to enable people to give robust, safe advice about babywearing and infuse the people they meet with excitement and confidence about using a sling, and help them use it safely and confidently. It is not a consultancy course (therefore does not cover advanced techniques such as back carrying or complex woven wrap techniques), but is designed to equip trainees with the tools they need to be able to support the parents they meet. It covers topics such as:

  • the benefits of babywearing
  • the physiological principles of baby positioning to protect airway, spine and hips
  • confidence with the most common types of sling
  • practical demonstrating skills

  • demonstrating and discussing the safe use of slings in many circumstances (eg feeding)
  • troubleshooting common difficulties
  • assessing boundaries and responsibilities
  • babywearing in a historical/sociopolitical context

Those who attend this course, complete the post-course assessment and receive their certificate of completion are eligible for insurance from three providers.

Dance and exercise classes with slings

Please read this first if you are considering setting up one of these classes. The safety of child and parent is paramount at all times and there is simply too much to cover when the class instructor is not already very familiar with slings and aware of the risks involved (this is more than just being aware of the “TICKS” guidelines). If you want to discuss whether you are suitable for entry on this course please email me before you book. I reserve the right to refuse training.


Feedback

“I really enjoyed trying different carriers. I found the trouble shooting sections particularly interesting and fun. I learnt a lot and feel more confident with all carriers and especially with how to wrap a new born.
I really loved it and now want to do the consultant training even more. Rosie was clearly very enthusiastic and dedicated and made everything so interesting. She was pretty inspiring.”


“Everything I had hoped for was met, I feel like a peer supporter now, not just someone who loves slings!”


“Hi Rosie, I couldn’t go to bed without sending you a note to say a huge thank you for the course today. I’ve never felt more included and welcome and I’m so thrilled I came along. Thank you for your hospitality and brilliant teaching, I’m raving about babywearing to my husband and cannot wait to volunteer at a meet soon.”


“I loved the content of the day, the discussions, playing with different slings, learning new ways of slinging, wrapping etc. The course was well run, well organised and I felt empowered to speak, share and question.”


“I feel much more confident in my knowledge of both the benefits of babywearing, and how to go about enabling parents.”


“I really enjoyed meeting other like minded people. I liked the theory of babywearing as it related closely to the work I do as Breastfeeding Lead in the NHS. I enjoyed trying all the different slings and carriers and understanding in what situations they would be used.”

“Rosie was born to teach people. Simply fantastic in the way information was relayed. Would highly recommend.”


“The whole day was so good! A key element was the ability to see and try so many different types of slings and to have time to go through basic principles regarding how to use them all. The role play aspects where we were able to troubleshoot carrier problems was also very useful.”


“My personal learning aims were met, it exceeded my expectations. I found the course was extremely enjoyable and covered so much subject matter but was not overwhelming. My aims were well and truly met. I now believe I could give a new babywearer good/correct advice and help in ways I was unsure about prior to the course.”


“Having someone with your experience and knowledge available all day to ask questions and watch demo was incredible. I really enjoyed the contextual and historical information about Babywearing and what led us all into that room that day. It put everything into the ‘bigger picture’ and made me feel such a part of the huge Babywearing community. Having such a massive amount of slings in the room to try and compare was utterly invaluable – such a rare opportunity. I thought the balance between practical and theory was absolutely spot on. As someone who’s very interested in the sociopolitical aspects of Babywearing I was really pleased to see this covered in the course and really appreciated that you placed Babywearing so firmly in this context during the day.”


“The course really opened my eyes to consider the needs of individuals and how essential it is to be inclusive and approachable and gave me the tools to do this confidently (especially regarding narrow base carriers). It was useful to be shown how to exaggerate movements and words when teaching and to have the opportunity to practice this. Rosie’s enthusiasm was infectious and made the whole day very engaging. The size of the group worked well and I especially enjoyed how well we all got on.”


educational resources build a happy brain rainbow brain carrying matters

Educational Resources

This page contains various resources that may be useful for education and supporting others. Leaflets, posters and postcard packs can be purchased. Images and PDFs can be downloaded free of charge by clicking on the photos. Please ensure you credit me (Dr Rosie Knowles) if you use them.

Click on the image to download a PDF, or order a pack of high quality printed leaflets using the button below.

Buy the Carry Safe leaflets here

Click on the image to download a PDF, or order a pack of high quality printed leaflets using the button below.

Buy the Guide to Slings leaflets here

Click on the image to download a PDF, or order a pack of glossy postcards or posters using the button below.

Buy the Seven Reasons poster here

Click on the image to download a PDF, or order a pack of glossy postcards or posters using the button below.

Buy the 4th Trimester products here

Click on the image to download a PDF, or order a pack of glossy postcards or posters using the button below.

Buy the Build a Happy Brain products here

Click on the image to download a PDF, or order a pack of glossy postcards or posters using the button below.

Buy the Skin to Skin Matters products here - coming soon!

Click on the image to download an image of Carrying in the Heat, or order a pack of posters using the button below.

Buy the Carrying in the Heat posters here

Click on the image to download an image of Carrying in the Cold, or order a pack of posters using the button below.

Buy the Carrying in the Cold posters here

Secure Attachment and the "Fourth Trimester"

Secure attachment is the deep and enduring emotional bond that connects one person to another across time and space; a "lasting psychological connectedness between human beings" (Bowlby/Ainsworth).

wrap hugSecure attachment to other people is vital to human health and wellness; we thrive on relationship, on belonging. Such healthy attachments are the bedrock to future positive mental health and enjoyable relationships. However, Sutton Trust research shows that 40% of children lack secure attachments; instead they display insecure-ambivalent, insecure-avoidant or disorganized/disoriented attachment, and are significantly disadvantaged, especially those growing up in poverty.

Research shows that one of the strongest predictors for insecure attachments in children is to have a parent who lacks secure attachment themselves.

 

So, how do you build a secure attachment relationship with your child?

Secure attachment is created by loving responsiveness to your child's needs. It is not about your parenting style. Your baby may sleep in a crib or your bed, be fed from a breast or a bottle, be held in arms or a sling, be weaned in any style, be brought up by any combination of carer and still have secure attachments. It is not about subscribing to a particular parenting philosophy. You do not have to sacrifice everything - your identity, your sanity, your relationship, your job, your money or anything else at the "altar of childhood".

Building secure attachment is about having respect for a child's personhood, building their sense of self-worth within a consistent, loving and responsible relationship, regardless of their age or understanding.

Your child's humanity is as valuable as your own; neither more nor less. You are your child's advocate in the world and their greatest defender. You can provide for their every need, and they depend entirely on you and your surrounding network. They will learn whether or not they matter from how they are treated and how their requests for support are met. Securely attached children are confident that they will be cared for, and that any distress will be met by love. They are easily soothed by their caregiver when upset, are more able to be self-reliant, form positive relationships and generally have smoother paths through life.

However, their needs need to be balanced with that of the family, as a crumbling family dynamic will ultimately not be in anyone's best interests.

The "fourth trimester" is where attachments begin to form.

What is the Fourth Trimester?

Kay and AlexTheories regarding the size of the infant cranium, the shape of the upright human maternal pelvis, and the limits of the mother's metabolic energy provision for growth all discuss why human babies are born at a stage where they are still very vulnerable. This is in contrast to many other species where a young animal will be able to walk after its mother within hours of birth, or sleep in a hidden nest. To survive, a human baby needs to be held and carried around by his carers, fed and kept warm or he will die. To thrive, a baby also needs love and secure attachment.

The ‘fourth trimester" is the period immediately after birth, a few more months of intense nurturing to allow a baby to continue with their essential development from a place of security and safety.

A baby who has spent all their life growing peacefully in the womb, gently compressed by uterine walls at the end of the third trimester, will find the sensation being born, followed by freedom and open space in the outside world enormously different. Limbs that have been limited are suddenly free to stretch wide, darkness has turned to light, the muffled gentle rhythmic sounds of the mother's body have been replaced by loud, unfamiliar noises or deep silence. Constant gentle motion has turned into complete stillness or sudden movements. No wonder that when babies are held close, rocked and soothed, contained in soft boundaries once more, that they settle; this feels right and familiar.

 

The "fourth trimester” is all about gentle transitioning from the peace and stability of the womb towards active involvement in a new world.

A newborn needs to be supported to gain skills and strength at a steady, individual pace from the security of an unshakeable foundation and place of comfort and familiarity. Being held, close to familiar noises and scents is essential to development and positive learning; the infant brain is growing rapidly and forming new connections all the time. Connections that are reinforced frequently will persist into later life, whereas those that are rarely used will wither away. It is worth taking the time to ensure that these unconsciously forming connections are positive ones. Young infants do not have the cognitive development to behave in "manipulative" ways; but they do learn to trust someone who proves reliable time and again as these pathways are reinforced. They will be startled and upset when this love is withdrawn.

The importance of responsiveness

If you are sensitive and responsive to your baby as they begin to communicate their needs with you (by crying, wriggling, yawning etc) they will learn that they matter to someone. If they are uncomfortable, the people they are learning to trust will soothe them. When they are hungry, they will be fed, when they are tired, they will feel secure enough to sink into sleep. They will not be frequently left alone unattended for long periods of time, and will not be left to exhaust themselves in calling for someone who never comes. When they cry, loving arms will be there to comfort and keep them safe. These same arms will show them the world and provide a safe place that facilitates learning. Carrying matters; babies need it. It does not make them clingy, rather, the solid foundation of secure attachment relationships will be the springboard to confident independence later in life.

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How does babywearing help?

One tool that can help you meet your child's need for loving contact in these early months is a soft carrier that holds them in a comfortable, safe and anatomically respectful position. Such carriers will help you to meet their needs to be close to you while allowing you to be hands-free for daily life. There are many other positive reasons to carry a child; such as reduced crying, reduced plagiocephaly and more. Parents benefit too, for example carrying can be helpful for those with postnatal depression, and increase overall activity levels. This idea is not new; most of the world’s families across history and cultures have used some form of sling to make life work.

karena-1

You can find out more from your local sling library or consultant; there are hundreds across the UK. They will help you to find the right type of carrier for your needs. 

What about my older child?

Attachment relationships continue to form beyond the early months and children's brains are very "plastic". Warm, responsive, emotionally available parenting will help to build a child's sense of self-worth at any age. There is evidence that "mind-minded" parents (ie those who treat their children as intelligent, relational individuals with feelings, and speaking to them in such a way) seem to have children with more secure attachments. Active play and laughter, as well as consistent loving boundaries help to reinforce neural connections that the primary caregivers are a reliable source of security; forming strong foundations for the future. Read more about how carrying can help the learning brain.

carrying matters

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References

Bowlby J. (1969). Attachment. Attachment and loss: Vol. 1. Loss. New York: Basic Books

Ainsworth, M. D. S. (1973). The development of infant-mother attachment. In B. Cardwell & H. Ricciuti (Eds.), Review of child development research (Vol. 3, pp. 1-94) Chicago: University of Chicago Press.

Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.

Sutton Trust; Baby Bonds Parenting, attachment and a secure base for children. March 2014 Research by Sophie Moullin, Jane Waldfogel and Elizabeth Washbrook

http://www.parentingscience.com/attachment-parenting.html

Rethinking Maternal Sensitivity: Mothers’ Comments on Infants’ Mental Processes Predict Security of Attachment at 12 Months; J. Child Psychol. Psychiat. Vol. 42, No. 5, pp. 637–648, 2001


Common Queries

Common Queries

Families often have a lot of questions about using carriers, such as “what is a healthy hip position”, or “is it OK to face my baby out in a carrier?” “Will using a sling make my child clingy?” “What do I do in different weather conditions?”

This page links to many of the common queries around slings; information sharing to allow people to make informed choices that work for themselves and their families.

Slings and Exercise

more

The Fuss about Facing Out

more

Carrying While Pregnant

more

Do Slings Create Clingy Children?

more

Breast and Bottle Feeding Safely in a Sling

more

How Babywearing Can Help with Post-Natal Depression

more

Carrying in the Postnatal Period

more

Sleeping While Your Baby is Sleeping in the Sling

more

Healthy Hips; Busting Some Myths

more

Keeping Your Baby Safe in the Cold

more

Keeping Your Baby Safe in the Sun

more

Beginning to Back Carry

more

Help, My Child Cries in the Sling!

more

Carrying Older Children

more

Beyond the Knee to Knee

more

Slings and Prams and Guilt

more

The Last Days of Carrying

more

Carry Me Daddy!

more

Don’t forget the sling safety guide is here.

If you need more specialised support or have a query not covered here, please do get in touch with me!

You can find more educational resources here for downloading (such as infographics and leaflets and images) and you can read about carrying in some special circumstances here.


The Importance of Carrying

Seven Reasons to Carry Your Baby

Read more

Attachment, Babies and Carrying

Read more

Secure Attachment and the Fourth Trimester

Read more

Why Carrying Matters (for Juno Magazine) issue 44

Read more

Stretchy Wraps and Close Caboo

I am a big fan of stretchy wraps and their variants (like the Close Caboo). They come in all shapes and sizes, and are usually to be found cuddling a tiny baby close to someone’s chest. Many babies adore the security and safety of the wrap and fall quickly to sleep. For many parents, they are the first slings they own, for good reason.

Like all carriers, stretchy slings need to be used safely and the TICKS guidelines should always be followed. The most important consideration is to protect baby’s airway; a baby’s neck should never be folded in half and two fingers should fit between their chin and their chest.

The most frequently adopted position for carrying is upright and facing in, with legs slightly spread apart (the M position) and head well supported, as this will also protect growing hips and spine. The stretchy wrap will provide gentle mouldable support and can be adjusted to provide head support.

Babies often sleep in stretchy wraps/Close Caboos, when well positioned, as the closeness and snuggliness of the layers of fabric (always at least two layers of fabric with a stretchy!) mimic the close conditions of the womb during pregnancy, and being in contact with a parent’s skin and near a parent’s heartbeat and able to hear a parent’s voice is extremely reassuring for babies.

The most common style of carry is the pocket wrap cross carry (where baby’s legs are on either side of two cross passes). Once you have the hang of it, it is quick and easy, and the wrap can be left on all day and baby popped in and out.

carrying in the postnatal period

What is a Stretchy Wrap? (see further below for the Close Caboo)

A stretchy wrap is a length of fabric, usually made of soft and stretchy machine knitted cotton, that is usually between 4 and 5m long and about half a meter wide. Some have bamboo blended in with the cotton, which adds to the softness and comfort, and some have a small proportion of spandex, which adds to their elasticity and stretch.

They are suitable from birth, and in fact are often used for kangaroo care in hospitals with premature babies, and most people will find their stretchy wraps will be suitable for at least six months and often many more, especially for the days when active babies are sad and need all-over-cuddles or need some sleep. The gentle all-round pressure helps to reduce excessive stimuli and allow a baby to switch off and sleep.

Not all stretchy slings are the same (varying in stretchiness and ease of use) but by and large, they have the same purpose – to be a comfortable one-size-fits-most sling that a parent can pre tie before putting baby in. This means that the sling can stay on all day and baby can be tucked into it easily and quickly when needed, and taken out again very simply. There is no need to retie a stretchy over and over again during the day. The stretchy does not need to be removed for breastfeeding (see below for how to do this safely).

How do I put my stretchy on?

The key to success is in preparation; getting the tension of the passes right before baby goes in, and ensuring their position is correct. I always recommend that each pass is in place in baby’s kneepits to ensure baby is in the M shape and held chest to chest before the fabric is then spread across their body, one side at a time. These images show optimal positioning for a young baby in the wrap – each kneepit is supported in the M shape and baby is chest to chest in the gentle J shape.

Here is a quick subtitled video showing how a young baby can be positioned well.

Many people worry that it looks fiddly, complicated or that there is too much fabric. But really, it is simple – you just tie it on the same way each time and pop baby carefully into the cross passes on your chest. The videos here all show just how simple it can be. I work with “two-way” stretchy wraps (they stretch lengthways and widthways and are easy to maneouvre).

With premature or especially small babies who still have their feet held very close to their bodies, other techniques (still using the same tie method) may be more suitable, such as this one (video link). Please get in touch with your local sling educator (www.slingpages.co.uk) for extra help.

Please note that horizontal cradle style carries are no longer recommended due to airway risk. Some older instructions unfortunately still contain this position.

Here is another video of the pocket wrap cross carry from Noah’s Arc Sling Library

And here is an audio described version of the above

A step by step stretchy wrap photo tutorial guide; this is a two-way stretchy wrap. Two-way stretchy wraps stretch along their width and their length.

The key to success is in preparation; getting the tension right before baby goes in, and ensuring their position is right before spreading any fabric. Quick link to this tutorial here.

Video of the Pocket Wrap Cross Carry with a two way stretchy wrap  (Hana, Boba, JPMBB), showing how to avoid slumping. This is the same technique as the photo tutorial.

A more detailed, slower video with doll can be seen on this YouTube link

How to take a baby out of a stretchy wrap without untying  – this allows the wrap to stay on all day and baby can be popped in and out, rather than retying over and over again.

A short video for how to do the pre-flipped shoulder to keep fabric away from baby’s face. This is important to ensure there is no airway obstruction.


The pelvic tuck with stretchy wraps (and all carriers) is important, for baby’s airway support and also for comfort.

pelvic tuck

Passes in knee-pits and good M shape position

Top Tips!

  • Make sure the fabric is snug. Slack fabric leads to slumping later. Take time to make sure all the passes are tight and when stretched out, are no looser than the volume of your baby's body.
  • It will be much easier if you hold your baby in the secure M and J shape positions onto your chest before you put the carrier on.
  • Put both baby's legs into each cross pass and ensure he is sitting down with the passes in his kneepits, and then straighten him up and check his position. His ribcage should be snug against your chest and his chin up.
  • Then spread each pass one by one, kneepit to kneepit (this avoids sideways slump).
  • Ensure there is no fabric over your baby's face; fold the fabric out of the way, ensuring each pass still comes up to the neck.
  • Pull up the third pass to the back of baby's neck. Some people will fold the top edge over a rolled up muslin to provide a little extra neck support for active babies.
  • You should feel like you can lean forwards (with one hand on baby's head) and baby should not swing free.

Post-natal stretchy use

Dads use stretchies too

reduce crying

Common Queries about Stretchies

Breastfeeding in Stretchies

It’s possible to breastfeed in a stretchy, once feeding is well established and you are confident with your use of the sling. The video below shows you how you can use your stretchy as an aid for feeding without needing to unwrap each time. Please note that baby’s head is not covered by fabric and her neck is supported throughout. When baby has finished feeding, she must be returned to her safe upright position and not left to sleep in the horizontal position.

No breastfeeding is hands free, and it is usually a good idea to get some help and advice from people who are familiar with how to do it.

Can I face my baby outwards with the stretchy?

Forward facing out in a stretchy is not recommended for several reasons, even though some older instruction manuals show how to do it. Newer companies do not have this carry in their instructions. Why not?

  • No head support can be created in this position, and babies have heavy heads in proportion to their bodies. A sleepy head lolling forwards may compress the airway and impede breathing, just as the cradle carry may do.
  • A baby facing out has no support for the hips and legs (see this article for more)
  • The spine is artificially straightened in the forward facing out position when it should be curved.
  • Babies do not have the ability to “zone out” from all the conflicting sensory streams that comes from being held facing out. They need to be able to switch off and rest against a reassuring parent; this is hard to achieve facing out.

 

Read more here about facing out carriers; this can work well with older children.

How long will I be able to use my stretchy wrap?

That depends on the stretchy. Many people find that as babies get bigger and want to be able to see the world around them, they can find the all-over cuddle of the wrap a little restrictive for seeing. At this point, opening the shoulders out can help with visibility, but do keep a hand near any wobbly heads. Stretchies are great for older babies who are sad or uncomfortable and want a cuddle, or are ready for a sleep.

Most people will find the stretchy wrap works very well for the first six to nine months of age (a few will last into toddlerhood), and is just the start of a happy babywearing journey as their baby grows bigger. At this point, parents may begin to consider other carriers that have a wider vantage point. Some will allow more open shoulder strap angles, some will allow hip carrying, (such as ring slings or the Scootababy) and back carrying may not be far off!

 


Troubleshooting your Stretchy Wrap

  • Feeling too tight? Baby should be close enough to kiss, able to rest his head on your upper chest just under your chin. You should feel able to take a deep breath without feeling constricted (one hand's breadth between your baby's ribcage and your chest.) Any looser and baby may begin to slump. You can often lower your baby by putting your hands inside the carrier under her bum and bringing her down a little. Many stretchy wraps will have a little give in them and as you walk, baby is likely to settle down a little lower naturally.
  • Too loose or too low? Your stretchy is likely not tight enough; retie or see the video for how to tighten.
  • Baby slumping to one side? This can be avoided by putting baby's legs into each cross pass in turn, just into the knee pits, and ensuring he is positioned right before you then spread each pass.
  • Baby seems to be too curled up or folded inside the stretchy? This is likely due to the fabric not being snug enough, see the video for how to "unfurl" a slumping baby to keep their chest cavity well supported.
  • Baby's face buried in fabric? Ensure stretchy is snug (looseness leads to slumping over. You can fold or flip the shoulder passes (see photo below) for airflow and visibility, and use the other side as a hood if tolerated.
  • Baby wants to lean back and look at you? You can use a rolled up muslin folded into the top section to provide some neck support.

Unfurling a slumped baby

Stretchy too loose or too low and don’t want to re-wrap? Here is how to tighten it up to get baby back into a safe position.

Folded shoulders for airflow and a hood

A rolled muslin forming a neck support


More videos (for one way stretchy wraps like the Moby) or the pocket double hammock carry for babies who prefer to be legs in can be found here on the videos page.


Carrying twins in a stretchy wrap

Many parents of twins will use a good, supportive stretchy wrap to carry their small twins, with one twin in each cross pass. It can take a little practice, do come and get some help!

Putting twins in a stretchy wrap

There are many other ways to carry twins as they grow; get in touch with us to get some one to one help or visit our twin support group Peas in a Pod with one of our peer supporters for some simple advice and guidance.


Close Caboo Carrier

This is a semi-structured carrier made of one-way stretchy fabric that has the two cross passes sewn into position, and is tightened once baby is in by pulling any excess fabric through two rings at the side. There is less fabric than the typical stretchy, and it can seem simpler to put on at the beginning, which some people find useful. See the video for how to do it well and safely; the key is to prepare it properly, to fit your baby’s body right at the start. It is popular with those who find the tying and wrapping of a stretchy less to their liking but still wish for the cuddly wrap feel.

Common issues

  • Each pass needs to be untwisted and pre-tightened into a hammock shape before putting baby in; too-loose passes at the beginning will mean that baby sinks and slumps.
  • Ensure you have the cross piece on the back pulled down to the middle of your back, not resting by your neck.
  • Try to get the passes the right snugness for your baby’s body before you put them in.
  • Each cross pass must be tightened (or loosened) in strands across the full width of each pass to be effective and avoid slumping.
  • The third part must be tied on to ensure good head and neck support.

Some people can find it harder to fold the shoulders out for good airflow and visibility, due to the fixed hem (this is easier with a good two way stretchy wrap). The preflip in the photo tutorial is an excellent solution to this!

Much of the advice and top tips for the stretchy wrap will apply to the Caboo too, see above.

Close Caboo

Click on the image for the photo tutorial

front carry with a close caboo

Putting on a Close Carrier

Vija Kangaroo Care Tops

These special items of clothing are designed to hold a small baby close to parent’s chest inside some clever built-in pouches. They are very simple to use, and even come in twin form! More information here

Kangaroo Care shirt

carrying in the postnatal period

If you need some more support, your local sling educator can be found listed on the Sling Pages.