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


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.


Encouragement card

Encouragement and Affirmation Cards

Parenting is tough; modern society does not make it easy for families. Parents and carers are often bringing up their babies feeling isolated or uncertain and in need of support and encouragement. These little cards are designed to lift you and help you to keep going with your responsive parenting journey; it will all be worth it.

Read more about why infant mental health matters here and how babywearing can help the formation of the mother-infant-dyad here.

Scroll through the images and let us know which is your favourite, or if you have ideas for more!


useful videos

Useful Videos

I have made several educational useful videos and photo tutorials to help people, which can be browsed on my own YouTube channel (basic babywearing how-tos and vlogs) as well as a wide range on my local Sheffield YouTube channel (I run a sling library there).

I am adding more and more short videos to my Instagram reels and IGTV, link here.

If you are looking for a specific video for a particular type of sling, please see the categories below.

I would highly recommend a look at my safe carrying page for guidance on how to keep your child safe in a sling.

Here are some safety reminders, please ensure you know how to protect your baby’s airway and ensure a good position for them before you use a sling.

Please note that these videos are to be used at your own risk. There is no substitute for hands-on help! Always keep your child safe.

 

Here are some reminders of the positioning of babies and children in carriers.

Young babies should be held in this supportive tucked position that respects their natural anatomy. The M shape describes the shape of the legs; with knees higher than bottom. This is how babies naturally position themselves when they are relaxed and held in arms, or resting on the floor or in reclined seats. A newborn has a much narrower M shape than an older baby (and each baby will open his/her hips at his/her own pace).

The J shape describes the shape of the head and spine; a gentle curve with the pelvis tucked under. Having a tuck at the base means that the heavy head is less likely to slump over. Chin can be kept up and the chest cavity kept open and uncompressed.

Here is a reminder about the Pelvic Tuck (with videos)

Carries with a Stretchy Wrap

Many parents love to use a stretchy wrap for their newborn; it is very comfortable as it distributes the weight widely around the body . It is also very snuggly for babies and reminiscent of the warmth and gentle pressure all around that they enjoyed in utero.

They are not hard to use; these videos will show you how to put stretchy wraps on safely, how to fix them if baby feels too low, and how to use the stretchy as a breastfeeding aid without needing to remove the sling (please note the safety advice in that video!)

Silent, captioned video with baby, showing you how to put two-way stretchy on and how to put baby in

Voice and video with doll, showing you how to ensure good positioning every time.

How to breastfeed a baby using the stretchy wrap as a supportive aid

Ensuring a good pelvic tuck position with a stretchy wrap

VIDEOS OF ONE-WAY STRETCHY WRAPS and OTHER TWO-WAY CARRIES

Pocket Wrap Cross Carry with a one way stretchy wrap (eg Scottish Baby Box wrap, Happy, Moby, etc)

Front Wrap Cross Carry with a one way stretchy wrap (often much easier to do and feels more secure!)

Slingababy video of Front Double Hammock with a Moby (one way stretch)

Video for front double hammock with a Didymos (not very stretchy!) stretchy wrap, for babies who prefer legs in, or have not yet uncurled

Je Porte Mon Bebe video for front double hammock (any two way stretchy, with a baby whose legs have not yet uncurled)

USING A STRETCHY WRAP WITH NEWBORN TWINS



Soft Structured Carriers (Buckles/Tie Straps)

The videos in this section look at soft structured carriers (full buckle carriers and meh dais/bei dais (formerly known as mei tais), showing you how to use them for front, hip and back carries, as well as how to make a good seat in a carrier with the pelvic tuck.

FRONT, HIP AND BACK CARRIES WITH A WAISTBANDLESS CARRIER (eg Integra/Connecta/Pouchlings etc)

Front Carries with a waistbandless carrier

Hip and Back carries with a waistbandless carrier

FRONT CARRIES WITH WAISTBANDED CARRIERS (CROSS AND RUCK STRAPS)

Front Carry with a Waistbanded Cross Strap Carrier (Sleepy Nico, Mamaruga, Beco, etc)

Front Carry with a Rucksack strap carrier (Tula, Boba 4G, Lillebaby, Emeibaby, etc)

Raising baby up in panel if baby is too short for it – photo tutorial

 

BACK CARRIES WITH BUCKLE CARRIERS 

Watch Rosie do a quick back carry with a preschooler and a waistband carrier (works well for willing older children!)


CARRIES WITH A MEH DAI/HALF BUCKLE

Front Carries with a Meh Dai/Half Buckle

Hip/Back Carries with a Meh Dai/Half Buckle

 Ring Sling Carries

Ring slings are a popular choice with parents wanting something simple yet versatile, and they can be used from newborn to toddlerhood and beyond. There is often a learning curve to making them as comfortable and safe as possible; the videos in this section will show you how to use them well. Practice makes perfect and sometimes some one-to-one help can make all the difference. Here you can enjoy a video as if you were having a consultation how to use a ring sling with Rosie and Lucy.

CARRIES WITH A RING SLING

Carries with a Woven Wrap

Woven wraps are very versatile and can be used for children of every age, from newborn to preschooler, on the front, hip and back. They come in several different lengths –read more here.

In this selection Rosie demonstrates just a few of the possibilities and links to other excellent videos to help you make the most of your woven wrap.

FRONT CARRIES WITH A WOVEN WRAP

 

 

HIP CARRIES WITH A WOVEN WRAP 

BACK CARRIES WITH A WOVEN WRAP

Sheffield Sling Surgery videos

Your own local sling library/consultant for more support can be found at the Sling Pages

VIEW SLING PAGES


Congratulations

You've been carrying your baby for one whole year!
The close contact has connected you to each other and helped your baby's brain to grow. Hopefully it has brought you many happy adventures together and been useful in many ways: sleeping, feeding, travelling...
Congratulations

There is a lot of evidence to show that babies need to be close to their primary caregivers in the early months and years of their lives. This shared space creates an intimate connection between the two individuals that builds lasting bonds; and these bonds can shape your child's future. It may well have helped you too, to survive the challenges of parenthood.

Choosing to carry your baby has been one of the most important things you could have done for your family unit. I congratulate you for that and encourage you to keep going!

If you'd like to download this for yourself or to give to a friend or someone you know, here is the link to the PDF.


help my child cries in the sling

Help! My child cries in the sling

"Help! My child cries in the sling... she seems to hate being put into it..."

This is a frequent worry faced by many parents when they try out a baby carrier for the first time - either the very first sling they have ever used, or when trying to find something more suitable or comfortable for their child's needs as well as their own. I've come across many parents who are concerned that their child unfortunately hates the carrier they have spent money on, or convinced that there is no sling out there that will suit their baby as they always cry when they are put in.

Fear not - it is very common for babies and toddlers to fuss and cry and wriggle in slings, especially when it is a new experience, and my advice to parents in these circumstances is "don't worry, this is very common, you are not alone" and "yes, there are solutions". Crying in slings is common.

So why is it my baby cries as soon as I put her in a sling?

I think the key thing in such situations is to try and understand the experience the child is having - to put yourself in their shoes (or booties!)

Put yourself in your child's shoes Put yourself in your child's shoes

Being able to see things through a baby's eyes can often explain a whole host of issues - babies are small people with feelings just like adults, and they express these sensations in the more limited means they have at their disposal - laughing, wriggling, crying, bouncing, sucking, moaning, yelling, chewing, rooting, leaning, twisting etc. Being able to read and understand your baby's cues is vital to a good relationship and this is one of the benefits of a carrier; parents and carers are usually much more aware and rapidly responsive to a child who is close to their bodies and visible, as opposed to one who is detached and in a pram or a bouncy chair or a play gym etc. So it is good, your baby is protesting, he/she is communicating with you and you are aware of that! Now to meet the need he/she is expressing and thereby solve the problem.. The sling itself is usually not the cause of baby's displeasure.

What does your baby need?

  • Is your baby too hot? (it is common to get very warm in a sling quickly. Your own body heat next to a baby's with the extra layers of the sling will bring their temperature right up, and we all know its unpleasant to be sweaty and over-dressed.
  • Is your baby thirsty?
  • Is your baby hungry? It is always worth making sure your baby is well fed before wyou embark on a new experience - and come armed with bottles, snacks etc to satisfy any hunger. It is usually worth meeting this need rather than ignoring it, as babies won't understand your priorities and will just continue to be upset. If you’re learning how to use the sling with someone, they will be more than happy for you to feed your baby - you are more likely to be able to absorb information when your child is happy. You can talk while feeding and still learn and you will always be able to try the carrier again later! Babies who are breast-fed may need to feed often, and few will refuse food that is offered, even if they've just been fed. Bringing a baby close to a chest full of milk will often create a desire to be fed, or to suck, even if tummies are full.. if you were a baby who could smell milk and were being held in a position where you couldn't reach, it would be maddening, and you might kick, or wriggle, or yell.) If your baby seems to be burrowing down, or chewing their fingers, or shaking his head from side to side, could that be a cue to be fed? Perhaps you can learn to feed in the sling? 
  • Does your baby have a sore tummy or is he too full of food to tolerate pressure on his tummy, just like an adult after a large meal? A seated sideways carry may be more comfortable.
  • Is your baby wet or dirty, and therefore uncomfortable, or are they needing to eliminate? Babies are very aware of their own bodily functions.sleeping while your baby is sleeping in a sling
  • Is your baby tired? Many babies have a fussy period before they go to sleep. You may already be aware of this tendency in your baby when they are falling asleep in bed, in the car, in the pram etc, the sling is no different. A baby may learn that slings often mean sleep and if he doesn't wish to sleep, may protest. A little rocking with baby in sling is usually enough to help them drift off. Sometimes the new experience of trying a sling can be too much stimulation for a weary baby and push him over the edge from tiredness to tantrum, just as it would if you tried to feed him, or change his clothes. A good guide is two new things in a row (so at a sling meet, just try two things!)
  • Is your baby in pain? Teething can be uncomfortable; distraction by play is a great tool, and if a baby suddenly has less distraction he may become aware once again of the ache in his jaws. Abdominal distension from constipation or sore genitalia may affect carrying.
  • Is your baby responding to how she is being handled? Primitive reflexes like the Moro reflex (that causes the limbs to spread wide and then grasp) or the Tonic Labyrithine Reflex (over-extension, ie back arching due to an unsupported backward-lolling neck) can make babies feel insecure and unwilling to settle into a sling. Lifting and holding your baby securely from both the upper body and below the bottom can help to calm them before moving into a carrier.
  • Is your baby responding to how you feel? If you are anxious or irritable while handling your baby, he will pick up on your muscle tone, shaky breathing and jerky movements and become distressed as something feels wrong. Sometimes it is better to just try again later when you are in a better frame of mind.
  • Could you and your baby have some difficulties connecting, due to such circumstances as a complex pregnancy or a traumatic birth history (regardless of the objective outcome)? A lot of your unspoken feelings about your unborn baby and how your child arrived in the world can significantly affect bonding later, as can prolonged separation in the first few days or weeks of life. The rate of post-traumatic stress disorder after birth is surprisingly high (up to 9%) and there are several studies that demonstrate that such stress can impair bonding. This could be because of prematurity or illness, it could be due to feelings of guilt that are hard to shake off, even if they aren’t justified. Family dynamics and expectations, especially if they are in conflict with deep biological feelings can also have effects on how babies are handled and responded to. Babies are very sensitive to the feelings of their carers and will react accordingly - your baby’s behaviour and distress could be a signpost to some of your own internal discord and pain. This is where midwives, postnatal doulas and the NHS Afterthoughts services etc can be very helpful indeed in guiding families to find resolution and healing and I do recommend getting some support if you think this may be you.

In summary, if you and your baby are feeling good before you start, you are likely to have a more positive experience, and the more positive associations that are built up, the sooner your baby will begin to trust, enjoy and even ask for the carrier!

What is your baby's personality?

This is an important aspect. I often meet people who almost expect their babies to become utterly still in a sling, and to remain very calm. Well, after all, they're being carried close now, in a giant hug. What's not to love? What's not to be happy about??

Well, not everyone appreciates all-over cuddles, especially if they are not tired, and if they want to be active. This is where understanding your baby's personality may be very useful... imagine you were playing happily and patting a colourful thing in front of you. All of a sudden you are lifted up and wrapped knee to neck in a giant warm bandage, or suddenly put into a carrier, possibly one where you can't see very well. Some babies may love this; and settle down to happy drowsiness (usually because they are ready for cuddles, or are familiar with a well loved sling). Others may enjoy the sudden change of height and scenery and being able to smell their carer. Others may feel annoyed at being taken away from their happy activity, or be cross about not being able to see, or feel too hot, etc and don't appreciate the abrupt change - these babies may strain and bounce and wriggle or cry in protest. Most children I meet are pretty active in some way -  and it would be unreasonable to expect them to suddenly change from an active, inquisitive personality into a more docile, still and placid one, especially if the parent also stands strangely still, with their muscles all tense with anxiety about the use of the carrier and if baby will like it. "Mummy doesn't feel right, she's not soft and relaxed - this isn't good."

Remember as well, where is your child in their natural sleep-wake cycle? The more you're able to understand your baby's cues as they express themselves the more likely you are to be able to meet these needs before they feel they have to cry to be heard.

Tips to help you and your baby get used to a sling together

Practice makes perfect

  • Get confident with a demo doll first. Sling libraries and sling consultants are usually well stocked with weighted demo dolls which will allow you to figure out how to use the sling safely (remember the TICKS guidelines) and confidently. If you are very unsure while using the carrier, your baby will pick up on your nervousness and become unsettled.. this applies to every kind of carrier. This is why I always encourage people who come to me for help to use the dolls first, even if it feels like it will take longer... in the long run it will be more productive as you will have figured out which bits go where and how to tighten that section, so when it comes to trying it with your own child, you will be able to concentrate more on your child and how they are finding it, than simply getting it on. Even a teddy will help if you don't have access to a demo doll. It's the preparation (for example, knowing how to keep a child high on your body while you bring the panel up smoothly, or having a ring sling already set up can make a world of difference to the speed at which you can get the carrier on before your baby gets fed up!) Most babies will only tolerate a few "tries" with a sling, two, three at the most.
  • Use your carrier daily, for you both to get used to it, even ten minutes at a time, building up gradually.

Involve your child in the whole process

  • If possible, choose a time that baby is likely to be receptive to the sling; if she is fussing as she is experiencing an unmet need, the sling may not be the answer and merely exacerbate her cries.help my child cries in the sling
  • If baby is happily playing, do respect that, and don't just snatch her away from her delighted learning. We'd feel a bit put out if someone just removed us from the middle of our day jobs to be cuddled - and for children, play is indeed their "work." Sometimes you may not have a choice (eg school run time!)
  • If the time is right, engage your baby during the process, make it fun!
  • Tell her what you are doing and make the process of being put into the carrier enjoyable in its own right. A toy, a teether necklace, a song. Rock or sway while you go through each step, and take your time - there is no reason why you can't stop halfway to go and show your baby her reflection in the mirror, for example, before carrying on. Babies have not yet learned how to be patient - they may spot a toy and want it at once - being denied the opportunity to get the toy can be frustrating and lead to wriggling.

Be caring and careful

  • Observe how your baby likes to be carried in arms. Does she prefer hip carries? Does he love piggy backs? Try to reproduce this as far as you can. Babies are often "nosy" in the 4-8month period, and ring slings or hip carriers can be a brilliant way to carry a baby to meet their need to be inquisitive! Their preferences will often change as they grow. Try arms out for babies over 4months - freeing the shoulders can make a big difference!
  • Check your baby is safe (keeping his airway open and his breathing unobstructed is vital) - see link for more information on this
  • Check that he is comfortable - if something feels wrong or hurts him, he will let you know somehow. Understanding how to create a comfortable position that allows deep relaxation is important. We all shift our positions without thinking during the day (eg recrossing legs, pulling up socks) and it is hard for a baby to do this as easily. We must be caring and careful. So familiarise yourself with the ideal M shape pelvic tuck position (knees above bum with pelvis tilted inwards) which will avoid any strain on the joints and allow a comfortable curve of the spine. Such a shift from a previously "splatted starfish" position to a hammock-shaped seat can really help. Ensure baby can move her legs freely at the knee (make the carrier narrower if needed) and no red marks are developing (raising the knees up can help with this problem). Babies should have free and easy access to their mouth with their hands for sucking or exploring. Check that fabric is not digging into baby's neck (a muslin roll can help here) and that any knots, webbing or buckles are not pressing on baby's body. Ensure baby feels secure, but not restrained or restricted (too tight carriers, or too large carriers, can pose problems of their own).

Keep your baby occupied!

  • Remember that your baby still wants to experience the world even while carried, as they do when playing on your lap or on the floor. Help them to be able to see a little, in a way that is appropriate for their age and still respectful of growing spines and hips. A carrier that has straps or fabric that comes close to the face may be irritating (do remember that babies grow taller, and many carriers can be adjusted to ensure faces and heads not obscured). Make sure that there is some activity going on - we all know about the sway we do to settle babies when carried in arms, and how often we shift them around, or the rocking/pushing of the pram - this gives a child some sensory input, rather than remaining still. I often encourage parents to go for a short walk round the block when they have just put a sling on with their baby - the motion and movement to get out of the house and the fresh air and change of scenery usually works wonders and parents come back with happier babies. Of course, once the parent is standing still again, and baby is bored with the reduced activity, he will protest!

Keep going!

Learning a new skill can take a little time and effort... both for you and for your baby. New experiences need to be absorbed and processed.. and every day is a new day, we all have off days, babies as well as their parents. If your baby cries in the sling, try using your carrier a little bit every day, for walks or participating in safe but engaging activities.. and bit by bit see if it gets easier and your baby becomes happier.  The more relaxed and confident you are, the more your baby will respond to that (just like anything in life.) Don't force it, take your cue from your baby! If after a good go, things still don't feel right, try another one from your local sling library, and ask your friendly consultant/peer supporter to check your positioning - this is the best way to work out what carrier will suit each unique parent-child combination, and will save you money in the long run (you won't buy a carrier that doesn't work well!)

There are so many great things for you and your baby to gain from being able to use a sling - it is worth a little perseverance to get your carrying journey off to a great start, and hopefully this will be the beginning of a long and happy shared experience together!


Online Babywearing peer supporter training

Babywearing Training

Do you love babywearing and want to know more about it, or be able to support others with their sling use? Then one of my courses could be just what you need!

  • Do you want to understand more about why sling and carrier use is such an important tool for new families, and be able to be an effective advocate for their use?
  • Do you want a good grounding in basic babywearing safety across a range of circumstances and an introduction to the major types of sling and how to use them well?
  • Do you want to support families with their carriers?
  • Are you thinking about setting up a sling library service or a specialist baby class (yoga, forest school etc)
  • Do you want become a consultant, able to work with more complex situations?
  • Are you a health care professional wanting to know more about safe sling use and how to use them in specific settings?

Please browse my courses below!



Babywearing theory and sling/carrier safety – online course, £45

This online course 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 is a deep exploration of the science around connection, child development, infant mental health, anatomy, physiology, psychology, sociology, neuroscience, anthropology and more! It also provides a brief introduction to the major types of carrier.

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 or Consultancy 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.

Structure of the course

  • Why Carrying Matters  – the science.
  • Introduction to Basic Babywearing Safety.
  • The Different Types of Slings And How To Use Them.
  • Assessment Module (to confirm learning)

Enrol onto the Theory and Safety Course (£45)

Peer Supporter Course, £95 per person, half a day online learning, half a day practical learning (in person or online)

The Peer Supporter course is a combination of online learning and a practical  training session, either online via Zoom, or in person.

The online learning covers the theory of babywearing, basic safety, an overview of the main types of carriers and how to use them, the role of the peer supporter, and a little about special circumstances. It is more in depth than the simple theory/safety course.

The practical session focuses on actively supporting new parents with hands-on-help, providing them with support with fitting and troubleshooting. Babes in arms are welcome as we recognise that babies need their parents! We would encourage you to consider the impact that older, more mobile children and toddlers can have on your and others’ learning.

More information about the course and the equipment can be found here.

Satisfactory completion of this course and the assessment will generate a certificate of competence as a Babywearing Peer Supporter.

Structure of the Peer Supporter Practical session

  • Building and assessing skills in using the main types of carrier.
  • Learning and practising how to support others and troubleshoot effectively.
  • Opportunities for discussion with Rosie and fellow students.
  • Assessment Module to ensure receipt of information and ensure the high standards of training are met.

If you have done the online theory/safety course in the past and wish to upgrade to Peer Supporter training, please contact Rosie.

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

Book onto an upcoming Peer Supporter Course

prem, kayPeer Supporter Course for HCPs, £95 per person, half a day online learning, half a day practical learning (in person or online)

The Peer Supporter course is a combination of online learning and a practical  training session, usually online via Zoom or MS Teams for health care professionals around the UK.

The online learning covers the theory of babywearing, basic safety, an overview of the main types of carriers and how to use them, the role of the peer supporter, and a little about special circumstances. It has a greater focus on newborns or children with extra needs in health care settings.

The practical session focuses on actively supporting new parents with hands-on-help, providing them with support with fitting and troubleshooting. and can be tailored to work with particular carriers.

Bespoke courses for groups are available.

  • Satisfactory completion of this course and the assessment will generate a certificate of competence as a Babywearing Peer Supporter.

Book onto an upcoming Peer Supporter Course (specify you are a HCP in the booking)Contact Roșie to discuss a customised group HCP peer supporter course

Babywearing Consultancy course – new format for 2024

I love offering consultancy courses, equipping people with the skills they need to support parents and carers with their children – the impact of such people can be life changing for families. As Kiri and I worked with our 2022-2023 cohorts, two things became clear – firstly that people really value the face-to-face element of training, especially with the more complex situations we are more likely to encounter as consultants, and secondly, that there is a huge amount of knowledge being imparted in a very short space of time, which can be challenging to absorb and then put into practice independently.

With that in mind, we have changed our format to be a longer course that allows people the time they need to learn as they go, and apply their new knowledge, develop questions and build relationships while still part of the course, and kept the face-to-face aspect in a single weekend of in-person training.

The course has three sections.

  1. A comprehensive online theory section. This covers all aspects of babywearing safety and the basics of carrier use, the history of babywearing, the science behind close contact, how to develop consulting skills, and much more. This is in a modular format that can be done at your own pace before the practical sessions, and will take around 12 hours of learning time.
  2. A series of 5 live 2-3hr Zoom sessions where we begin learning and practising how to use the major carrier types in depth, how to adapt them to individual needs, as well as working on communication and exploring common scenarios. Each week has a different theme and you will be encouraged to put your skills to use before the next session, to allow for real-time practice and personalised feedback.
  3. A weekend of in-person learning with me and Kiri in Sheffield, where we work on complex situations, disabilities, and the ‘soft skills’ that are so key to effective consultations and satisfying encounters (as well as what to do when things are not working as you had hoped!). This is the culmination of the course where we bring everything together.

All our trainees become part of their own cohort for discussions and feedback, as well as joining the Carrying Matters educator groups (and the UK professional groups) for ongoing support.

Dates for spring/summer 2024 are currently fully booked, Autumn/Winter courses dates will be available soon, please contact me if you want to know more or arrange a group course.

The course costs £600, and payment plans are available. Please do get in touch if you have any queries. Further reading here.


Why train with me?

I am a Carrying Advocacy educator and trainer, and am well known for the evidence base and scientific focus of my training, as well as my ability to demonstrate clearly and simply, and explain concepts simply and engagingly. My interest is in supporting new families with babywearing, due to the enormous value this skill can add to their wellbeing and their long term health and my goal is to see this become available to every antenatal and postnatal family, via educated advocates!

I have trained hundreds of people and educated many more over the last ten years. 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 and become consultants.

Feedback

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

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. This is not a peer supporter or consultancy course.

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 courses do I need?
You will need the Peer Supporter Course.

I want to offer classes for new parents and their babies with slings as part of the class. Is the online theory course enough?
No. You must do the Peer Supporter training. The online theory 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.

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.

Do I need insurance?

Those who attend this course, complete the post-course assessment and receive their certificate of completion are eligible for insurance from several providers, such as BGC, Therapist, and more.

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.

“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!”

“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.”

“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.”

“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.”


adoptive and foster families

Slings and Adoptive and Foster Families

We all know how vitally important it is for children to build secure attachments with their primary caregivers, both for a sense of security and belonging now and in the future. It is much harder for this supportive relationship to develop when the primary caregiver has difficulties of their own, and when children need to be taken into care. The adverse experiences being endured by children in these circumstances have been shown to have a long term effect on future mental and physical health

This page collects some of the most useful writing on the topic of sling use among adoptive and foster families.

Leah Campbell's story

Adoptive and foster parents will know that their children need all the love they can give; and a sling can play an useful part in building these bridges amidst the turmoil. The biochemistry of creating a secure attachment is not a conscious process, or one that depends on ancestry; the release of oxytocin and the down-regulation of the stress response that happens with consistent, close and loving contact happens in the background.

Carry the Connection website

There are many other benefits in terms of language acquisition, socialisation, and also helping children to learn which of the adults around them are their primary caregivers.

Sue, a foster parent in the South, is a strong advocate of using slings as part of her care.

“Many of the babies who we care for have been exposed to either drugs, alcohol or domestic violence whilst in the womb. Carrying them has, without doubt, enabled them to develop into calm, sociable, happy, securely attached babies who meet (and often exceed) their developmental milestones.

Babies who have been neglected for the first few months of life can be very wary of people and situations. By carrying them they learn more about the world from a position of safety. They take cues from watching our faces and  learn to trust people and situations more more quickly.

Using carriers when introducing babies to their adoptive parents show the babies that this is someone to be trusted. Only I carry the baby in a sling whilst they stay with me although many other people hold them. However from the first day of introductions the adoptive mother wears the baby in my (the baby’s) sling. I believe this shows the baby that Mummy (or Daddy) is a special person which enables the attachment to switch between us. “

“Children with disrupted attachments are often indiscriminate in who they seek to have their needs met by. Children should always be guided back to their parents by family and friends if they are approached by the child particularly for food and nurture. This process is called funnelling and is extremely important in giving a clear message to the child about who their primary caregivers are. A sling or carrier could be helpful in this process, reducing indiscriminate attachment seeking behaviour and discouraging over-enthusiastic family and friends from picking up and nurturing the child.” Carrying the Connection

This blog post from Slings and More (based in the North East) assesses the science behind how slings can help  adoptive and foster parents to build secure attachments.

“Foster and adoptive families have an immense role in helping to form strong attachment bonds with the children they look after and to help those children who do not have strong attachment bonds to begin to form them.”

This is a personal account of a mother’s experience of using slings as she adopted a little girl.

Her father told her: “You two should have some time alone. She needs to learn your smell and the sound of her mama’s heart.”

Perinatal mental health challenges can be very real for adoptive parents too, and slings can be enormously helpful for all shapes and structures of family unit.


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 below to download a PDF, or order A3 posters using the button below.

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

Click on the image to download a PDF, or order A3 posters using the button below.

Buy the Bonding with your Baby posters here

Click on the image to download a PDF, or order A3 posters using the button below.

Buy the Babywearing and Mental Health (mother/father) posters here

Click on the image to download a PDF, or order A3 posters using the button below.

Buy the Babywearing and Mental Health posters (inclusive) here

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

Buy the Carrying in the Heat posters here

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

Buy the Carrying in the Cold posters here

Read Rosie’s well loved Why Babywearing Matters book here, published by Pinter and Martin.

Buy the book here

Read Rosie’s well loved Why Babywearing Matters book here, translated into Polish by Lenny Lamb.

Buy the Polish book here

Bonding with your big kid

Bonding with your big kid is just as important as bonding with your baby. Older children need love and secure attachment relationships too, as their brains are still growing and their foundations still being laid down.

“I wish I had known about slings when I had my first child!”

“My son suddenly wants to be carried all the time suddenly and he’s so heavy now, I feel like we missed the boat.”

“My big girl is finding it hard with our new baby and seems to be much more clingy than usual. I wish I could carry her somehow..”

Do any of these comments seem familiar to you? I hear this kind of thing almost daily, and while part of me rejoices that now, at least, these parents do know how fantastic slings can be for family life, I appreciate their sadness.

But did you know, big kids like to be carried too? How many of us have hoiked our hefty toddlers onto our hips when their legs get tired of trundling along, or felt little arms wound around our necks when they are tearful? How many of our huge preschoolers still appreciate long hugs and piggyback rides? All children need closeness, long beyond the baby stage, long after they take their first steps, long after they start school… and so do grown ups! Loving contact is vital to our emotional health, from cradle to grave.

bonding with your big kid

A sling is, at its most basic, a tool for enabling close contact, almost like another pair of enfolding arms around your child, while your real arms can be used for other things. A good sling, when used well, provides a feeling of all-around gentle pressure, as if being hugged all over. This can be very valuable for children struggling with sadness, with sensory overload, with tiredness, or fear from loud noises, for example. Being close to a parent’s body is reassuring and sends a valuable message to a child that “You are loved. I will look after when you are unhappy, I will keep you close when you need it. I am always here for you.” There are many other advantages to slings beyond this opportunity for connection; not least that they can be very comfortable and help to distribute the weight of a child around your body evenly, making it much easier and much less tiring than in-arms carrying. They can help to provide nourishment –  breastfeeding or bottle feeding on the go, they can make school runs easier, allow greater freedom in exploration, enable naps, and keep exuberant runners out of danger in crowded areas or near roads etc.

Slings with Big Kids

You can use pretty much any kind of sling with a bigger child, even a stretchy, if it is a high quality hybrid one like the JPMBB or the Ergo wrap. I’ve helped a couple of parents with toddlers find the stretchy love, as there’s nothing quite like the enveloping gentle bounce you get with these. They do tend to work best and most easily in front carries.

Ring slings can be fantastic, if you have the shoulder style that suits you best (pleated vs gathered), and made of a fabric that is supportive enough. People often suggest linen or hemp or silk to add strength to the softness of cotton, which indeed they do, but many 100% cottons are more than sturdy enough for heavy children, who can become easier to carry as they develop more core strength and become more compliant and easier to carry than the “bowling ball stage” – it’s worth trying a few out!

Woven wraps are the most versatile, as they can be tied in different ways, in different positions and with different levels of support. As with ring slings, the fabric used can make a difference to how a wrap feels – fibres with extra support can be helpful but may not be necessary, and as above, understanding tightening techniques and how to get a good position can really help you make the most of your current wrap

You can get toddler size meh dais, half buckles and full buckle carriers, even some up to preschool size. Again, it is worth trying a few out at your local sling library as one size does not fit all, and the body size and shape of the carrying parent plays a part too (some preschooler carriers will just be too big for petite mums, for example). Waistbands may need to be worn lower (around the hips) for front carries, and some creative methods for getting a good seat in a back carry may need to be employed! Please do take advantage of your local sling professionals about whether you need a bigger carrier for your child; it may be that your current carrier just needs a few tweaks in technique to get the most out of it. Many people upgrade to toddler carriers earlier than really necessary, and too big a carrier may be more problematic than one thats just a touch small (see my “beyond the knee to knee” article for more information).

worth

What about the inevitable comments “he’s too big to be carried like that, he should be walking!” or “You’ll just make that child clingy, you know”? Well, I think a sling is as valid a means of transport as a pushchair, and far more comfortable than achingly weary in-arms carrying. Don’t be afraid to carry your toddler – for every comment you get, you may well have planted an idea in someone else’s head. Ensure that your child doesn’t feel hurt by any comments, sometimes talking about any incidents together afterwards can be helpful. Using a sling for your bigger child from time to time will not harm them, nor will it make them babies again, any more than a hug or a hip carry would do.

My own experience

My big girl, who was nearly 4 at the time of writing, is much less often carried these days; much to my chagrin.. but she is vocal about it when she does want to be carried, climbing up me and wrapping her legs around my waist. I am happy to oblige as I’m never sure how many more carrying days we have left to enjoy. She has moods, and disappointments that the world doesn’t revolve around her, and sometimes she finds it hard to wind down. Often, at these moments, a sling has been our saviour, holding her close so she can relax, feel safe, and  listen to my reassuring murmurs, while I can still get on with some of the things that just can’t wait, or save my back and arms from her lopsided weight! We use all sorts of carriers –  ring slings for quick up and downs, woven wraps for sleepy cuddles, preschooler buckle carriers for rainy school runs, warm snuggly half buckles for winter walks.

 

Even my (then) six year old found a wrap carry a great reassurance one day when he got separated from us at the Yorkshire Sculpture Park; he was very distressed when found half an hour later and just wanted to be holding onto me. My husband’s shoulders got pretty tired after a few minutes; but I was able to carry F on my back for well over half an hour, due to the support and the weight distribution, enough time for him to feel reassured and connected again. I found it really helpful too – it was a pretty horrible forty minutes and having him in close contact was very valuable for my own feelings and allowed me to breathe and absorb, and move on.

end of babywearing

A local story of re-connecting with a sling

I’ve got to know one family with a preschooler pretty well, they hadn’t used a sling for over a year, but started again, almost from scratch. Here’s what they have to say about their experience of carrying a bigger child.

After starting nursery, H became anxious and disconnected. She chewed her fingernails to a painful point, and became difficult to communicate with, as well as regressing in toileting. Instead of adopting behavioural control techniques, I drew on my experience from other parts of our lives and adopted a regression tactic. A big part of this was returning to carrying her in a sling. We had used our high-street carrier rather than a pram on our dog walks, but had given this up over a year before as she had outgrown it.  We wondered if a ring sling would be a solution for short snuggles for reconnecting. H was too heavy to attempt this from online videos, so we booked a workshop with a local sling consultant, who reassured us that she wasn’t too big, and showed us how to ensure we were all comfortable. The ring sling has been perfect for our needs and has really helped us all. More often than not, it has doubled up as a dramatic scarf for the 80% of the time H wanted to walk!

H is now almost 5. Our new buckled carrier is the perfect tool for winding down for bedtime on a camping trip, resting tired little legs whilst hiking (without the bulk of a framed carrier), and elevating her out of danger in busy, crowded areas. I really believe there is no such thing as “too big to sling!”

Slings with Two Kids

Another situation where carrying a bigger child can really help is with sibling jealousy.  The other day I spoke to a family who hadn’t used their sling with their toddler for some time, and now have a new baby. Big sister has been feeling a bit jealous of the new arrival and has wanted to begin breastfeeding again. They asked for some advice, and I suggested that their daughter would really appreciate the contact that would come from using their ring sling and buckle carrier again… and so it seems to have proved. It’s not so much the desire to be a baby again, but more of a chance for communication – “you still belong to me, don’t you?”

I’m working with another lady whose older child is struggling to accept their brand new baby. She asked me to show her how to breastfeed her baby in a sling, in the hope that this would allow her to be hands free to play with her toddler. She’d never carried her first child but was loving the slings with the little one. Successful breastfeeding in a sling is a challenge that requires care to do well and safely, and in my opinion is never fully hands-free. However, one hand available can make a big difference – you can hold a book to read, help with a jigsaw at the table, stir a mixture, hold a hand, for example. Amongst other things, we looked at a ring sling, which can be used for little babies as well as bigger children who love to sit on the hip and look around, so it is a carrier that can be used for children of multiple sizes. Hopefully, carrying the bigger child from time to time while the baby is sleeping, or in a pram or carried by Dad will be helpful for dealing with big feelings and the need to know that his Mum is still Mum and will always be there to meet his needs, even with the new addition taking up so much of her time.

There are some carriers that can be used with small babies and bigger children; which means the same carrier can be used for both children when needed. The ultra- versatile ring sling and woven wraps are good examples, which mould around the parent-child dyad and can be used from birth to preschool age and beyond.

Some mei tais with adjustable width can work well for families with children born with a small age gap. The buckle-waist equivalent half-buckles can be useful, or those with wide wrap straps that can be tied in such a way that bigger children will be supported knee to knee. Some full buckle carriers can be used from birth and their panels can be adjusted to the size of the child. Some come with inbuilt adaptations for using with babies, and some have separately purchased inserts for small babies to rest on until they grow big.

Do visit your local sling library or get in touch with a sling consultant for some help navigating all these options; there will be something to suit nearly every situation!

safe sling position
about rosie

Slings during Pregnancy

During pregnancy, carrying an older child can be an opportunity to help deepen relationships and prepare for the new arrival, being reassuring that things really are going to be all right after all. Carrying while pregnant has its own challenges too; ensuring the bump isn’t compressed, that weight is well distributed, that any symphysis pubis discomfort is not exacerbated. Do see your local sling consultant or chiropractor or physio for help if you need (bearing in mind that many health care professionals may not be up to date with ergonomic, safe carriers.) There is more reading here about carrying while pregnant.

In summary, older children do not stop needing the love and support of their caregivers for a surprisingly long time. Our society seems to believe that we should encourage separation of children and caregivers as young as possible, to breed “independence”, when actually, neurophysiology suggests that children will learn independence at their own pace, as their cognitive and emotional capacities develop.