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.

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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.

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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


child care providers

Sling Training for Child Care Providers

Many parents are now expecting their child care providers to have some knowledge of safe sling use, and to use slings with the children in their care. In Sheffield, we provide training for those working in child care settings (as well as a module of the Early Years Parenting PGCE at Sheffield Hallam University). Here one of the course teachers explains why sling use in a child care setting matters.

Contact us to book a course here

Attachment in the Child Care Setting

Secure attachments with their primary care giver is vital to children’s social and emotional development. It helps them to grow into happy and healthy sociable beings.

The relationship between a child and their parents, is of course, paramount. But what about those children whose care is provided by more than one person? What if their care provider is absent for periods of time due to work or illness?

My husband and I work full time. Our two children have attended nursery since they were 6 months old. Between them they are at nursery for 80 hours per week. We have seen first-hand the difference that a strong attachment with nursery staff can make.

For those children who are cared for by extended family or private care providers, building bonds with those carers is critically important. A strong attachment with nursery staff can make a big difference to children’s happiness and comfort, and also to parent’s confidence in leaving their babies with a childcare provider.

Nurseries are telling us that prospective parents are asking if they practice babywearing. Parents are listing use of slings as one of the criteria they are using to base their decision of childcare provider.

Let us help you offer this service to the children in your care in a competent and safe way.

child care providers

How can sling use help in child care settings?

Slings can help carers to hold children close, responding to their needs quickly and soothing children who are upset. Childcare providers tell us how they put distressed babies or tantrumming children into slings and feel them calm down, as they are rocked and swayed in the carrier, often falling asleep.

Slings are particularly helpful for providing familiarity for children who are already carried in slings by their parents. Using slings with these children can help replicate the routine they have at home and provide a familiar source of comfort.

Slings enable babies to be carried at height, seeing the world through the eyes of the person carrying them. It provides a new perspective for them, being able to observe how their carer interacts with the world, how they communicate with other people, how they behave. This observation and learning helps their social and emotional development as well as their language acquisition.

Slings also provide a safe haven for over-stimulated over-tired babies and children. Holding a baby close in a sling provides them with some respite and rest during a busy and active nursery day.

As well as the emotional and social benefits, for childcare providers, using carriers has obvious logistical and practical advantages. Slings can be used on day trips and walks, whilst one baby is in a sling, the same carer can push a double buggy, maintaining the 1:3 staff to child ratio.


There are a number of circumstances in which slings could be useful for childcare providers:

  • Providing security and attachment

  • Settling-in and transitions

  • Replicating familiar routines from home

  • Encouraging bonding with multiple staff 

  • Assisting in sleep and nap routines

  • Soothing and comforting babies/children

  • Going on day trips and walks

  • Quick carries around nursery buildings

  • Being ‘hands-free’ to look after other children


Different types of slings

There are several different types of slings that could be used. Each type of sling presents different pros and cons and some aspects to consider include:

  • The age range it is best suited to
  • How easy it is to learn and master
  • Potential for trip hazards (for example from long straps)
  • Potential for overheating (for example from multiple layers of fabric)
  • How to fold, care for and store


Safety Guidelines

Of course, whichever sling is used, safety guidelines must be followed. The most important aspect is to ensure children are able to breathe easily; once babies are over 3-4 months they can hold their own heads up and protect their own airways. Ensuring they are not too hot is also important.

The best known safety guidelines in the UK are the TICKS guidelines.

Comfort for children and for the staff matter, as well, so choosing a comfortable sling is a good idea, it is worth trying a few first. If you are a childcare provider using, or thinking of using slings, it is a good idea to undertake staff training and introduce a policy and consent forms. This will give you a chance to try some carriers and see what will work best for your needs.

Parental consent and the consent of staff members should be secured before putting a baby/child in a sling.



Positive Effects of Carrying for Society

The positive effects of carrying for society are many; making a change at an individual level can have a significant impact when lots of people do it! In-arms carrying and using slings is one way that we can change the future that we all have to live in.

Possibly one of the most important positive outcomes for carrying for a parent and the society we live in is the effect it can have on mental health, which is a society-wide issue. 

Western society is increasingly fractured and isolated, with a decreased sense of local community and shared care. The burden of mental unwellness in our society is growing, and becoming a parent with this background can be very tough indeed.

The birth of a baby is often an overwhelming time for both parents, especially when also faced with the expectations and demands of a fast-paced culture that often judges people by their apparent productivity and appearance. It is no wonder that postnatal depression is on the rise – affecting at least 10-15% of new mothers. This is likely an underestimate as parents feel ashamed to admit their feelings, with the effects of hiding their struggle having significant knock-ons for the whole family.

Fathers are often unrecognised to have the condition themselves, and this all adds to an increased risk of children coming to harm. This is a terrible indictment on our culture and its lack of care for some of the most vulnerable individuals in our communities.

The way we live now isn’t going to change overnight; funding for parental leave or greater support for mental health isn’t going to become suddenly available, and the media bombardment of products for parenting won’t vanish. But neither are the emotional needs of young children going to go away, especially if we want them to grow up well and be happy, confident mature individuals who are well integrated into society.

We need to find ways to nurture our children while still functioning as our culture expects us to, and this is where carrying children (often using a sling) can help. Carrying children encourages and protecting parent’s precious closeness with small children while helping to build the bonds that will be the foundations for a positive future. Giving children a secure and confident start in life pays dividends later for the whole of society.

  • Families who enjoy secure attachments and strong bonds are more likely to weather the early years of parenting safely and build resilient children with a secure self-esteem. This will help to counteract the growing burden of mental "un-health" especially as funding for mental health services continues to decrease. Carrying (and using slings), via oxytocin release, helps to build these bonds; and can improve resilience to the Adverse Childhood Experiences that so many children experience. Read more about ACE's here.
  • Anything that improves mental health and assists families struggling with PND is worth investing in, especially something as accessible and low cost as a carrier.
  • A very sobering review of international attachment studies done by the Sutton Trust found that infants under three years who do not form strong bonds with a parent “are more likely to suffer from aggression, defiance and hyperactivity when they get older.” They found that up to 40% of children lack this secure bond with their parents, and this is likely to lead to their own children also suffering from insecure attachment; a vicious, repeating cycle. “Parents who are insecurely attached themselves, are living in poverty or with poor mental health find it hardest to provide sensitive parenting and bond with their babies.”
  • They also found that children with weak attachment were more likely to be obese later in childhood (with subsequent effects on their long term adult health).
  • Communities are the normal social structures of the human species; finding common ground and sharing the strains of life together keeps us going. Many families find community among like-minded parents; most sling users make strong supportive friendships within the sling community.
  • Carrying keeps us active; movement is essential for health and fitness. Dynamic carrying in arms (if possible) helps children to hone their growing neuromotor skills, and carrying young children (or those with tired legs) is good for adults too; bone remodelling, muscle health and posture.
  • As the rates of breastfeeding are higher in carried babies, the health benefits of breastfeeding will be more marked in societies who carry a lot (reduced breast cancer risk, reduced osteoporosis, increased transfer of antibodies, to name just some.)
  • Babies who are carried are more content and cry less. Crying is very stressful; and successful calming of a distressed baby will build a parent’s confidence in their ability to care for their child and also reduce the feelings of tension in social gatherings or in large public open spaces.
  • Carried babies may have had less ear infections, less corrective treatment for plagiocephaly, and thus have been less in need of the NHS budget.

I believe that health care professionals should therefore promote frequent carrying of infants to achieve the best possible outcomes for families, and for the long term benefit of the societies they live in. It is a low cost intervention that can have far-reaching effects.


positive effects of carrying for parents

Positive Effects of Carrying for Parents and Carers

In-arms carrying and using slings doesn’t just bring good things to babies – they can make a real difference to parents and other caregivers too. Read more about the benefits of babywearing for adults here.

  • It encourages bonding and deepening of a loving relationship via the release of the hormone oxytocin; having baby close heightens the parent’s awareness and can increase their responsiveness to their baby’s needs. You can read more about the effects of oxytocin here.
  • It can increase parental confidence. The parent may be more “in tune” with their baby, as the carried child is part of the parent’s personal space, and the parent will be more aware of changes in a child’s mood, and thus be more able to respond to the child’s facial expressions, gestures and vocalised needs sooner. This will build mutual trust and contentment.
  • There is evidence to suggest that sling use can help with perinatal mood disorders such as postnatal depression, in part due to oxytocin release and in part due to increased bonding.
  • Fathers and other care-givers will be able to use a sling as well, increasing family connections and helping baby recognise more people by their voices and scent. Sling use can be very valuable in giving family members “cuddle time” and can be an useful tool for childminders as well.
  • Slings can provide “hands-free” parenting, which can be very useful, such as making a quick snack, interacting with an older child, doing the housework or other chores. A “fussy” baby may calm and settle in a sling, allowing the parent more choice about how to use their time.
  • Slings can provide opportunities for physical exercise and mental stimulation; a new skill to learn and a new social circle (social sling meets, for example!) Many people find that carrying their children on walks helps to lose weight and tone muscles. Dynamic (in arms carrying) is also a good workout!
  • Slings can provide greater access to the world – in a good sling the only limitations are where your feet can take you. Onto the beach, off the beaten path, up a tower, onto crowded public transport, around busy airports, the world is your oyster!
  • Slings can provide comfort and nurturing for older children as well.

Read more


Benefits of babywearing positive effects of carrying for baby isara grey carrier escalator

Positive Effects of Carrying for Baby

Carrying your baby is essential to their normal physical, psychological and neurological development. Human bodies are adapted to be a carrying species, it is part of our evolutionary history, however, our bodies are not as fit or as strong as our nomadic ancestors. It can be hard to carry in arms for prolonged periods of time. Nevertheless, babies need to be held, so a good, safe sling can be very useful in to help with increasing carrying frequency.

Remember, it is the relationship of closeness and loving touch that matters, as well as the position adopted in a good sling. The type of sling or the fabric that you use is just personal preference.

The benefits of babywearing- or the positive effects of carrying for baby are many;  here are a few.

The positive effects of babywearing for baby are many; here are a few.

  • It encourages bonding with the parent and helps to meets baby’s strong need for a sense of security and attachment, which will lead to greater confidence and independence later in life, as well as greater resilience and better long-term physical health.

 

  • It helps to regulate temperature, heart and respiratory rates, and emotional and physical growth. This can be especially useful for premature babies (the term “kangaroo care” and “fourth trimester” come from this concept) or children who are unwell.

 

  • It promotes and encourages the establishment of a successful breastfeeding relationship, in part due to the oxytocin release from the soft touch. Mothers who carry their children in soft slings are more likely to breastfeed beyond the early weeks.

 

 

  • Regular close skin contact is believed to help babies regulate their circadian rhythms better and distinguish the difference between night and day sleep.

 

  • Skin to Skin mattersIt reduces crying, both frequency and duration, (Hunziker and Barr 1986) and can improve sleep. It is safe for your baby to sleep in the sling, if the airway is well protected. Less crying means more time to be in “quiet absorption’, promoting learning and positive interactions with the world. The Esposito study discusses some of the mechanisms behind movement and how carrying is calming for babies.

 

  • Babies with colic can be hard to soothe, but the motion gained from being gently rocked in a sling while the parent/carer walks may help to settle them, and also the parent/carer may feel less helpless. There is no evidence to suggest that babywearing actually reduces colic itself.

 

  • Many parents of reflux babies spend a lot of time holding them upright and have tired arms and sore backs! A good sling that supports an upright position can thus reduce regurgitation and the discomfort of reflux. A spread squat position helps relax puborectalis muscle, to aid bowel elimination.

 

  • The motion experienced by a baby being held by the carer allows the vestibular balance apparatus to develop more rapidly and enhances neuromotor development and muscle strength. It improves neck and head control, but is not a true substitute for “tummy-time” (tummy-time head-lifting is against gravity from a prone position). This is more marked with dynamic in-arms carrying (where this is possible). A sling or carrier should never be used as a prolonged restraint (unless danger is present such as crossing the road). 

 

  • Children should always be encouraged to be active as much as possible (WHO 2019) and if they want to get down and it is safe and practical to do so, this is ideal. However, this doesn’t mean that a child who is otherwise very active needs to be automatically removed from the sling after a certain amount of time. Sleeping babies do not need to be disturbed, just gently adjusted to ensure safety.

 

  • It is believed to encourage sociability and language development; being able to hear the parent’s voice close up and watch their interactions with the world and other people from a higher vantage point is beneficial and also aids formation of family relationships. Studies into reduced talking in outward facing buggies highlights the importance of children being able to communicate easily with their carers.

 

  • It allows baby to retreat from an overwhelming world and snuggle into the parent’s body for respite when needed. This is harder to do with world-facing carries, so encouraging parental responsiveness with front-facing out positions is important. (The challenges of facing forwards is covered in more depth here)

 

  • Babies can learn very easily from a place of consistent safety, as their brains are not engaged with mere survival.

 

  • Good, correctly designed slings that encourage the physiological spread-squat "M shape" position (that mimics hip-perching) can help prevent hip problems later in life in those children at risk of hip dysplasia. There is currently no convincing evidence that narrower based carriers cause hip dysplasia in otherwise healthy hips.

 

  • Babies who are carried are less at risk of plagiocephaly (the flattening of the skull bones at the back of the head from prolonged periods lying on the back, more common since the “Back to Sleep” campaign). Slings are recommended as one solution (by the NHS, too!)

 

Further reading

"Why Babywearing Matters", Rosie Knowles, 2016

To have and to hold: Effects of physical contact on infants and their caregivers, Infant Behavior and Development, Volume 61, November 2020

 


If you would like to read in more depth on this subject, my book “Why Babywearing Matters” discusses much of the evidence base for the importance of carrying. It is normal behaviour for the human species to carry their infants close to their bodies; the book considers the anthropological, physiological and psychological reasons for this. Carrying really matters.


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Blog

The Carrying Matters blog page.. enjoy reading! If you have any topics you'd like to see covered, get in touch! I enjoy writing and am always keen to hear of new ideas, and to host guest blog posts too!

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Carrying in the Postnatal Period

lindsay 10days

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

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

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

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

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

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

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

Carrying your child in the postnatal period is important.

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

 

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

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

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

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

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

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

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

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

twin stretchies
Twins in a stretchy. Image shared with permission

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

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

Carrying after a Caesarean

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

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

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

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

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

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

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

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

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

Read more about babywearing fitness classes here.

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

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

Toddler carrying after birth

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

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

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

Involving the whole family!

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

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

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

family


slings and prams and guilt

Slings and Prams and Guilt

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

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

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

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

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

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

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

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

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

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

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

snowsuits scarves slings and safety carrying in the cold

All safe and responsive carrying is good

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

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

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

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


carrying children matters, carrying matters, rosie knowles,

Why Carrying Children Matters

Why does carrying matter? There are so many reasons why holding and carrying children matters, on multiple levels (biological, developmental, psychological, sociological, long term health) that it would take a whole book to discuss, even in brief!

Carrying behaviour is normal for the human species; babies are very vulnerable at birth. They are born with great needs, there are many months and even years of maturation needed before human infants are able to control their bodies fully and become able to care for themselves independently. Babies and young children are dependent on their primary caregivers for a very long time. This prolonged childhood is thought to be one of the reasons why the human species has been so successful; allowing the human brain to develop complex skills such as language, creativity and the ability to alter the environment around them.

Mothers’ and babies’ bodies are adapted to each other; during pregnancy, during birth, and during the early years. They “fit together” and create a very special shared space, honed over the millennia of evolutionary processes. They work perfectly in harmony, when given the support and freedom to do so.

carrying matters

This is where the “4th Trimester” concept comes from; holding and carrying babies recreates in some part the intra-uterine environment of warmth and safety and containment and allows them to develop new skills from this platform of security. Our human instincts are strong (a baby’s cry tugs at our heartstrings and we feel the urge to gather them up, hold them close and rock gently while murmuring in a soothing way) and we are discovering much of the neurochemical science behind this normal, natural behaviour. Oxytocin release builds loving connection via multiple pathways. Soft touch has helpful effects on the hypothalamic-pituitary-axis and cortisol production, reducing pain and modulating the stress response. Gentle and responsive parenting builds and reinforces the neural circuitry as it develops in the child, creating a healthy positive inner thought state that affects long term mental health. Furthermore, building this resilience helps to combat the adversity that so many children experience. Early “skin to skin” contact is enormously useful for beginning this process of connection.

Children need loving nurture in the early neonatal period and long beyond this for normal, healthy development. Carrying babies close to an adult’s body, as human beings have evolved to do, is vital for normal physiological and psychological development. Research into the importance of skin to skin contact, soft touch and responsive parenting, as well as a better understanding of disability reinforces this.

I talk about the positive effects of holding, carrying and babywearing, rather than the “benefits” of these practices. The word “benefit” implies an extra thing, an advantage, something that can be added onto what is baseline… but the holding and carrying (however it is done, in arms or a sling) that builds connection is part of normal human development. It is the baseline! It isn’t something that some parents can choose to do to give their child an extra advantage in life. It is what all babies need, like nourishment, warmth, safety. The absence of these loving connections that involve gentle physical touch is harmful to children.

Carrying multiples, carrying twins, carrying toddler and baby, babywearing
prem, kay
carry me daddy

We can agree that carrying children matters. However it is not just babies and children who need the close contact; parents and caregivers also benefit hugely from holding their offspring and interacting with them closely. The same biochemical pathways that help babies and young children to thrive are present in adults too, and families flourish when the needs of all its members are met. Adults need loving contact too; and a child who calms when comforted in arms or a sling provides positive reinforcement that parenting is manageable after all. Many parents find that babywearing can help with low mood and improve their confidence, as well as giving them freedom to get on with their lives in the societal constraints in which they live.

Carrying in arms and in a sling really does make a significant difference to the overall wellbeing and physical and mental health of all members of society, both now and for the future. A society where children’s needs and rights are taken seriously, where knowledge of how to build securely attached children and adults is put into practice, and where the most vulnerable among us are treated with love and kindness, is one in which we would all wish to live. This is why carrying matters; it can change the world around us.

To find out more, please click the links below.


do slings create clingy children

Do Slings Create Clingy Children?

Mum and baby on the beach
Only Mummy will do when overwhelmed

Do slings create clingy children?

Many parents worry that by carrying their baby in a sling, that they are going to create a “clingy child” who won’t be put down. There is a lot of pressure from society to "put your baby down", a fear that responding to the cries of a child will somehow spoil them. Many people believe that children need to be trained into early "independence" and that too much love holds a child back. This is very, very incorrect.

It is disconcerting for a babywearing mother who has carried her child frequently from birth to find that he wants to be held much more than his contemporaries, and when the time comes (if it does) for childcare from other individuals, her baby may protest very vigorously and will not allow another adult to look after him.

All too often, at this point, the words “rod for your own back” surface and the use of the sling is blamed for the child’s behaviour, labelled as “clinginess”. People can use this as a reason to reinforce fears that a child has been "ruined" by the cuddles. For a new parent,  doubt can creep in; a fear that somehow, somewhere, a wrong choice has been made and a child’s independence has been stunted by keeping them too close.

Watching parents and children struggle to separate can have an influence on bystanders; encouraging them to think that sling use is more trouble than it is worth. They are wrong.

BreastfeedingSecure Attachment Matters

It would be worth at this point, to briefly recap the value of close bonding and secure attachment. Close contact that began at birth and has continued uninterrupted will have initiated, facilitated and consolidated a positive bonding process (mediated by oxytocin).

Such children are likely to have secure, positive attachments to their primary caregivers, which is essential to their physical and psychological health. This is how to build a happy brain; responsive parenting. Children who know their own value and have a rock-solid foundational experience of having their basic needs met, will have trust and confidence in the loving adult relationships around them. This builds resilience, a vital tool to help children thrive despite adversity.

When it is biologically appropriate, they will be more able to turn to independent play as they know and trust their mother is there, even if out of sight; she will not abandon them, she has consistently always come back. As they grow older (towards their first birthday), and begin to develop more co-ordination and independence in movement under their own steam, they will have the underlying security to roam further and further freely. This takes time to develop, and individual personalities play an important part in this.

child beginning to discover movement
Beginning to discover movement

With this natural, biological change and development in their bodies, they will also demand less frequent contact, less frequent feeding, and begin to expand their horizons. This is often the point at which carried babies begin to want to be carried less; to reach for the floor where they can explore, and investigate the world around them. They may even begin to refuse the sling from time to time, often to the carrying parent’s chagrin!

Modern society expects children to become independent individuals extremely young, praising and rewarding those first shuffles forwards, first crawls and first steps, and being quick to criticise or discourage behaviour that demonstrates need. However, it is normal for babies to express their needs, such biologically appropriate behaviour should not be “trained out of them”.

If a child has been carried in arms or a sling from birth and has strong, secure bonds with his caregivers, it is entirely normal for him to expect support from these caregivers in the way he has always experienced it, whenever he asks for it. The neural connections in his growing brain have been solidly reinforced over and over again. It is also normal for him to protest when he is removed from his trusted habitat and asked to accept different caregivers he may not know. This child is not “clingy” in the sense our society means it; it simply means he is habituated to the close contact he has enjoyed all his life, just as his ancestors were; and such close contact is normal for human babies.

With the natural progression of his emotional and psychological development, as well as the growth of his physical skills and strength, his needs will change. Until that stage is reached, a child will expect continuity of care and for things to remain unchanged. The eight month to twelve month period is often when children experience separation anxiety and often coincides with things like parental return to work, introduction of new spaces and places, and of course the sling will play a part in providing reassurance, until a child is ready to move on. It is a safe space, rather than being the root of any “clinginess”.

In our society, babies are carried much less and put down a lot more than they used to be. Some fairly recent British data in 2000 (Baildam et al 2000) suggests that mothers spent an average of just 61 minutes in 24 hours simply holding their sleeping or crying six week old child. This figure was only 17 minutes when the child reached one year old.

a six week old baby
A six week old just sleeping in arms

When feeding contact was added to the data, 6 week old infants spent an average of 3hrs 27minutes out of 24hrs in contact with their mothers, and 2hrs 23minutes at one year old. Given the trends in current mainstream society, this is likely to have declined further.

For many babies, their parent’s body has never been their primary habitat, their early communication attempts were never met positively, and for some, their bonding may be less secure and demonstrate more insecure or ambivalent patterns. Earlier “separation” may have been gained, but at some cost to future mental health.

Don't be afraid to hold your unhappy baby or to use a sling if they want to be close to you (it means you can be hands-free while you meet their needs). It is always worth building secure attachment relationships. Your baby's babyhood does not last; soon they will no longer need you in the same way, build that solid foundation while you can!

Normal Independence

So, when does normal, biological independence for the human child develop fully when allowed to proceed at its own pace? Well, personality plays a part in this; a single family may have very different children who have been parented the same way and yet have different needs and develop confident independence at different times. Generally, however, anthropological studies would suggest that full independence would occur when a child has completely self-weaned from breastfeeding and bed-sharing, no longer requests frequent in-arms carrying, being able to reliably move from place to place unaided, and able to verbally communicate effectively; usually around age three for carrying (even only occasionally, in piggy back form). Breastfeeding and bed-sharing often continues much longer in more traditional societies.

back carry
Still enjoying a sling piggy back from time to time

This is much, much later than the socioeconomic model many of us live in. Children are incredibly adaptive, and as there is so much technology available and so much societal pressure to encourage this early separation, this often means that babies can and do learn to need their parent less than they normally would at their current age.

They can learn to not to raise their arms or cry for contact, they can learn to stop asking for breastmilk, and they can learn to sleep alone, however they may be missing out on much of the opportunity for emotional and psychological growth in these crucial formative years. This is the current societal norm; to put babies down rather than hold them close.

So it is no surprise when a parent chooses a more instinctive and natural means of rearing their child, that clashes develop with other parents and older generations who have simply done what the culture around them does and did before them. Why change things?

Grandparents may feel rejected if they feel their own child has chosen to parent differently from them; gentle discussion about current research and new understanding of child development and tactful understanding can go a long way in resolving such conflicts.

Many families will feel they have little chance to spend as much time with their children as they would wish due to work pressures; regret or resentment about this may manifest itself as criticism of others who are able to care for their children in a different way. They may not know there are comfy slings for older children; would it be worth visiting the local sling library?

Sleeping in Slings

People often worry that their babies will only ever sleep in a sling or resting on them. This is the natural, normal place for a child to sleep, in the haven of his parent’s secure provision. A baby falls asleep when he feels warm, safe and loved; it is no surprise that babies love to sleep in their parents’ arms; and as we have discussed, as they grow, their need for this will gradually decline.

sleeping in a sling
This little boy fell asleep in the sling… a successful transfer to bed (Risaroo Wovens)

If you have the kind of life that cannot allow a child’s sleep physiology (or accepting non-parental child-care etc) to mature at its natural pace, then it would be wise to ensure that your baby is well used to happily and easily and trustingly settling to sleep in different locations; or well used to care from other trusted adults and this will be easier if he has the underlying attachment foundations and parents who respond to his need as it arises; he will trust them that the places they lay him to sleep are secure, once he is a little older with the psychological maturity to accept this.

Summary

In summary; slings will not make clingy children; your child is demonstrating normal human infant behaviour, and has had a very positive start to life with a securely attached foundation to build on. All children eventually learn to feed themselves, settle themselves to sleep, walk unaided and accept care from other adults; some learn it sooner than others, but they do all learn it, and as parents, it is our responsibility to choose a method of childrearing that feels right to us and is going to give our children the best start in life possible in the circumstances we live in.

 

References

Baildam, E. M., Hillier, V. F., Menon, S., Bannister, R. P., Bamford, F. N., Moore, W. M. O., and Ward, B. S. (2000). Attention to infants in the first year. Child: Care, Health and Development, 26:199–216.