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!


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.


Secure Attachment and the "Fourth Trimester"

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

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

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

 

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

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

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

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

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

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

What is the Fourth Trimester?

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

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

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

 

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

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

The importance of responsiveness

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

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How does babywearing help?

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

karena-1

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

What about my older child?

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

carrying matters

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References

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

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

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

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

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

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


carrying a premature baby

Carrying a Premature Baby, personal story

This is Kay and Alex's story of carrying a premature baby. She tells us about their lives together and what role slings have played in their rocky journey. It is a truly inspiring story of great courage and endurance and I am honoured to have played a small part.

 

"For as long as I can remember I have wanted to be a mum, but my real journey to parenthood started 5 years ago. I decided that I didn't want to wait for the "right person" to come along and started looking into fertility treatment for single women.  Unfortunately the process wasn't was easy as I expected; after lots of tests and surgery I discovered that I had endometriosis which may affect fertility..

I started out doing IVI with donor sperm but after two attempts with no success it was suggested that IVF might have a better chance of working. I decided to take part in the egg-sharing programme to reduce the cost and hopefully help someone else too. During this time there was a lot of compulsory counselling to ensure I was aware of all potential outcomes. I'm very lucky that I have a fantastic support system of family and friends around me, especially my parents.

The first attempt at IVF was not straightforwards, I got 14 eggs, (7 of which were donated), but only one was fertilised. This was put back and I got a chemical pregnancy but miscarried. I also got a relatively rare condition called Ovarian Hyperstimulation Syndrome (OHSS) which made me really ill and I had to be hospitalised on numerous occasions. Due to the poor fertilisation rate it was thought that I had poor egg quality so had to pay the full cost of IVF treatment (as a single woman I was not entitled to any NHS treatment.)

On the second IVF attempt, medications were reduced to try lessening the risk of OHSS but because doctors were anxious about this, the egg collection was done too early and 5 eggs were lost during retrieval. This attempt was unsuccessful. I again got OHSS but much milder this time. The emotional rollercoaster or IVF is unimaginable and the hormones of treatment don't help! You spend all your time so focused on preparing to become pregnant, trying to stay positive, eat well etc, then once the embryo is implanted you have the longest two weeks praying you are pregnant and counting down to the day you can take a pregnancy test... but as soon as it is test day comes you don't want to do the test because you are until then "Pregnant till Proven Otherwise" ( PUPO). Internet support groups become your sanctuary because others undergoing IVF can understand what you are feeling, while your family and friends sometimes don't understand why you put yourself through so much. IVF became my only focus.

After the second attempt I had an eight month break to save up as I had used all my savings. I decided that the next would be my last attempt and I would do everything I could to try to help it work so I would have no regrets. I changed my diet (cutting out all processed food), saw a nutritionist, had regular massage (including Mayan abdominal massage) and acupuncture. We changed the IVF regime to one that had a higher chance of success but also a higher risk of OHSS. It was a risk I was willing to take. I had partly given up hope of this round working, as I got two fertilised eggs out of 19 when I began getting the OHSS symptoms again on day 2.

I did a home pregnancy test two days before test day..... and it was positive!

I didn't know how to react, so burst into tears before laughing maniacally then calling my best friend and my parents. The excitement wore off quickly though when I was admitted to hospital with OHSS at just 4+1 weeks. At a point when I had hoped that the hard part was over, it turned out that this was just the beginning of another difficult journey.

kay USSAt 18 weeks pregnant, I began getting tightenings. As a midwife, I knew that Braxton Hicks could start early, so I just assumed it was this. though I also worried it might be something more. At 19+4 with continued tightenings, I was seen by my consultant for review and thankfully everything looked ok and possibly just a urine infection causing all this. I was reassured two days later when I had my anatomical scan and everything looked good with a healthy active baby.

I continued to have tightenings but tried to ignore them as everything else seemed OK. Then exactly two weeks later after my scan at 21+6, I started with the smallest amount of bleeding. Again I was reassured as baby seemed OK and it had settled, possibly caused by a cervical erosion, and just to observe. I continued spotting on and off but nothing major, until I was at work on a shift on labour ward at 23+1 weeks pregnant.

I had a significant bleed and was terrified. I felt it was too far on in the pregnancy to lose the baby now but it was far too early to be born. I burst into tears. I am so grateful that I was at work surrounded by fantastic colleagues. I was admitted to the antenatal ward for observation overnight and I didn't go home again.

I continued to have tightenings and bleeding to varying degrees over the next three weeks. Getting to 24 weeks was a major milestone and I was given steroids to mature the baby's lungs. At around 25 weeks my waters went though because of the bleeding it wasn't obvious. Baby was breech and because of the situation I kept being told I might be taken for a Caesarean if bleeding increased or I went into labour. I saw paediatricians who told me stark statistics about survival rates and disability. As a midwife I knew these things but as a mum it just didn't sink in. I was tearful and losing hope. At 25+5 I had a major bleed that got me taken to labour ward and starved in case it continued and and I needed theatre. I spent the next two days in high dependency being observed and in denial.

Writing it down now it seems so silly but even given the bleeding, tightenings and water break it still never clicked to anyone that the pain I was in could be labour. At exactly 26 weeks I was found to be 7cm dilated. Two hours later I had a vaginal breech delivery complicated by the head getting stuck.

Alexander Benjamin was born weighing 1lb 12 oz and in a very poor condition.

newborn Alex

The room was full of people but no-one was saying a word. Looking back at his notes now it says it took 18minutes to stabilise him before taking him to intensive care but it didn't feel that long to me. It seems awful to think about it now but at that point once Alex was born all I felt was relief. I was glad the pregnancy was finally over after months of feeling ill and stressed. I had spent the last few weeks trying to detach from the pregnancy as I feared the worst, but in the moment when Alex was taken away and we (myself, my parents and my friend) were left alone the silence said it all.

phototherapyI know it can often take up to an hour to get a baby settled into neonatal unit with all the lines, Xrays etc so we patiently waited. After nearly two hours I went to ask if we could see him.. the midwife came back saying the consultant wanted to come and talk to us first. I know the language of medical professionals and I honestly thought we had lost him. The consultant came round and told us that "Alex is a very sick little boy" and that the first 24hours would be critical. I think the adrenaline stopped me from feeling the full effects of the situation but looking back now at pictures and videos of those first hours has me choked up. Alex was beautiful to me, but so frail. You can count every rib and due to the manipulation of delivery his leg is almost black with bruising. He was covered with monitoring leads and various IV lines plus on a ventilator to keep him alive. He was put under phototherapy immediately.

Only I was allowed to touch him but couldn't hold him yet.
kay first holdMy first hold came on November 17th, aptly, World Prematurity Day. I was nervous about pulling a line or hurting him but also so excited to hold him! He was put skin to skin down my top and his ventilator tubes taped to me to keep him safe. I can still smell him now and it brings me to tears. As a parent you take for granted the milestones you will see; the birth experience you imagined, the crying baby just born and put skin to skin at once. I didn't get these, and my milestones with Alex are different, but even more amazing after the challenges he has faced. We spent 135 days in the neonatal unit and I was there 12 hours a day for 133 of those days. (Two days I was ill from sheer exhaustion and wasn't allowed in.)

skin to skin ventilatedI spent my time holding Alex as much as I could and when he was too poorly to be held I touched him through the incubator and spoke and sang to him. I felt being physically close would help us both bond better, especially after an awful pregnancy and so much separation. I was already aware of the Sheffield Sling Surgery due to friends attending and had contacted Rosie early on in pregnancy as I had planned to carry my baby in a sling. Once Alex was over the first big hurdle of coming off the ventilator at a month old, I got back in touch to find out if slings could help us while still in the NICU. The physiotherapist on the unit was very in favour of using slings and gave me a Vija top to try, but I felt it was more comfy just using my strappy top as we got so tangled with the wires.By the time we moved to HDU it was a slightly more relaxed environment with staff that seemed more in favour of breastfeeding and skin to skin. I decided, after discussion with Rosie, to buy my first sling, a Hana stretchy wrap.

It felt complicated at first getting used to the technique of wrapping and because of all the monitoring it would often take someone else to help me get all the wires sorted, but once Alex was put into the sling he fell straight to sleep. I noticed that often his heart rate and oxygen sats would improve too and it made me even more determined to keep him close.

skin to skin ventilated

Our journey through special care gives me mixed emotions. On the one hand I would never wish this experience on anyone. The constant stress, not just for myself but also family and friends around me. The fear that if I leave, something might happen. Every time the phone rang panic would set in and don't even get me started on the paediatricians coming up to the ward!

However, my life has changed completely in so many good ways. I have realised and experienced how fantastic the care is from my colleagues. I have become closer to my family and friends and I love watching my parents with Alex. I feel I will be an even more sympathetic and understanding midwife and I hope my practice will change to support women who go through similar experiences. Most of all I have realised my dream of becoming a mum and to the most incredible little fighter I have ever met.

fighter Alex

 

I feel I have a strong bond with Alex and many people have commented on how well I can read him. I believe it is because of staying close to him as much as I have and having him in the sling has facilitated this.

Alex has Chronic Lung Disease and came home on oxygen in March. He is doing incredibly well on the lowest level now, but transporting the oxygen has been a bit of a challenge for me. The canister is heavy and the container rucksack has narrow shoulders so has hurt my shoulders; trying to balance that weight against Alex has not been easy. At times I have felt isolated simply because of that. However I have met some wonderful people on my journey through special care and in the sling community (often the two groups mix!) and we wouldn't be where we are now without these challenges.kay alex hana

We are still using our Hana wrap, and I've been trying out a snuggly Sleepy Nico! I've learned how to use woven wraps; we are beginning to back carry; the end of the oxygen is in sight! Time to tuck Alex up into the Sleepy Nico and reconnect after a long day.

back carry o2


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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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!

carried baby

I am a Carried Baby

Why do we carry our babies? We carry them because it is a biological, instinctive parental response, that blesses the children we carry, and that blesses us. I find myself blessed by the small part I…

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Can I carry my baby in a sling if I have epilepsy?

Guest Blog from a friend of mine about her choice to use a sling to keep her child close despite her diagnosis of epilepsy. It has worked out very well for her. Here she discusses the processes of…

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Breast and Bottle Feeding Safely in a Sling

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

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Carry Me Daddy!

“Dear Daddy


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

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

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

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

Carry me Daddy, while you still can!”

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

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

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

Mohamed

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


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