Top FAQS

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

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

Firstly; some of my most popular articles:

Do the babywearing “rules” really matter?

Babywearing and infant mental health

Babywearing and the mother-baby dyad

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

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

Carrying in different circumstances

Can I sleep while my baby sleeps in their carrier?

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

How can I carry safely in hot weather?

What good summer slings are there?

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

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

Carrying adopted or foster children

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

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

What if babywearing just isn’t working for me?


sling faq pelvic tuck professionals training

Health and Social Care Professionals

It is now widely recognised that the early years of a child's life matters enormously for their long term health and wellbeing. Many health and social care professionals are increasingly aware of the need to support new families right from the beginning, helping them to build bonds and promoting the creation of secure, healthy attachment relationships. Sling and carrier use can play a very significant part in this.

Rosie is a practising GP, and has been working in babywearing fields for many years, creating unaffiliated resources for NHS use, writing an evidence-based book on the topic, and has trained many health and social care professionals. This is includes health visitors, infant feeding teams, midwives, paediatricians, nurses, perinatal mental health workers and many more.

Her courses aim to equip professionals with a thorough grounding in the science of infant and maternal mental health, and how slings and carriers promote health for a lifetime. She is very aware of the special considerations that arise when working with newborns or vulnerable children and families, and the particular challenges that may be encountered in clinical sessions. She can tailor courses for particular needs and focuses.

Find out more about training courses

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. “

This website, Carry the Connection, is an fantastic resource all about adoption; some of the challenges faced and how carrying children can help. I highly recommend this for all families considering adoption.

“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.”

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.”


educational resources build a happy brain rainbow brain carrying matters

Educational Resources

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

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

Buy the Carry Safe leaflets here

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

Buy the Guide to Slings leaflets here

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

Buy the Seven Reasons poster here

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

Buy the 4th Trimester products here

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

Buy the Build a Happy Brain products here

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

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

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

Buy the Carrying in the Heat posters here

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

Buy the Carrying in the Cold posters here

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.


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 Harriet (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.

Here in Sheffield, where the sling revolution is well and truly underway, 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.

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.



carrying in special circumstances

Carrying in Special Circumstances

Sometimes there is a need for extra support with using slings; don’t be discouraged if you or your child have extra needs, there are always ways to keep carrying in special circumstances.

If your child can be held and carried in arms, there is likely to be a way to carry them safely in a sling. Twins can be carried in slings, as can a baby and a toddler at the same time (tandem carrying). There are ways to carry safely in pregnancy, to carry after birth, to carry premature babies. We will help you to carry your child if you have a disability, or if your child has special needs or physical health concerns. We are here to help you find a way to keep them close.

This page links to some useful information; personal stories about carrying in special circumstances, professional advice and useful links. Please see our Common Queries page for simpler situations.

If you have a special story, please get in touch to share them with me for the wider community!

Here is an excellent downloadable article on Potential Therapeutic Benefits of Babywearing by Robyn Reynolds-Miller.

You can find more educational resources here for downloading (such as infographics and leaflets and images)

If you need more specialised support or have a query not covered here, please do get in touch with me or find your local sling library at Sling Pages.


carrying a premature baby

Carrying a Premature Baby

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


healthy hips busting some myths

Healthy Hips - busting some myths

Healthy Hips - this is a very common worry for parents who want to ensure they have the best information regarding their child's safety. Here, Rosie busts some of the myths and assesses what we really know on the subject.

People often ask me about the importance of a good position for their child’s hips in a carrier, having heard about “hip dysplasia” and “knee to knee”. These are good questions to consider, as there is a lot of hearsay and slightly misinformed information circulating around the internet.

I thought it would be helpful to discuss some common queries and consider what “best practice” might be. I will look at what hip dysplasia actually is and assess if narrow based carriers really are harmful to children. I will suggest some alternatives that are much more respectful of child anatomy and more comfortable for baby and parent.

1) What is hip dysplasia?

There are many terms used for this spectrum of related developmental hip problems in infants and children. These are often present at birth. Most recently the term “Developmental Hip Dysplasia” is being used, as there is evidence to suggest that while many hip disorders, (ranging from full dislocation, to unstable shallow sockets) are present at birth, some children with apparently normal hips go on to develop problems in the first year of life.

healthy hips

Image from Hip Dysplasia website

In simple terms, dysplasia means “growing abnormally”. Compared to adults, an infant’s hip sockets are made up of a greater proportion of softer, more pliable cartilage in relation to bone. This means that it is easier, anatomically, for the ball (the femoral head)  to slip out of of the socket (the acetabulum) and be misaligned (subluxated) or fully dislocated. A normally formed hip joint will not encounter problems, but this softer structure, in combination with an abnormal socket shape, explains why some joints will dislocate.

In a child who has an abnormally developed hip joint, the combination of the shallow angle of the socket and the softer structure means that the ball (femoral head) is not held securely within the socket and can become misaligned and even slip out if the joint is placed under downward strain. If it does not slip back in, it is a dislocated joint and will need intervention.

Image from the Hip Dysplasia website

2) Is my child at risk of hip dysplasia?

The causes for hip dysplasia are poorly understood. There seems to be an increased risk if there is a positive family history of hip dysplasia. Female babies seem to be 4-5 times more at risk than males, and several factors in pregnancy seem to be relevant. For example,

  • a tight uterus
  • reduced uterine fluid that constricts the baby and prevents free fetal movement,
  • breech delivery
  • another condition that affects how babies lie in utero (such as fixed foot deformity)

all seem to be related to the presence of dysplasia. The left hip seems to be more frequently involved than the right. Furthermore, the growing baby is exposed to the mother’s oestrogen hormones. Oestrogen is thought to encourage ligament relaxation near the time of delivery, which may help with giving birth, but potentially may also cause the baby’s hip ligaments to be somewhat lax and increase the risk of an unstable joint.

These are not risks that a parent has any control over, clearly.

However, there are studies that strongly suggest that some cultures who swaddle their infants tightly (such as the Native American societies prior to the 1950’s, and some Japanese societies) have a far greater incidence of developmental hip dysplasia and childhood hip dislocation.

It is interesting to see that once the Najavo Indian culture, (who carried their babies tightly bound on cradle boards with their legs straightened ie  extended and adducted), adopted bulky cloth nappies, the incidence of childhood hip dislocation decreased dramatically, even though they continued to use the cradle boards.

This was due to the nappies encouraging the babies’ legs to be held in a more natural flexed and abducted position (like a spread squat, as if child held on hip with legs around parent). African cultures, who do not swaddle their babies, and carry them constantly astride their backs from birth, have a very low incidence of hip dysplasia. You can read a couple of very helpful scholarly articles here and  here for more information.

In 2015 the Journal of Paediatric Orthopaedics published an article based on data from 40,000 children in Malawi and a systematic review of current evidence. “The majority of mothers in Malawi back-carry their infants during the first 2 to 24 months of life, in a position that is similar to that of the Pavlik harness. We believe this to be the prime reason for the low incidence of DDH in the country. In addition, there is established evidence indicating that swaddling, the opposite position to back-carrying, causes an increase in the incidence of DDH. If a carrying position of infants during their early months of development can reduce the incidence of DDH, then a public health initiative promoting back carrying could have significant world health and financial implications in the future management of DDH and also have potentially huge effects on the timing and severity of development of adult hip arthritis.”

“Hence it appears logical to discourage putting the baby’s legs in the extended position, and encourage keeping the baby’s hips spread apart. This latter position places the head of the femur (the ball) against the acetabulum (the socket), and encourages deepening of the socket.” (Quote from Orthoseek–  a source of authoritative information on paediatric orthopaedics.)

So, a parent can potentially reduce the small risk of hip dysplasia by carefully considering some of the practices they adopt.

3) How is hip dysplasia diagnosed and treated?


Diagnosis:
Most suspected cases of hip dysplasia are picked up at birth or at the six week check, by physical examination, but some cases are missed, sometimes with significant consequences. There is a strong case for routine ultrasound screening for hip dysplasia, as comprehensive ultrasound screening during the immediate newborn period has demonstrated hip laxity in approximately 15% of infants (Rosendahl K, et al. Pediatrics 1994;94:47-52)

Treatment: Mild cases can be managed by “double diapering” to keep hips in the flexed, abducted spread squat position. More severe cases may need splinting with a Pavlik harness and sometimes surgery is required. Many children respond very well to this and lead normal lives. If left untreated, and picked up later in childhood (eg a limp) developmental hip dysplasia can have chronic consequences, such differences in leg length, awkward gaits or decreased agility. Older children may even develop early arthritis of the hip. Sometimes complex surgery is needed.

4) Is there anything I can do to reduce my child’s chance of hip problems?

It isn’t fully clear exactly how large a role the choices parents make (eg swaddling, cloth nappy use, carrying in an appropriate sling) have on the likelihood of hip problems later in life. Some babies may have mild DDH at birth that is not discovered at all, and thus unwittingly benefit from good hip positioning that a wider based carrier gives, encouraging the mild laxity to self-correct. There are many cases of babies who have been found to have DDH and been advised to use a wider based carrier by their orthopaedist, and the shallowness has self corrected. Clearly, wider based carriers are beneficial.

Furthermore, by 6 months of age, the risk of hip dysplasia has largely passed, and by one year children are stronger, better developed, and able to place their hips in a healthy position themselves when required for comfort (ie pull their knees up or ask to get down), so older children are not at risk. It is young babies in the first few months of life that need more caution.

2018 update. There has been a small increase in the late diagnosis of DDH, which is thought to be possibly related to the use of tight swaddling, a technique to settle babies that has seen some resurgence recently. Firm swaddling of the lower body forces babies’ legs into prolonged positions of tight adduction and extension which can be damaging to hips that are already vulnerable. Swaddling should always be done in a hip healthy way (read more here about the late diagnosis of DDH).

It would seem sensible, therefore, at least in the early months of life, to encourage babies and small children to have their hips held in a healthy position, that is less likely to place strain on lax ligaments or possibly shallow hip sockets. A good, wide-based sling or carrier can assist with this healthy hip position. This will also be more comfortable for the child – consider perching on or astride a stool versus sitting on a chair or even in a hammock!

It is worth being aware that there is often variance in the advice orthopaedic surgeons offer, based on their depth of knowledge of babywearing. There is little formal research on the effects of slings per se in children with DDH, and much is extrapolated. The Institute of Hip Dysplasia is a helpful resource.

5) Will my narrow-based high-street carrier harm my baby’s hips?

Much debate has been held on the role that narrow -based carriers  may have on the worsening of pre-existing, undiagnosed hip dysplasia, or promoting its development in normal hips. It is worth bearing in mind that few parents use narrow based carriers for any significant length of time, as they are often not especially comfy, and babies’ legs are free to move in the carrier, rather than being held forcibly in one position. Many narrow based carriers are wider than they used to be, so small babies often end up in a slightly abducted and rotated position anyway.

So the simple answer to the question is “Probably not, in the majority of cases.” This assumes your child’s hips are normal, and they are not one of the postulated 15% of infants whose condition is missed by health care professionals (however well-meaning).  These children will most certainly benefit from a wider based carrier.

So you are unlikely to damage your child’s hips if they are healthy. It will be up to you to assess the risk that mild DDH may not have been identified at the routine screening, and make the choice for yourself.

These narrow based carriers usually have a particular feature of robust head and neck support. The reason for this is because a child who has unsupported legs will usually end up with an arched, over-straightened spine where their head and airway is not adequately protected. Baby’s heavy head is more likely to fall backwards, and therefore rigid neck supports are needed to keep him safe. This is in contrast witih carrying positions which do encourage the natural pelvic tuck and therefore a curved spine and baby’s head becoming self-supporting while he rests against parent (think about how you often only need to support baby’s bottom when they are sleeping on your chest or shoulder).

Parents of children with normal, non-dysplastic joints are unlikely to “cause” hip dysplasia by choosing to use one of these narrow-based slings, but these designs do not, on the whole, promote the flexed, abducted spread-squat position that seems to encourage better hip joint positioning and deeper development of the socket. A sling that supports baby’s thighs from beneath (“knee to knee”) is more likely to keep hips in this optimal position, and reduce strain on still-developing joints. It is interesting to note that the bigger brands who are well known for making narrow based carriers have begun to redesign their products to be more broad at the base and more respectful to baby anatomy.

It will be no surprise then, that most professionally-trained babywearing consultants will advocate the thighs being supported right into the knee pits into an M shape, with knees held higher than the bottom (nearer to an imaginary horizontal line out from the belly button). This puts the femoral head into an ideal central position in the socket, and is the position adopted by the Pavlik Harness as you can see above.

Here is are some drawings that show the most typically seen position in a narrow based carrier, and then the ideal hip position in a sling

1) Classic high-street narrow-based carrier. The legs are hanging downwards, entirely unsupported. The infantile hip-socket is taking the full weight of the legs and there will be a lot of unhelpful strain. It is similar to balancing on a beam at the gym with all the weight being borne on a narrow strap between the legs. Baby’s back may be straightened, meaning their head is able to fall backwards, needing rigid head and neck support.

2) A properly fitting, wide-based carrier. Observe the M-shape that has been created, with the thighs securely supported all the way to the knees, which are held above the bottom. The hip joints are in the optimal position, and there is no weight at all dragging down on the joint. Orthopaedic consultants recommend thighs to be resting at an angle of 100 degrees from the midline.

Below is a summary and a side on view of the M-shape position, showing how there is no downward strain on the socket and the child is supported widely across a large proportion of their base. The baby is clearly seated comfortably with their weight widely distributed, and the gentle curve of their spine protected. This baby’s upper body will be supported against the parent with head resting on parent’s chest, and rigid head supports are not needed (using natural anatomical positions).

6) What slings would you recommend for healthy hip position?

All safe babywearing is to be celebrated and encouraged! Using a narrow-based carrier will not harm the majority of children (see above), so if you have one already, there are a few things you can do to improve your child’s comfort such as using a scarf tucked into the seat, as in this video. This will encourage a change of position from legs hanging straight downwards (extended and adducted) to supported knee to knee (flexed and abducted) in the M shape, as discussed above. It is, however, only a temporary solution – I would advise you to use a wider-based carrier.

To reproduce the hip-healthy M shape, when putting a child into a carrier, tilt their pelvises inwards slightly and push the feet below their bent knees upwards to encourage flexion. All babies are different, and some will naturally spread their legs more widely than others. NEVER force your baby’s legs to move into a position that does not come easily.

If you don’t yet have a sling for your baby, go for a soft one that is well designed to both promote healthy hip M-position and encourage the natural gently curved J-spine shape that young children have (rather than a tight C shape where a heavy head would be drooping down onto the chin curled over). The secondary curves begin to develop later on in life – the cervical curve when they gain head control and can lift against gravity, and the lumbar curve at the crawling/walking stage . Until then, spines should not be artificially kept straight (ie babies should avoid too much time in rigid car seats, stiff inflexible carriers, or lying supine on their backs).

It is worth remembering that well-designed slings that focus on supporting a child’s legs and curved spine can be used in a less than ideal way. It is possible to use a good tool in a less than optimum manner, especially when in a hurry, so it is worth taking your time to position the sling well and to be actively aware of your child’s hip and spine positions when putting the sling on.

Examples of suitable slings (this list is not exhaustive and is merely a guide). See your local sling meet/consultant/library for more help and advice or read our sling guide.

Stretchy wraps, Close Carrier hybrid

Woven wraps

Ring slings or Scootababy hip carrier

Wide-based buckled carriers

Meh Dais and Half-Buckles and variants

7) What do I do when my child’s legs are too long for “knee to knee” support?

Small babies, sadly, all too soon grow into big babies, with longer legs, and can start to out-grow their slings in terms of thigh support along to the knees. And then they start to toddle! When a child can stand unaided and walk, he will have the muscle and ligament strength to bear the weight of his own legs well, so full knee-to-knee is less important for toddlers, but for smaller babies, helping to support their legs is important. You may need a wider sling, or you can adjust the one you have already with a helpful scarf – there is a great video here from Slingababy.

8) Where can I find more help and support and reading about using a sling for my child?

There are numerous resources in the UK where you can get babywearing advice and encouragement, such as your local babywearing consultant, sling meet, or sling library. The links below will help (again, not an exhaustive list!)

The Sling Pages

The Carrying Matters Sling Guide

Dr E Kirklionis’ book A Baby Wants to Be Carried is highly recommended, for its overview of the evolutionary theory behind baby carrying and the spread squat positioning.

You can read my book Why Babywearing Matters too

Hip Dysplasia Institute statement on babywearing and Hip Healthy status


Carrying while Pregnant

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

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

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

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

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

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

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

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

big kid with bump

First Trimester

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

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

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

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

Second Trimester

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

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

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

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

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

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

candy cane chest belt to avoid tying round the middle

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

3rd triThird Trimester

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

kathy

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

3rd tri

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