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.



carrying in the postnatal period

Carrying in the Postnatal Period

lindsay 10days

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

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

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

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

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

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

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

Carrying your child in the postnatal period is important.

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

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

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

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

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

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

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

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

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

twin stretchies

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

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

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Carrying after a Caesarean

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

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

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

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

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

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

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

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

Read more about babywearing fitness classes here.

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

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

Toddler carrying after birth

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

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

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

Involving the whole family!

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

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

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

family


Perinatal mood disorders

Perinatal Mood Disorders and Carrying

The prevalence of Perinatal Mood Disorders (pre and post-natal depression, anxiety and post-traumatic stress disorder) is increasing in Western society as it is increasingly fractured and isolated, with a decreased sense of local community and shared care. The birth of a baby is often an overwhelming time for both parents, especially when also faced with the expectations and demands of a fast-paced culture that often judges people by their apparent productivity and appearance. As a GP, I see many families struggling with these conditions that are often diagnosed, and keeping babies close may play a part in surviving these illness, mainly due to the closeness with your child, rather than the choice of sling.

Postnatal depression is on the rise – affecting at least 10-15% of new mothers (with many more sufferers (and fathers) never being recognised to have the condition). Anxiety and PTSD are also worryingly common. Parents are encouraged to put their babies down as much as possible and regain their old lives; babies are expected to learn independence as quickly as possible and stop relying on their parents for their every need.

This approach to caring for children is very new in human history and runs counter to attachment theory, which suggests that the human infant thrives on responsive parenting and close contact.

Read about Ruth’s experience of antenatal depression here; for the rest of this post we will focus mainly on postnatal depression (PND).

What is Postnatal Depression?

Postnatal Depression is a depressive illness which affects between 10 to 15% of new mothers. Many more are never diagnosed with this condition, which can become a very significant issue in the functioning of a family. It is often poorly managed by health care providers, and can be misunderstood by the community and dismissed as “just the baby blues” or “tiredness.” It is common for sufferers to feel very alone and unable to explain just how they feel and why it is so difficult to endure. Prenatal depression is also experienced by many new parents, and postnatal anxiety and Post Traumatic Stress Disorder are also commonly experienced pre and postnatally.

Sad woman

Why is it so common?

Western society is increasingly fractured and isolated, with a decreased sense of local community and shared care. Depression is common in our culture, for reasons not clearly understood, but partly due to the way we live. The birth of a baby is often an overwhelming time for both parents, especially when also faced with the expectations and demands of a fast-paced culture that often judges people by their apparent productivity and appearance.

Before parenthood, people’s identities are often based on their roles and responsibilities in life; work, friendship circles, hobbies and interests. After a baby arrives, this often changes dramatically, sometimes in unexpected ways, and for many, the huge change in the pace of life and the loss of control can be very difficult to deal with. “The burden of conscious responsibility with no let up and the unusual and unexpected degree of fatigue can make a mother feel desperate about whether she can survive and how she will manage.” (Kennell & Klaus) This is the role that community used to play; supporting and carrying each other’s burdens as part of a committed and close-knit group of people who lived together, an experience that few parents enjoy in the West today.

What does it feel like?

Common words used to describe PND are guilt and inadequacy.

“The worst part was the guilt I felt about crying every day when I had a beautiful new daughter.”

“It isn’t about not loving your baby but about feeling overwhelmed with responsibility and unable to cope.”

“My head can feel empty and I have no thoughts.”

“It is just so hard to face another day of feeling totally unlike myself, missing my old life, unable to enjoy this new one.”

Fathers suffer from depression after birth too.

“The first few weeks were the hardest and I would just sit and cry. I felt like this shouldn’t happen to me, I should just be taking it on the chin and getting on with it. But the truth is, I felt alone and without the support of my wife, I would’ve been a lot worse.”

Many parents with PND feel a sense of dissociation and detachment from the child they want to love so much. 

“It isn’t about not loving your baby but about feeling overwhelmed with responsibility and unable to cope.”

Caring for people with PND is hard.

“PND is the scariest and loneliest place on the planet and puts a terrible strain on the whole family.”

“My husband felt helpless because he knew something was wrong but I wouldn’t admit it and shut him out. All he could do was try to look after me and be there when I finally admitted it. It caused a lot of irrational arguments.”

perinatal mood disorders
Perinatal mood disorders

What can I do?

If you are suffering, or think you may be suffering from perinatal mood disorders, first be reassured that you are not alone and the vast majority of people with it survive with few long-term ill effects.

Here are some suggestions that may help.

Get help where you are.

Tell your nearest and dearest how you really feel.

“I found the hardest bit was to admit that I wasn’t coping, even when it looked like I was, I was fine on the outside but was a complete mess on the inside.”

Many women testify how supportive their partners and families and close friends are once they understand – ask them to help with the basic jobs of daily life; cooking, cleaning etc. Help them to see how useful you will find it when they listen to you with acceptance and without judgement, and how their understanding when things go wrong is vital. Guilt is a large part of PND and many kind people may inadvertently add to this burden.

Get help from your local health care providers.

This may be your GP, your midwife, your health visitor, your local SureStart centre. The quality of care from these resources can vary enormously. It can help to write down on paper how you feel in advance and what you think you need (validation, formal counselling, CBT or medication, for example) and take it with you to appointments. Continuity of care is great, if available; a HCP who listens and cares can make a greater difference than one who fires questions and is keen to tick boxes and prescribe medication at once.

“Guilt and lack of confidence are so typical of PND and my HCP was essentially validating those feelings even though objectively I was doing a great job!”

Be armed with information (e.g. if you wish to carry breastfeeding, sertraline is safe in these circumstances). The Breastfeeding Network is a valuable resource. If you are not satisfied with the care you are receiving, find different care.

Get help from your local non-NHS resources.

These can be very useful, such as HomeStart (a befriending service) and local PND groups. A postnatal doula may help, and there are many national helplines and resources (see below)

Get help from online social resources.

There are many forums and parenting groups full of people who know how you feel, and will listen and share. Being among people with the same values and parenting beliefs may be a source of great encouragement. Equally, avoid too much time online.

Get out!

It can be very hard to actually get out of the house when struggling with dark thoughts or hopelessness, but it is worth the effort involved. Even a walk down the road is a good start, and encourages release of endorphins (the natural feel-good hormone). Arrange to meet some friends, and ask them to encourage you to come. Try to make a plan for most days, and be kind to yourself if you decide on a pyjama day instead. Try to arrange some time to spend alone with your other half, to remember who you still are, as well as parents.

Get nourishment.

Good quality food, drink, exercise and sleep are vital to your own health and sanity, as are times to enjoy the things you used to. Dress well in bright mood-enhancing colours. You are still a person and your own needs should be met as much as your child’s. Some people make use of night-time carers to allow some much-needed uninterrupted sleep.

Get past your birth story.

For many women, recovering from birth takes a while, especially if it was not the hoped-for experience. The NHS Afterthoughts service and counselling can help if you feel a sense of grief.

Get a sling or carrier.

Keeping your baby physically close is well known to stimulate the release of oxytocin. Oxytocin is a hormone that is closely related to bonding and attachment. It is released during labour and breastfeeding, and, crucially, during skin-to-skin contact and social interaction. It has an important role in encouraging nurturing feelings and a sense of belonging, and reduces anxiety and depression by affecting cortisol release.

Babies who are in close contact with their parents have been shown to have a corresponding higher level of oxytocin than their non-carried counterparts; which subsequently helps to reduce baby’s own stress levels and improve their sense of secure attachment; their needs are met at the point of request. Calmer babies are easier to care for; win/win.

The soft touch of close skin to skin contact reduces the release of cortisol, the stress hormone, via C afferet fibres affecting receptors in the hypothalamic-pituitary-axis. Stroking has been shown to reduce pain responses.

Modern life is fast-paced and for many, constant carrying of ever-growing children can be difficult to achieve, or uncomfortable after the travails of birth. This is where the practice of using a sling, (sometimes known as babywearing) can be of great value. A soft sling that allows you to keep your child close to you, (thereby stimulating the release of oxytocin and reducing cortisol), and helps your baby to relax and sleep in secure comfort may make a huge difference to your life and your feelings and help you to feel that you can cope. Anxiety may settle a little as you know your little one is safe next to you. 

“The sling brought us back to an almost pregnant-like state, with him a part of me, listening to one another’s cues. He was calmer for being close to me, which made me feel more confident, which brightened my mood. Leaving the house felt less daunting so I got more exercise and again increased my confidence. I talked to him more, whether he was awake or not, and he became my son rather than a tiny scary stranger.”

“My favourite thing in the whole world, that never fails to calm me or lift my mood has been cuddles with my baby, particularly skin-to-skin. For me, there is no antidepressant like it.”

“When she was in her pram I felt completely removed from her and her world. I was just an accessory, she was a job to do and I was irrelevant. Using a sling finally helped me bond properly with her and made a massive difference to the PND.”

Many slings are extremely comfortable to use, and can be very practical indeed. It is possible to learn how to feed discreetly in a sling, allowing you more flexibility about being out of the house for the day with your baby.

Slings give you and your baby the freedom to be on the move together, rather than feeling stuck; to go out into the world for a walk or go shopping without struggling with the complexities of a pram. Movement and exercise are vital to wellbeing; and using a sling safely can help your body recover from birth and become stronger.

Slings can be beautiful and colour therapy can help to lift the mood. Learning a new skill can be therapeutic, and many parents find a great sense of community among other sling users both locally and online. This can help with feelings of isolation, especially if you have chosen to parent differently from your family or your peers.

help my child cries in the sling

 Get a sense of perspective.

What matters in these early months is you and your baby. It does not matter what other people think; the house does not need to be pristine, you do not need to impress people with how well you are taking to parenthood. I have heard many women describe how they “are falling apart on the inside”.

“I thought because I wasn’t suicidal or not looking after things that it couldn’t be PND so held back for a long time from accepting it and getting help.”

“I found the hardest bit was to admit that I wasn’t coping, even when it looked like I was, I looked fine on the outside but was a complete mess on the inside.”

Get confident again.

Reflect on what you have achieved so far and use that to build self-belief. Learn to trust yourself, be an instinctive parent – and you will fin that as you encourage others, you will find yourself lifted too. Some people find going back to work can be very helpful; the chance to use skills again and have adult interactions once more can be a great boost to self-confidence.


The unhelpful "rules" of babywearing

There are so many unhelpful rules of babywearing. I'm not talking about basic safety guidelines, but about the unspoken rules about how things must be done.

This needs addressing. I love babywearing. I love how special it is. I love how empowering and enabling it can be and what a difference it can make to children and their carers and the society around them.

I also love that it just makes life work for so many people on a practical level, regardless of all the benefits and reasons about why it is an activity that matters. Babywearing may be magical for many, and has so many positive effects on a physiological and neurological level, but really, for some, it’s just about getting stuff done, keeping the cogwheels of daily life turning, or helping to survive very tough situations.

I have watched thousands of people carrying their children all around the world and I love that I am part of a tradition of child rearing that goes back beyond the history books into our anthropological origins. I love it so much that I wrote a book all about it!

Carrying children is normal human behaviour, and it isn’t, and shouldn’t be, complicated or difficult. It shouldn’t be scary, inaccessible or expensive. It does not belong to groups of people to “own” or to build tall walls around to make things secret or elitist. Babywearing (the use of a sling or carrier to keep a child safe and close to a parent) is for everyone, every gender, every colour, every ability, every size, every shape. Babywearing should bring us together, not divide us. It should not alienate or exclude entire groups of people.

However, as the practice becomes more mainstream and the industry grows, this alienation is unfortunately happening more and more often. Marketing campaigns and the general make-up of many babywearing groups suggests that this is an activity for relatively well-off middle class “standard sized” white women in nuclear families, carrying able-bodied and healthy children. This is a direction that needs to be arrested before it becomes too entrenched. I’ll say it again, babywearing is for everyone and can be done in so many ways.

the unhelpful rules of babywearing
carry me daddy
the unhelpful rules of babywearing
Smiling Carrying Woman carrying baby - credit Steph Oliver-Beech benefits of babywearing

One way that babywearing can become elitist is in the development of complex rules, and I’d like to have a discussion about some of these “rules” and “guides” of babywearing that I am seeing shared around. I understand that it can feel reassuring to have black and white lists of what you can and can’t do, and schedules for certain types of carrying. These can act as a framework for where to begin with using a sling. This is valuable, especially as many of us have lost the shared collective wisdom that comes from living in communities and no longer learn how to parent from the people living around us. Many of us turn to books and to the internet and ask for guidance.

However, I think these “rules” often end up making things harder and disempowering the very people who need the most support. Here are some common examples.

Some commonly stated "Rules"

  • Do not use a stretchy wrap beyond three months
  • Do not back carry with a stretchy wrap
  • Do not use a soft structured carrier for a newborn
  • Do not do any form of sideways cradle carry
  • Do not use a narrow based carrier
  • Do not face your child out in a carrier
  • Do not back carry a baby before they can sit unaided
  • Do not back carry a newborn in a ring sling
  • Low back carries are dangerous, high back carries are much better
  • Once your baby is walking you must begin to use a toddler-size carrier
  • Bigger children must be carried on the back
  • Do not use footed pyjamas for babies in slings

I could go on…

These rules can be useful, but often they exclude significant proportions of the population. You can use a stretchy wrap to carry an older child, if they are safe and comfy. You can use your stretchy wrap in many ways, including on the back, if your child is safe and comfy. You can use a soft structured carrier for a newborn, if it fits them and is safe and comfy. You can carry a child in a sideways seated position or even a cradle carry, and facing out, if they are safe and comfy. You can use a narrow based carrier for a baby or a baby sized carrier for a toddler, if they are safe and comfy. You can carry a baby on your back in any form of carrier if they are safe and comfy. You can carry any age baby on your back or your front if they are safe and comfy. You can carry your child who is wearing footed pyjamas if the child is safe and comfy (ie their toes have room to wiggle). You can carry your child whatever size you are. In fact, you can do pretty much anything you want to do, if your baby is safe and comfy.

Do you get the theme?

I think the only “rules” when it comes to carrying a child in any form of sling are

  1. Can they breathe safely and without any obstruction at all times?
  2. Are they being held safely and securely in a carrier that fits (to ensure they are able to breathe easily and cannot slump into a position that would obstruct their airway)?
  3. Are they as comfortable as the circumstances allow?

How do you check if a child is breathing safely in the carrier?

  • Look at them, listen to them, be aware of them.
  • Check their airways are free of any fabric and they are not slumping or folded over with their ribcage compressed and chin on the chest.

How do you ensure they are safe and snug in the carrier and that it fits?

  • A well fitting carrier holds a child close to the parent, close enough that if the parent leans forwards, the child does not swing free. This helps to avoid slumping over in the carrier.
  • If a child’s body can slump, the carrier does not fit or is not tight enough.
  • The “knee to knee” rule is often overstated in its importance for older children (the M shape can be protective for children at risk of hip dysplasia in the early months.)

How do you ensure they are comfortable in the carrier?

  • This is all about being responsive and connected to the child being carried.
  • They should fit inside the carrier, be able to breathe safely, and should not be too hot (overheated babies are more likely to stop breathing).
  • Check on your child, be aware of their experience and how they are behaving in the carrier. The more you interact with your child the more you will know that they are OK (or not!)

If your baby is safe, able to breathe and is comfortable, and you feel confident that all is well, then it probably is well. Carry right on! And if you would like some encouragement, find a friendly educator and help them learn how to support you in a way that builds you up and keeps you carrying happily.

It is important to remember that every child and every parent has different needs. Parents of twins may need to be able to back carry one twin from a very early age, to be able to cope with family life. They may choose to use a buckle carrier on the back, and if the child is able to breathe safely and is not uncomfortable then that makes their lives work. Telling them this is forbidden creates needless barriers and makes life harder. A stretchy wrap for a one year old may not be as comfortable as a woven wrap, but for a parent on a budget who now has a less-unhappy toddler held close while the baby can be cleaned, this is a win-win situation. A four month old who will will only tolerate facing out in a narrow based carrier can be happily transported on a school run. Millions of women around the world have carried young babies in low torso carries with simple pieces of cloth.  A disabled child who cannot sit unaided can be held safely and securely on the back in several types of carrier which will definitely make everything much easier. Do be aware of how your language and how you educate can affect others and significantly disempower people.

Oh, but these rules are for normal people!” This is a common dismissal of any criticism of “rules” and is unbelievably inappropriate. Our society is made up of people of all abilities and all skills. More than one billion people in today’s world have a disability; that’s 15% of the population. This ratio may not be reflected in the proportion of children who are brought to babywearing groups, just like people of colour are missing from these gatherings. The fault is not theirs; it is ours. We must be more inclusive and we must make efforts to reach out to people. Just imagine how different things could be, if some of these walls of prejudice were pulled down from the inside.

Grainne and Tessa are a great example of how babywearing can actually empower beyond the “rules.” Little Tessa was born without a nose (arhinia) and had to have a tracheostomy when she was very young. Her family were told that she was safest to be sleeping in a separate room with various wires and monitors attached to her for any alerts in a change of breathing. In fact, Grainne decided to wear Tessa in a sling, keeping her close and safe and visible at all times; if Tessa stopped breathing, Grainne would see it and feel it as it happened, thanks to the sling (read more about them here.) The sling made life work for them, and also made it much happier during some very tough times. Common sense, knowledge of safety and a willingness to bend the rules worked together to enhance their lives, when they could so easily have missed out.

carrying in special circumstances

This is a superb blog for further reading; all about ableism in the babywearing community and I urge you to read it.

http://bindungtraegt.de/ableismback-wearing/


when the time comes to stop carrying

When the time comes to stop carrying....

There will come a time when you stop carrying your child. This is likely to bring very mixed emotions.

Our lives as parents are full of the most exciting and precious “firsts”; the first flutter, the first cry, the first kiss. Then comes the first feed, the first smile, the first word, the first steps. Not all firsts are delightful, of course… but at least there is some relief in getting some of these hurdles done and dusted; the first injury, the first day at nursery, the first day at big school..

Inevitably, there are “lasts” too. Sometimes these are planned and some are welcomed; the last injection, the last day at pre-school before the long holidays, the last day in a plaster cast. Many “lasts” creep up on us unnoticed, which is a mercy; would you want to know that tomorrow your child would no longer ask for milk, that yesterday was the last time your child would agree to hold your hand in public, or that you’d just carried your child in your arms for the last time? It’s inevitable… our tiny babies grow bigger, and they just don’t stop growing, until before we know it, we have toddlers, and then pre-schoolers, and then school-age kids, teenagers, and one day our children will have children of their own.

All parents stop carrying their children eventually, for many reasons.

  • Some stop soon after birth, because they feel their bodies aren’t strong enough and that their baby is too heavy (this is usually just a matter of finding the right sling to be comfy and supportive, getting muscles used to it and then carrying daily. Many families carry toddlers and preschoolers in slings with great happiness and in comfort. Do go and see your local sling library for help.
  • Some may stop out of fear that the sling isn’t on right or isn’t safe. It is good to be safe and to know how to use your sling well; this is where sling libraries and consultants come in. They can help you build your confidence and keep you carrying happily. See the TICKS guidelines and “Sling Safety” for more.
  • Others may stop out of fear that too much carrying will spoil a child and make them clingy (for a full discussion of the cultural misconceptions behind this please see here – “Do Slings Make Children Clingy?”). In summary; a sling won’t spoil your child and will actually help their emotional development.
  • Still others will stop because their baby doesn’t seem to enjoy being in a sling at all. This can be easy to sort out (see “Help! My child cries in the sling” for some further reassurance and troubleshooting).
  • Some will stop because a child who has previously been happy is now wriggling and pushing away and it seems that they have outgrown the carrier (this is often due to visibility issues, which can be easy to fix  –  options such as hip carries, back carries can be very useful. Do go and see your local sling resource for help.)
  • Some will stop because their child is now able to walk and “no longer needs carrying…” This isn’t true, big kids like to be carried too! Some toddlers will go on “sling strike” for a while as they want to explore their new skills of walking and many will come back to the cuddle of the carrier when they are ready, on their own terms. It is usually best to be guided by your child.

when the time comes to stop carrying

And finally – some will stop because their older child no longer wishes or needs to be carried; and this is where my daughter and I are now. I cannot carry my son any more; he is eight years old and hefty and I am just not strong enough (I still hold his hand as he drifts off to sleep every night, long may it last – every chance for connection is so precious). My little big girl is 5 and started school in September, she is still light and portable, but she really doesn’t want carrying much these days. We carry in arms and with piggybacks more than slings, probably, but from time to time when she is tired or overwhelmed,  she will ask for a carrier; and specifies which one too. The ring sling (purple, please!!!).. the clip one (no, not that one, THAT one!)… or the wrap (on the front today, Mummy.. no, on the back! no, front, haha! Can we have the Elsa one today? Oh, there’s a new wrap, can I have a sweet if you want a go Mummy?) She really surprised me by asking for a sling almost every day of our last summer holiday; probably as I wasn’t working and was therefore more “available” to carry her and she wanted to make the most of it. I loved every last second of each snuggle, being wistfully aware that our carrying days are numbered.

She’s been in slings all her life, since she was a newborn. It hasn’t harmed or slowed her development; she crawled and walked and ran at the expected ages, is fiercely independent and is often a speck in the distance running far ahead. She is strong and lithe and fast on her feet. She sleeps all night in her own bed. She sings all day long and she sings herself to sleep; and I am convinced the slings played their part in our family journey together.

I’ve used slings that I chose both for their comfort and their beauty, and we have enjoyed great happiness in them together. But they have also brought us great value beyond their functionality. The slings have allowed us to be connected physically for far longer than would otherwise be possible with only-in-arms carrying. They have helped us to bond and to communicate (I am deaf and have to lipread), they helped us to recover from illness or sadness, they have allowed us to explore our glorious Peak countryside off the beaten track.

The closeness and security she has gained from knowing she can be held close when she needs it has given her freedom and self-confidence; a rock solid foundation from which to explore the world. It was easy to talk to strangers from the sling as she was at an equal height rather than always being small and looked down-on, and now that she stands on her own two feet looking up at people, her assured friendliness continues (as many visitors to our house will testify!)

I will be forever grateful for the role our slings have played in family life; and each carry now is tinged with nostalgia. One day it will have been the last time. Until then, I will carry her whenever she asks, and enjoy every single second.