Browse by Age Group • Aug 18, 2011

Should you wear a baby sling?

As a pediatrician and mother of four, I started babywearing for convenience, and only then began to understand the true medical benefits of carrying infants in a sling.  Babywearing is the ancient method of carrying a baby or toddler with the assistance of a sling or carrier. 

When my first child was one year old, I worked in Malawi, East Africa, as a visiting pediatrician.  A stroller proved useless on the muddy dirt streets, and I marveled at the ability of African women to tie a toddler to their back with a rectangular piece of fabric in about ten seconds flat.  But these African babies were so clam, so quiet.  They nursed through their shots and a waiting room with more than fifty babies was almost quiet.  Why?  Because these African babies were all carried.  And so I, too, became a babywearing mother. 

Here are the top medical benefits of babywearing/baby carrying:

1)      Carried babies cry less.  We all know this from practical experience, but in 1986 a team of pediatric medical providers in Canada did a study, published in the medical journal Pediatrics, that tells us specifically how much less crying carried babies really do.  Hunziker and Garr are researchers who found that babywearing for three hours a day reduced infant crying by 43 percent overall and 54 percent during evening hours[1].  Infant crying causes release of stress hormones in both infants and adults.  So, less crying means less stress and anxiety for both baby and parent. 

2)      Babywearing/carrying promotes infant physical development.  The upright positioning of a carried infant promotes neck strength and head control.  If an infant’s arms are positioned against the parent’s chest, the infant will press against the chest and strengthen his or her arms.  The flat positioning of baby seats and cribs do not promote such physical development.  The constant motion of carrying is not only soothing to a baby but also promotes balance and inner-ear development. 

3)      Babywearing/carrying improves breast milk production and breastfeeding. The physical contact with the infant causes mothers to release a hormone called oxytocin[2].  Oxytocin promotes mothers’ breastmilk production.  Many women are also able to breastfeed an infant in a sling, allowing for easy hands-free nursing, which is especially useful for busy mothers with several young children. 

4)      Babywearing promotes neurobehavioral development and speech.  Carried babies have a constantly changing view of the world, as opposed to staring at a single mobile hung over a crib.  They are exposed to varied voices, emotions, and facial expressions, all of which is crucial for neurobehavioral development [3].  Carried infants usually hear more language.  The more words a baby hears, the more words he or she will say as a toddler. 

5)      Babywearing improves maternal-infant bonding and attachment. Oxytocin also promotes maternal-infant bonding—that in-love-with-my-baby feeling.  Strong maternal-infant bonding promotes better infant care and decreases the incidence of postpartum depression and psychosomatic illness in the mother [4]

6)      Babywearing helps the carrier get exercise!  Carrying an extra 7-20 pounds around all day is an excellent workout for the parent, and a great way to get in shape after a pregnancy.  With a baby attached to you, every step you take around the house helps you build leg, back, and abdominal strength.  As the baby slowly gains weight, your workout intensity slowly increases. 

7)      No more flat baby heads.  Plagiocephaly is the medical term for the flattening of the back of a baby’s head that is the result of spending many hours per day sitting in an infant seat or back sleeping.   Back sleeping is strongly recommended to prevent SIDS (sudden infant death syndrome).  If infants spend all night on their back and all day in an infant seat, the constant pressure on the back of the skull can result in a flattening of the back of the skull which many people find unattractive [5].  Plagiocephaly can be prevented by keeping a baby in a carrier or sling instead of an infant seat or crib. 

Are there risks?

            All the mandatory safety warnings that come with slings can leave a parent concerned that babywearing may not be safe.  The primary risks of sling use are falls, and breathing difficulties from the baby’s face being held too close to the parent’s chest.  Fortunately, both have been studied by pediatricians, and babywearing seems to be safe provided that slings are used appropriately and are in good condition.  A 2002 study published in the medical journal Pediatrics noted that infants carried in slings did not have significant problems with breathing or oxygen saturation compared to infants in prams/strollers [6].  An article in the journal Injury Prevention, published in 2000, looked at injuries resulting from child carrier use.  Fall injuries were rare.  The study results indicate that, in the United States, an average of 1-2 injuries per year from child carriers require hospitalization.  The most common injuries resulting from baby carrying were falls, and the majority of falls occurred when slings were not used appropriately or were broken/worn out[7].  So, babywearing is safe, provided slings are in good condition and are used appropriately. 

What sling/baby carrier should I buy?  Practical product recommendations:

            The truth is that there is no one sling that is best for everyone.  But let’s be practical—you probably only want to buy one sling.  I’ve tried many different carriers, and here are my brief personal reviews of my top four slings:

1)      The Ergo baby carrier: The ErgoBaby is my favorite carrier, the most versatile, the most comfortable, and the easiest to use.  Among babywearing enthusiasts, the ErgoBaby constantly seems to come out on top.  It is, however, among the more expensive.  You also need a special Heart2Heart insert when used with small infants. 

2)      The Baby Bjorn: I used a classic Baby Bjorn infant carrier with my first three children.  It is small and packable but I, like many people, had back pain from use because it does not have a hip strap or method to shift weight on the hips.  I also found that young infants did not like the hands-and-legs-out positioning. 

3)      The Moby Wrap: Beware that this carrier is really a long strip of fabric with  instructions on how to wrap it around you to form a sling.  Once you learn the wrapping methods, it is excellent.  I used it daily for three weeks before I really had the mechanics of this down.  I even had to call customer service and watch the online instructional videos to get it right.  I found it to be especially good for young infants as it is adjustable to their small size and holds them in a very snug position.  It takes longer to put on and take off, compared to other wraps.  Taking it on and off also often requires that you let the ends of the fabric touch the ground, which makes using this wrap difficult while outside or in any place with a dirty floor.  Its low price makes this a good option for budget-minded new parents. 

4)      The Maya wrap: This is a traditional single-shoulder sling with an adjustable strap on a ring, and it is especially good for a toddler hip-hold.  Many people have neck pain with this sling, which does not have any hip support.  It is very packable and easy to use. 

References:

1)      Hunziker UA, Garr RG. (1986) Increased carrying reduces infant crying: A randomized controlled trial.  Pediatrics 77:641-648.

2)      Lonstein, Joseph S. (2007) Regulation of anxiety during the postpartum period.  Frontiers in Neuroendocrinology 28(2-3). 

3)      Ferber SG, Makhoul IR. (2004) The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: a randomized, controlled trial. Pediatrics 113(4):858-65.

4)      Anisfeld E, Casper V, Nozyce M, Cunningham N.  (1990) Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment. Child Dev 61:1617-1627.

5)      Littlefield, Timothy R. (2003) Car Seats, Infant Carriers, and Swings: Their Role in Deformational Plagiocephaly.  Journal of Prosthetics & Orthotics 15 (3): 102-106.

6)      Stening, W. et al. (2002) Cardiorespiratory Stability of Premature and Term Infants Carried in Infant Slings.  Pediatrics 110:5 879883.

7)      Frisbee, SJ and Hennes, H. (2000)  Adult worn child carriers: a potential risk for injury.  Injury Prevention 6:56-58.

Comments

  • Gretchen

    Great article! I’ve tried a LOT of “slings”–ring sling, mei tai, pouches, stretchy wraps and woven wraps, and my friend has an Ergo and my sister has a Bjorn. I keep coming back to wraps because I think I like things with learning curves. 😉 I like stretchy wraps for newborns and wovens are great once they get head control to move them to your back–they LOVE the view of being able to see things up over your shoulder.
    *Safety note* NEVER try to carry your baby on your back in a stretchy wrap (like the Moby). Babies can be suddenly wiggly and fall out.

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