Babies are both fragile and tough in equal measure, and this is why we are always told to “support” baby’s head. But, how and where should this support come from? As a consultant and a sling librarian one of the most common questions I am asked is “will that support her head”?
As with all safe sling use, the first thing we must consider is TICKS. Taking the first two items from this list, any sling should ensure that the baby is held tight against the wearer, remaining visible to the wearer always. Furthermore, the carrier should fully support the baby’s spine. If a sling is worn so that baby’s head is tucked inside it can make it tricky to see them. Therefore, if you are going to use this method, only the pass on side away from a baby’s head should ever be used – no fabric should ever obscure their face. However, a sling that is worn tight and providing support all the way to nape of the baby’s neck will provide all the support they require. For example, with a pre-tied stretchy wrap the passes should cross at the nape of their neck, with third layer coming to this point too. It should not be necessary to cap their head for support; although I understand some babies like the security it provides them (while others detest it completely and will fight it).
We are told to support their head because it is disproportionately large when compared to the size of their body (at birth it is already half the size of an adult’s head) and is roughly the same size as their chest until around two years old. Although, the head is well developed (to allow for brain development and growth), the muscles of the upper spine are not as well developed and take time to develop. The upper curve of the spine, the cervical curve, develops first and can be seen developing in infants from around 6 weeks.
But surely, a baby’s head will loll backwards if not supported. Not necessarily, the spine is an amazing invention and by ensuring a baby is fully supported and has a pelvic tuck (being held in their natural foetal/ m shaped position, with knees above their bottom, it is impossible for head to loll as the vertebrae stop it. This image from Sheffield Sling Surgery shows just how supported a baby is simply by being held in the correct position, without the need for anything supporting behind the babies head. Try it yourself by completing a full squat with your feet flat to the floor, bottom lower than your knees and not ‘supporting’ yourself with your hands. The minute you rock out of the squat you will be able to tilt your head fully back but not while in the squat positon. This is another reason having the carrier tight is important, by preventing a baby from slumping (and compromising their airway) they also can’t rock out of the squat. The first place anyone should consider adjusting for a baby that has a lolling head is their pelvis – the spine after all is all connected to one and other.
Another issue to consider when ‘supporting’ a baby’s is head, is that the carrier does not prevent movement. In the event of danger, even small babies can normally move sufficiently to try to remove or reduce the threat. But it is not just cradle carries where babies head is held fixed by a carrier. Unfortunately, the weight of their head can force the chin onto chest and obstruct a baby’s airway. This is most common in cradle carries. Carriers that have high-flat elasticated sides, as well as forcing chin onto chest by encourage even more curling of the spine, also can cause rolling towards the wearer. Both of these mean that the ability for baby to move their head away from trouble is restricted. It is for this reason, that most ‘bag style’ slings and cradle carry positions have been removed from sale or removed from instructions. Many carriers extol the benefits of their ‘headrests’ but if the baby can’t move their head (often due to ill-fitting carriers) then this head rest could be dangerous.
A ‘headrest’ is a strange term, as the head should ideally rest against the carrying adult. Further support behind the head is of course possible in many carriers, or with a supplementary hand, but it should not come at the expense of freedom of movement. Nicola Lawson, The West Yorkshire Sling Library
The final element to consider is the use of ‘sleep hoods’. Although, they can make a novice sling user more feel more comfortable when their baby is asleep, they should never be fastened on both sides to that the baby cannot move their head or so that the flow of oxygen to baby is compromised. In hot weather, it is also harder for baby to cool down if they are being covered too. The temperatures of ‘covered’ baby’s, whether in car seats, pushchairs or carriers, can quickly increase. If hoods are fastened in such a way, it impossible to keep baby in view, it is impossible to check on their well being.
I know that hoods, passes and head rests can help sling users feel more confident but they should never be at the detriment of safety. A gentle hand if leaning forward should be sufficient. If it isn’t, the carrier needs adjusting and fitting correctly. This is what your local sling professionals are here for, so just ask. You can find your nearest consultant/library by visiting Sling Pages.
With thanks to Dr Rosie Knowles of Sheffield Sling Surgery for allowing us to use her images and for proof reading this article before publication. Thank you to Suzie Young (registered Midwife) for reading through it too.