Safe sling use and the pressure to feed in a sling

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The arrival of a new baby is a joyous occasion and the desire to want to keep them safe is one that is at the forefront of a mothers mind. As mothers we do all we can from the minute we discover we are expecting (and before in some cases) to protect them. Keeping baby close to you can be one of the easiest way of helping mums know that baby is safe and this is why many parents will choose to use a sling with their baby.  Babies want and need to be held; they are biologically programmed to want to be close to their care giver.

Sadly though, there are risks when carrying a baby and it is crucial that we follow some simple safety guidelines. Special consideration should be a taken when carrying babies who were born prematurely, with a low birth weight or who have underlying medical conditions; however, it is also important to remember that carrying can be extremely beneficial to both baby and mother in these situations. Kangaroo Mother Care has been proven to have health benefits and to save lives and reduced length of hospital stay, and using a carrier can help attachment and bonding (especially important if mothers are suffering from PND). We must therefore acknowledge the risks of using a sling are outweighed by the benefits.

Changes in the carrying industry following the Infantino Slingrider recall in 2010 have looked to address many of the issues of carrying young babies and the increase in easily accessible trained babywearing support has become a much larger element of the carrying community. There has been an increase in regulation (primarily in USA) and  professionalism within the industry, with sling libraries and babywearing consultants now available across the country. As carrying has moved from a small niche audience to mainstream parenting, it is no longer unusual to see carriers on sale on the high street or to see parents using slings with their babies, toddlers and even preschoolers. Carrying our young is biologically normal. It allows us to meet the needs of baby while carrying on with our lives; whether this is looking after other children or simply getting out of the house.

47432285 - a mother breast feeding his baby at home
Copyright: lopolo / 123RF Stock Photo

It is this societal expectation to ‘get back to normal’ that leads many parents to want to do several things at once. One of the most frequently asked questions I am asked or read is: “Can I feed in it?” For many mothers, breastfeeding can be something they fear doing in public and want something to help them cover up, or to let them ‘feed on the go’. As a mother I understand this completely. As a breastfeeding peer supporter I understand the fears women have. As a society, we traditionally hold babies in arms in a cradle position (the need to support their head is drilled into us from when we are children) and this position is often associated with breastfeeding or seen as the main feeding position. Unfortunately, this position in a sling is dangerous if not done correctly. In arms a baby is supported and his parents are fully aware of what baby is doing. However, in a carrier their disproportionately large heads and weak neck muscles, combined with the weight of gravity and the bounce of fabric (as well as a feeling you are hands free) can cause babies chins to rest upon their chest. This has the potential to block their airway and sadly lead to positional asphyxia (similar effects can be caused by infant car seats).

8094358 - walk with the child in a baby sling. breastfeeding

Copyright: lenor / 123RF Stock Photo

As a carrying consultant, I often tell mums that “if you need my help to feed in a sling, you aren’t good enough at one or the other”. I don’t mean this in a way to criticise the mother (although I know many might see it like that). Breastfeeding and using a sling are skills that need to be learned and trying to mix them can lead to frustration and a feeling of failure. As babies get older and feeding is better established combining the two is a natural link to make, but in the early days when baby and you are learning what to do, please do not feel you have to try, it is ok to sit and rest, to watch the feed carefully, to learn the signs of when your baby is full.

Copyright: North East Sling Library

13032095 - mother with baby in a slingIt is the risk of positional asphyxia when using a cradle carry position (typically in a ring sling or stretchy wrap carrier) that has led to it being removed from many manufacturer’s instructions, why I have only taught it twice (both in situations where upright and off-centred positions were not possible due to other medical complications and neither wanted to feed in the sling) and why a post on social media asking how to do it can lead to many having a meltdown at their keyboards. Unfortunately, there are slings that still have it in their instructions or which advertise breastfeeding position as a selling feature (often cheaper brands sold on ebay/amazon) and there are thousands of videos on YouTube– a quick search of the site brought up 2100 hits (over 3000 if you use the search term breastfeeding in a stretchy sling) – of various levels of detail clarity.

Copyright: lenor / 123RF Stock Photo

Therefore, when carrying a baby in a carrier it is important to take time to learn how to use your sling; to read the instructions (I know as parents life is busy but it is worth it), to practice tying it and to seek help/support if necessary.  When looking at buying a sling (a term I use for all carriers except framed back carriers but which is often most used for stretchy wrap carriers) ask yourself some simple questions:

  • Is it from a respected company?
  • Do they have up to date instructions and safety guidelines on their website?
  • Can you get in touch with them for support?
  • Has it been safety tested and is it made with child safe dyes?
  • Is the price too good to be true?

When using your carrier it is important to follow the TICKS guidelines. These were developed in March 2010 and have become the gold standard for safe baby carrying in the UK (North America often use the Visible and Kissable rule). TICKS seeks to provide 5 simple and easy to remember steps to keep baby safe by maintaining a clear airway: Tight, in view, close enough to kiss, keep chin off chest and supported back. One of the simplest ways of achieving these five steps are to keep baby in an upright position and babies can be carried upright from birth; a well-fitting sling will provide a newborn with the support they need for their head (being held upright also has the benefit of  helping babies with wind). But, being upright, can make it harder to breastfeed in a sling to begin with, although as baby gets older it gets easier – this biological upright feeding position can be easier for baby too.  Keeping baby visible allows us to easily monitor them, to make changes if necessary. Tying the carrier tight and ensuring it fully supports babies back not only helps them to feel secure (by creating a point of stability), it prevents them from being able to slump in the carrier.

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Carrying your baby in a sling is a wonderful feeling and can be extremely empowering to the mother (and other caregivers). Done safely, it can be the key in unlocking amazing adventures together or simply getting out of the house. Enjoy the freedom, the cuddles and take one step at a time. Do not think, that by putting baby in the sling they are fine by themselves, babies needs change with seconds. It should be an enjoyable shared experience but one where the wearer is fully aware of babies needs at all times. If in doubt, stop and ask for our help: that is why I and consultants across the country are here.

 


Where to find out more

http://www.cochrane.org/CD002771/NEONATAL_kangaroo-mother-care-reduce-morbidity-and-mortality-low-birthweight-infants

http://apps.who.int/iris/bitstream/10665/42587/1/9241590351.pdf

https://sheffieldslingsurgery.wordpress.com/2014/04/04/sling-safety-with-young-babies/

https://www.nct.org.uk/parenting/sling-safety

http://babyslingsafety.co.uk/

http://www.which.co.uk/reviews/baby-carriers-and-baby-slings/article/baby-carrier-and-baby-sling-safety/baby-carrier-and-baby-sling-safety-tips

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“You’ll need a proper carrier” – framed carriers are they necessary?

hellvelynI love walking and have spent many happy hours walking in the Lake District and Weardale with my husband, dog and children. We first took Henry when he was just 4 months old and we have been going ever since but I have never owned a proper carrier. By proper carrier I am referring to a framed back carrier which are commonly seen as a necessary item if you want to do some ‘proper walking’. Well, I think I come in the ‘proper walking’ category: this year we took Henry and Isaac (then aged 6 and 4) to climb Catbells and more impressively Hellvelyn (they successfully summited both). I did take a carrier for Isaac – it stayed in bag the whole time on both days.

56089368_sFramed carriers are quite bulky pieces of kit and when I first started carrying simply didn’t have the room to store one. They are suitable only for older babies and children (approx. 6 months) who can sit unaided. Visually they look very similar to walking rucksacks, often with thick structured waistbands and heavy padded shoulders. They are readily accessible in many high street shops and outdoor shops with most being priced anywhere upwards of £80 (with some of the most well known being over £100). For many then, they seem the ideal piece of equipment to spend your days walking.

Reasons people like them include:

  • integrated storage
  • sun canopies on some
  • child can “see”
  • no need to take child out – simply take off and use the ‘feet’ to stand carrier up.
  • a little more roomy for the child

But, why then have I not felt the need to buy or use one? Firstly, they are bulky. I am used to carrying big backpacks but my spatial awareness is not one of my strong points. The bulk of them means I simply find them too big; especially if I want to traverse small gaps. I do not go on walks alone and thus my husband has been able to carry the necessary ‘baby kit’ in his rucksack. He has even been known to carry Henry on his back and a rucksack on his front.

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Why do I need to buy another carrier? Many people who want to use a framed carrier already own a carrier that would work perfectly adequately. Soft Structured carriers are perfect. They fold small, so if you are carrying a slightly older child and they want to walk for a bit you can wear it without it feeling heavy or simply put in your bag, and most have the flexibility of front carrying (some facing out) and even hip carries, where as a framed carrier can only be worn on the back. In a Soft Structured carrier, the baby/child’s weight is also closer to you and this can help with balance and our centre of gravity. Framed carriers can, especially for smaller parents, feel like they are pulling you back and make you feel like you need to lean forward to compensate.

In terms of how baby is positioned in a framed carrier, this can vary from a seat to more of a harness in a frame. This has a big impact on the comfort of the journey for the child.  The distance between the wearer and the child is an important factor to consider; especially in snowcold weather or exposed environments. In most carriers where the baby/toddler’s torso is against the wearers front or back they will benefit from sharing body heat. If the child is too hot, heat transfer to adult occurs to help the child cool down, and if they are too cold, warm up. But this cannot happen when they are not against the adults body. An adult may feel perfectly warm but babies and young children cannot regulate their body temperature as effectively as adults, and thus can get much colder than you would expect.

 


Further reading, links and images

http://www.babywearingadvice.co.uk/backpacks.htm

Framed Carriers

http://www.sheffieldslingsurgery.co.uk/new-to-slings/welcome-to-slings/

Thoughts on Framed Carriers

https://www.cpsc.gov/content/cpsc-approves-new-federal-safety-standard-for-frame-child-carriers

Photographs are either my own and thus copyright belongs to me. For stock images please read copyright details below:
Copyright: dmosreg / 123RF Stock Photo
Copyright: dmosreg / 123RF Stock Photo

Carrying, when it means so much more than just the sling.

Babywearing sometimes gets a bad press. Comments from ‘helpful’ members of the public or family members with statements such as: “doesn’t it hurt” and “you’ll make a rod for you own back”, can make it extremely hard for parents to feel like they are making the correct decision. I have long since stopped listening but for new parents it can be hard. For many parents though, carrying their babies and toddlers is a matter of survival. Whether it simply allows them to meet the needs of their new baby and older children, gives them their hands back or just because it makes life easier. With a newborn with severe reflux and breathing difficulties, and a toddler to care for, slings saved my sanity.
Carrying our babies helps us to comfort them when they are upset, help us heal from traumatic birth experiences or postnatal depression, and build a closeness with our baby. The memories and shared experiences we gain while carrying our children create a bond that it would be difficult to replicate in any other way. This is why people often get emotionally attached to the slings that we use – they are not just a carrying device – they are memories too. There are families, though, where carrying their children has even more importance and significance, as their babies have additional needs. I am honoured that a number of them are willing to share their stories.
Each has a different journey, a child with a different need, but all find a place for a carrier in their lives. Our first guest writer is Emily. Emily is a mum of 3 beautiful boys from Sunderland and one of the women who inspired me to carry my first child. I was humbled when during her third pregnancy she contacted me for help after her baby was diagnosed with Unilateral Talipes. I will let Emily take over here:  Continue reading

Please stop with the froggy legs

Please can we stop using the term “froggy legs”

This is going to be controversial but please, can we stop using the term “froggy legs”. That’s right, stop using the term which so many people use when discussing carrying babies in slings. My reasoning; it simply is not accurate and is used to describe so many different things that the meaning which it was initially designed for has been lost.

Ways the term “froggy legs” is used:

  • legs in for a newborn
  • knees above bottom or ‘m’ shape for a newborn
  • knees above bottom or ‘m’ shape for an older baby
  • even in a Buddha carry with ankles together

Times when term ‘froggy legs’ could be used accurately?

Well knees above bottom or ‘m’ shape with an older baby in a spread squat.

This is because a frogs legs are not in front of them; as you can see from the image above they are opened out to the side, ‘knees’ above their ‘bottom’ in an ‘M’ shape.  A baby does not open their hips into this position until they are around the 4 month mark. The key visual clue being when they start to put their feet in their mouth. Until  this point the position baby’s are actually adopting is a foetal position. But because baby isn’t lying on their side for us to see a traditional foetal position it gets missed. The two photos below show a newborn in the foetal position but only the image where the baby is lying on their side is a ‘classic’ foetal position. But in both they have brought their knees above their bottom, hands drawn near their faces and feet turned towards each other. This foetal position is probably the most commonly called “froggy legs”, when it is inaccurately used to describe the act of having baby “legs in” as opposed to  “legs out”. Legs in positions are generally no longer taught or advised by most UK consultants as it can make positioning them in the sling harder. When babies are still very curled up positions such as the Front Double Hammock, Kangaroo and Pocket Wrap Double Hammock work very well as baby is hammocked in sling rather than sitting on the crosses with lots of fabric bunched in little knee pits.

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The ‘froggy leg’ position should more accurately be described as a spread squat. Their pelvis has opened, their knees above bottom (flexed and abducted) in exactly the same way we as adults do when we do squats and even sit down. Baby is now able to bring their legs around their caregivers waist.

http://www.winfssi.com/images/Pithed.jpg

This position  in a sling is illustrated in the following images.

physio-transs-vav-grand2physio-transs-vav-grand1

The issue with using the term “froggy legs” is that it means so many different positions to so many different people; no wonder those starting their babywearing journey can be confused by what is best for their baby. Let’s try to regain the true meaning of “froggy legs” and work on how we describe baby’s position. Inaccurate use of terminology is only ever going to cause confusion.