Using a sling after a Caesarean section – can you do it?

One of the most common questions I am asked or see posted on babywearing forums and Facebook groups is: “Can I use a sling I have had a caesarean?” and the answer is quite simple. It is probably yes. Despite what woman may have planned or hoped for 1 in 4 babies born in England are delivered via Caesarean Section (CS). The 2013-14 NHS Maternity Statistics for England show that of 646,904 deliveries, 166,081 of these (or 26.2%) were caesarean section, with 13% conducted via emergency section. Therefore there are many mums who potentially want to use a sling to carry their baby who are no scared that they can’t now do so.

2 weeks post EMCS
 

Firstly, I am not a medical practitioner, I am a babywearing consultant and sling librarian who has worked with many mums who have had caesareans and helped them to find ways to carry their babies comfortably and most importantly safely. If you are in any doubt you must always consult your Midwife or GP. What I will consider are the ways in which we can look at carrying after a caesarean.

The recovery rate after a  CS is generally longer (NHS Choices) and the fact it is major surgery can make mums apprehensive about using a carrier. The key with carrying after a caesarean is to carry “high and tight” to avoid the scar. Incidentally, the high and tight rule applies to mums who have had a vaginal delivery too. Simply having a vaginal delivery does not mean you are ok to carry.  For example it is thought that 5 in 10 women who have had children have some degree of prolapse but that only 1 or 2 women in every 10 seek medical advice due to the sensitive nature of the condition (www.patient.info).  Other post-partum complications such as haemorrhage and tearing can leave women who have had a vaginal delivery feeling weak. Therefore there is no blanket rule to state having a vaginal delivery means you can use a sling or having a caesarean means you cannot. The amount of time post partum where a woman feels comfortable and capable of carrying will vary from mother to mother, there is no ‘set’ time. Listen to your own body.

Using a sling allows new mothers to get out. A social support network is important.
 

Women who have had a caesarean delivery will typically spend 3-4 days in hospital although this can be as little as 24 hours. Women who have had a caesarean section should resume activities such as driving a vehicle, carrying heavy items, formal exercise and sexual intercourse once they have fully recovered (including pain). This means that many women will not be ready to strenuous activity until after 6-8 weeks. This does not mean that women should be confined to the house and using a sling or carrier allows them to undertake gentle exercise such as walking. Gentle exercise should be encourage to avoid clots (NHS Choices) forming. This will also help woman to start building up muscles again. Using the sling can stop mothers from bending unnecessarily. Keeping baby close can stop you from having to keep picking them up from their Moses basket or crib.


Time and care should be used when placing baby in the sling to ensure the mother engages her pelvic floor and core muscles. 30% of postnatal women will have some form of stress incontinence after birth. The ability for mothers who have had a caesarean to use is a sling is particularly important as they are unable to carry anything heavier than their baby. This therefore means they should not lift car seats or or even push heavy travel systems and prams. The NICE guidelines recommend early skin to skin contact for mothers who have caesarean deliveries (2004). Skin to skin contact has also been shown to help emotional attachment between mother and child, as well as being beneficial in promoting breast milk production both which can be hindered by caesarean deliveries, typically as because their can be a delay in offering breast. Using a sling allows them to get out and start to socialise and help with mental wellbeing and help reduce risk of post natal depression. This ability to socialise is encouraged by NICE and postnatal care should encourage mothers to have a social network of support. (NICE Pathways)

Using a sling or carrier can play a crucial role in allowing a mother to regain her strength and posture after the birth. The key is to listen to your body and to build up the amount of carrying you do. Your body will develop muscle strength and get used to carrying your baby. Do not assume you will be able to carry for hours straight away. Your postnatal body will need time to adjust and remember you will still have increased levels of Relaxin in your system, especially if you are breastfeeding. Even if you do not feel capable of using the sling it could be used to help the emotional bond between baby and other caregivers

There is no right or wrong sling to use after a caesarean section. In all cases care should be used and it is beneficial to select those which do not sit lower on the mothers’ abdominal muscles and can place pressure on their stomach and scar. Typically these are those with structured waistbands although ideally these should be worn on the wearers waist above hips and far away from scar. I have fitted all manner of slings to mothers after a caesareans. These have included ring slings, wraps (woven or stretchy) and even buckle carriers. We are simply wanting to keep the sling away from the scar tissue and stitches.

If you want to carry and are unsure of the most comfortable way to do so it is worth having a consultation with a babywearing consultant as they will have the time , knowledge and experience to help you find carries which are comfortable. Remember there is no date by which you must have started carrying. You should only begin using a sling when you feel comfortable, do not rush your body. If you want your baby to get used to being carried in a sling ask your partner, grandparent or even a friend to carry them for you.


References and links

http://www.nhs.uk/conditions/caesarean-section/pages/recovery.aspx

Click to access pi-pelvic-organ-prolapse.pdf

http://pathways.nice.org.uk/pathways/postnatal-care#content=view-node%3Anodes-first-week&path=view%3A/pathways/postnatal-care/care-of-women-and-their-babies.xml

http://pathways.nice.org.uk/pathways/caesarean-section#content=view-node%3Anodes-care-after-caesarean-section

http://www.nice.org.uk/guidance/CG132/chapter/1-Guidance#care-of-the-baby-born-by-cs

 

How slings and carriers can be used to promote attachment with adoptive and foster families.

“The single most important child rearing practice to be adopted for the development of emotional and socially healthy infants and children is to carry the infant on the body of the care giver all day long”.


In 1996 James Prescott in his piece “The Origins of Human Love and Violence” stated that “the single most important child rearing practice to be adopted for the development of emotional and socially healthy infants and children is to carry the infant on the body of the care giver all day long”. This statement has stuck with me since the first time I read it and is integral in explaining why slings and carriers can be an important tool for foster and adoptive families.

The act of carrying our young is not a new concept, carrying is in fact normal. It is one of the few universal things which unite nations and cultures (although we each have our own carrying methods and histories), as babies and small children want and need to be held. Observe a newborn and you will see how they turn their feet inwards to cling to their mother, their hands grasp to hold on and they bring their knees above their bottom into a fetal position once more. These primitive reflexes have survived our evolution and remain evidence of their need to be carried. For biological mothers and fathers it can be completely natural for them to want to pick their children up, to hold them to kiss them and to carry them and in doing so continue to develop the strong attachments between baby and parent that began when baby was in utero.

Attachments are deep and enduring emotional bonds that connects one person to another, they are the foundations on which we can grow. As demonstrated by Maslow’s Hierarchy of Needs simply providing a child  with food and shelter is not enough for them to prosper. Safety, security and love are also needed.

Typically children will seek their attachment figure when they are upset or threatened (Bowlby, 1969) or when they feel unwell – there is therefore no spoiling baby by picking them up: it is meeting their basic need for love and reassurance. By choosing to use a sling parents are able to keep their baby close in order to be responsive and reactive to their needs. Neuroscientists Megan Gunnar and Bonny Donzella summed it up nicely when they wrote “the effect of sensitive, responsive, attentive caregiving is that it allows children to express and experience distress, communicate those emotions without stimulating increases in glucocorticoids.” As small babies and children have very few ways in which they can communicate; by keeping them close parents are able to pick up quickly and easily on non-vocal cues as well as respond to the more vocal.

Children who have been separated from their care giver have also been shown to elicit a cortisol response and prolonged and extreme levels of cortisol negatively affect the developing brain. This stress hormone for example was shown to rise in one study in 1992 when securely attached 9 month old infants were separated for 30 minutes from their mother and left with a babysitter who although ensured the child was safe, did not respond to their needs. It is also known that cortisol increases in babies without secure attachments, so by adopting methods which can help increase attachment we can go some way to reduce cortisol levels in infants. Children unable to manage toxic prolonged stress by themselves and need the help of caring adults to support them (Middlebrooks and Audage, 2008). If this is not available and toxic stress is prolonged infant brain growth is effected (National Scientific Council on the Developing Child, 2005).

Unfortunately not all babies or small children have the benefit of a loving or safe home, with strong and secure attachment figures. As such they will not receive support from an adult capable of responding sensitively or appropriately to their needs. Bowlby’s early work into attachment theory led us to understand the need for strong attachments and he described these as a “lasting psychological connectedness between human beings”. Typically between a primary care giver (usually the mother) and a child and that this relationship had a strong effect on the child’s social, emotional and cognitive development. Children who are unable to form this strong bonds in early childhood are at a disadvantage; as securely attached children and adults live happier, less conflict ridden lives (Whitborne, 2005).  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.

Carrying adopted and foster children can help promote attachments with their adoptive/foster parents and ease transition to their new life. This does not mean immediately a child is placed with a family putting them in a sling but it is a useful tool that should not be discounted. Baronel and Lionetti in 2012 stated that adoption is “an intervention that assures the adoptive child the opportunity to catch up on emotional development and to partially resolve prior traumatic attachment experiences”. As using a sling has been shown to promote secure attachments between mother and child, primarily because of the speed by which mother could respond, we can therefore hypothesise that carrying an adopted child in a carrier could have the same benefits for attachment and this appears to be the case from case studies I found and from my own experiences.

There are several reasons why carrying a child in a sling can be helpful. These can typically be broken into health reasons and practical reasons. Using a sling or carrier has been shown to enhance growth and weight gain (Charpak, 2005), stabilize baby’s heart rate, resulting in lower cases of bradycardia and tachycardia (McCain, 2005), and even ease the symptoms of reflux (Tasker, 2002) to name just a few. While also simply giving the wearer their hands back, especially important if you have older children to care for, or for those days where baby simply doesn’t want to be put down. But the majority of research has been done between child and biological parents, primarily the mother. However, anybody can sling: parents, grandparents, child minders and nursery nurses, older siblings etc. Therefore carrying your child could be as important to adoptive parents as it is to biological parents, maybe even more so. This is one of the why for example The UP Project, a UK community interest company which provides free carriers to disadvantaged families, includes foster and adoptive families in the category of families they can help.

In 2009 Bick and Dozier found that when mothers engaged with biological and non-biological children, oxytocin production was higher after the interactions with the non-biological children. Oxytocin or ‘the love hormone’ has been associated with “attachment related thoughts” and there is a “general consensus that oxytocin has positive effects on human social behaviour” and a “secure attachment in infancy is important for normal psychological development…from which the infant explores the world beyond” (Campbell, 2010). Therefore the way in which close contact can help boost oxytocin production, and as a result attachment, can be seen as an important reason for adoptive and foster parents to carry the children in their care. This was supported by research conducted in 2007 which concluded that by replicating earlier missed experiences, such as close physical contact via the use of a sling, and being responsive to child’s needs, the caregiver would help the emotional development of child and promote attachment (Gribble, 2007). Gribble in this study began with the hypothesis that those physiological practices which help post-partum attachments should and could be applied to adopted children, and this seems to be the case from working with lots of families at sling library sessions.

For example, on one busy Saturday afternoon drop in session I had a visit from a Mum and Dad and their three children (two girls 3 and 2, and a baby boy of 9 months). A completely normal experience in my work. It was not until their 2nd visit that I discovered they were an adoptive family and they had come to find a sling: firstly for the practical reasons of getting their hands back but also to help with bonding. When I asked Mum why she chose to use the sling library she said that using slings had helped promote attachment with her baby and that “there does not exist the same closeness with our oldest child, who most people would have said at 3 and a half was too old to be carried”. Amazed that she could carry her older children Mummy A is now allowing her older children the opportunity to be carried to give them “the experience they never had as a youngster”.

“there does not exist the same closeness with our oldest child, who most people would have said at 3 and a half was too old to be carried”.

There are several different kinds of sling available and there are slings suitable for tiny premature babies through to pre-school and beyond, there is a carrier for all situations. One family who came to visit was Baby girl L and her mummy. With a dog that needing walking and a caravan they needed a sling. On this occasion Baby L had been placed with her parents from birth with them acting as foster parents while they went through the adoption process to avoid her having to be placed in temporary foster care. Born prematurely she was a tiny 5lb 1oz when she came to visit for the first time. After hiring a sling for 4 weeks Mum J told me that she want to try a sling “after a few people told me it was the next best thing to being pregnant”. Later on she was able to say that it has “most definitely helped with the attachment we have with Baby L”.

“after a few people told me it was the next best thing to being pregnant….most definitely helped with the attachment we have with Baby L”

IMG_2074Sling library’s and babywearing consultants exist across the country and they want to help parents to find the carrier that works for them. It isn’t a one size fits all world. My own sling library has carriers that can comfortably carry up to 24kg thus allowing even older children to be carried close to their adopted parent as possible. An appropriately chosen sling or carrier for age and development of child should mean that the weight is distributed evenly and make it comfortable for the wearer. Babywearing is like any form of exercise, take it slowly and build up. Then the only limit on how long you carry your child is how you both feel about it. It will take your body a little time to adjust to the extra weight, but this gets easier the more you do it, so little and often is the key when starting to carry older children.IMG_1836

With so many different types of sling available it can be daunting where to start. Babies under 3 months have indiscriminate attachments, predisposed from birth to form an attachment to any care giver, for them stretchy wraps and carriers such as the Close Caboo™ offer a relatively easy and affordable entry into the sling world. Small babies are the most likely to want to be carried and this can make the transition to a sling easier for them. As with everything, it is important to ensure you follow all safety guidelines, especially the TICKS guidelines and manufacturers instructions.

Still image of dis-allowed goal. (226)

For older babies and toddlers who may not have had the same experiences of close contact it may take more time for them to adjust. A hip carrier, such as the Scootababy™, does not enclose them to the same degree as a wrap based carrier. It is possible with older to children to find carriers with patterns or pictures that they like, making it “their sling”, giving them some autonomy and choice in the process of selecting the carrier can make it easier for them to become adjusted to it. Choosing a sling with a variety of carrying positions is also helpful and building up how long you use the sling. For some children they may not want to be looking at the adults face but may prefer to be on their back, close but not too close, while others seek the security of their carers face.1270200_10152359721119473_5123666437256962842_o

There is no one size fits all solution. Take time to see what works for both carer and child. One family visited me and hired a carrier for their newly adopted 15 month old who had only just begun to walk. They hoped that the sling would allow them to get out and about but she was hesitant to go in the sling to start with and after a month coped with small periods only. They show that we cannot expect miracles straight away, we should always move only at the baby’s pace.

My final case study is a story of international adoption. Thank you D, her husband A and baby R for letting me share. In the spring of this year they adopted an 1.5 year old little boy from China. They took with them a carrier with them and I want to finish with her description of using the carrier: “it was particularly useful on the internal and international flights and trips. It was such a brilliant way to bond with my new son, keeping each other cosy. R accepted the carrier without complaint, in fact he accepted everything about his new life with good humor and curiosity, and trusted us from the start. He is amazing. We are so lucky to be his parents, and I love being his Momma”. R demonstrates the resilience of children. The freedom and joy that the carrier gave them is the same freedom and joy biological parents, grandparents and aunties and uncles feel when they use a sling, let us make it the norm for adoptive and foster families too, after all Carrying is normal.

“It was such a brilliant way to bond with my new son, keeping each other cosy. R accepted the carrier without complaint, in fact he accepted everything about his new life with good humor and curiosity, and trusted us from the start.”

Finally I am going to leave you with a few words of wisdom from the first foster mum who got me interested in the benefits of sling use for adoptive and foster families, I feel she speaks the clearest of any of us.

“Part of the reason it can help is children that may have attachment issues when they are adopted, and need security, a feeling of safety and above all else to be claimed.  Using the sling as one means of promoting that close contact and parental availability all assists in the vital settling in and bonding period. Added to this the practicality of a sling as an excellent means of transport can be invaluable to a parent learning the job.”


Background

This  blog was originally published in 2014 as part of my Slingababy consultancy community project. The original blog can be viewed here. I was then approached by the organisers of the 2015 Northern Sling Exhibition to present a seminar on the topic. This blog is a reworking of original piece and includes more on attachment . Case studies are anonymous to protect the families involved.

References

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 Development 61:1617-1627.

Baronel L and Lionetti F, ‘Attachment and emotional understanding: a study of late adopted pre-schoolers and their parents’, Child Care Health Development, 2012 Sept 38 (5)

Bick J and Dozier M, ‘Mothers and children’s concentrations of oxytocin following close, physical interactions with biological and non-biological children’, Psychobiology 52: 100-1007, 2009

Bowlby J. (1969). Attachment. Attachment and loss: Vol. 1. Loss. New York: Basic Books.

Campbell A, ‘Oxytocin and Human Social Behaviours’, Personality and Social Psychology Review, April 2010, p. 281-296

Charpak, N., “Kangaroo Mother Care: 25 Years After,” Acta Paediatric 94 2005: 5, 514-522.

Gribble, K.D, ‘A model for caregiving of adopted children after institutionalization’, Journal of Child and Adolesent Psychiatric Nursing, Feb 2007, Vol 20:1, p.14-26

Gunnar MR, Donzella B. Social regulation of the cortisol levels in early human development. Psychoneuroendocrinology 2002; 27: 199-220

Middlebrooks JS, Audage NC. The Effects of Childhood Stress on Health Across the Lifespan. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2008.

McCain, G et al. “Heart Rate Variability Responses of a Preterm Infant to Kangaroo Care,” 2005 Journal of Obstetrics,

National Scientific Council on the Developing Child (2005). Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper No. 3. Retrieved from http://www.developingchild.harvard.edu

Prescott, J. ‘The Origins of Human Love and Violence’, Pre and perinatal psychology Journal, Spring 1996, Vol 10;3 p. 155

Tasker, A., Dettmar, P. W., Panetti, M., Koufman, J. A., Birchall, J. P., and Pearson, J. P. (2002). Is gastric reflux a cause of Otitis media with effusion in children? The Laryngoscope, 112:1930–1934

Whitborne, S,K. “The 4 Principles of Attachment Parenting and Why They Work” in Psychology Today 2013, July

 

A to Z of Sling Myths Debunked Part 2

After part one of my A to Z of Sling Myths Debunked blog was so well received, as promised here is Part 2 N to Z. Do you have any suggestions for an alternative alphabet of Sling Myths?

New means safe: Buying a sling new does not automatically make it safe. Discrepancies in manufacturing processes, cheap imitations, counterfeited carriers and simple errors in the fabric can make flaws exist in the sling. It is important to check your new sling over when it arrives in the same way you would with a preloved sling. If the price seems too good to be true be careful with your purchase. Cheap imitation and counterfeit carriers do not have any warranty or guarantees. Many new carriers and slings now come with a warranty card which allows you to register your purchase to be notified of any safety recalls. This is primarily associated with slings sold in the USA but it is becoming increasingly more common with UK slings too. Remember to always check for latest instructions for the sling you are using as manufacturers will occasionally change these in accordance with latest safety guidance and best practise. If you bought a sling for older children and intend to use for a new baby take time to double check latest version of instructions from manufacturer.

Overheat: Babies are worn in slings in societies and cultures across the globe. These range from the freezing Arctic north to sub-Saharan Africa so the issue of temperature control is an important one. Your baby is not going to overheat in a sling and there are some simple measures you can follow to ensure you both stay as comfortable as possible. Firstly ensure you both stay hydrated. Breastfed babies are likely to want to feed more frequently in hot weather, therefore keeping Mum hydrated is very important to maintain milk supply. If your baby is bottle fed ensure you offer liquids regularly. Clothing is an important factor to consider too. Layers provide an excellent way of keeping warm in cold weather and in hot weather fewer layers is key. Remember, the sling you are using can often be counted as several layers of clothing. Could you opt for a breathable fabric or lightweight sling? Finally make sure exposed skin is protected from sun and wind burn. Did you know that if you wear your baby skin to skin that it is possible for thermoregulation to occur. This is perfect if your baby has a temperature and is feeling poorly.

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Premature babies need a stretchy wrap: Stretchy wraps are often a parents first introduction to slings and are often suggested as ideal for parents of premature babies. Kangaroo Mother Care has been identified as helping premature babies to develop and grow and one element of this is skin to skin contact. Skin to skin can be facilitated by a wrap, whether stretchy or woven and in fact does not require a sling at all. Many stretchy wraps are suitable for very small babies (Hana Baby, Boba Wrap, Victoriaslinglady for example) and there are an increasing number of Kangaroo Mother Care tops available. However, although relatively simple to use there are occasions when a stretchy wrap would not be suitable for a premature baby. Those born with low muscle tone for example may benefit from the support of a woven wrap for example. Therefore it should not be a blanket ‘premature babies need a stretchy’ but more ‘contact a sling consultant for advice on your specific circumstances’.

Quit (don’t): The two most common reasons I find why people want to give up are 1) They are finding it tricky and 2) something is uncomfortable or hurts. For the first, the easiest way of getting better is by practise and asking for help. Once you have mastered the basics it does get easier. The second reason is more tricky. People often assume that if it hurts then you need to quit. Although this may be the case, it may also be your body getting used to a new form of exercise. If you have never carried your baby in a sling before don’t expect to be able to have the stamina to carry them straight away for hours at a time. If you have only ever front carried then your body will need to readjust if you start back carries. Like with any exercise the more you do it, the easier it becomes. Consider a different sling; more or less padding, rucksack or crossed straps. Again ask for help and someone can work with you to find a solution. It is important though never to ignore your doctors advice if they tell you to stop carrying and do not expect a babywearing consultant to just carry on; that would mean we were giving medical advice something we simply aren’t qualified to do. Could another adult carry baby? Or have you considered taking your sling to show your doctor and let them see it in use before making a blanket ban?

Ruin your back: “You must have a back of steel” or “oh I couldn’t do that with my back” are phrases I have heard a lot. However, no one ever says it to parents who are using a buggy, yet in 2009 83% of mums surveyed for a survey for pushchair manufacturer Maclaren admitted to back pain caused by using a buggy. By carrying baby it also eliminates the need to keep bending down and picking them up. Using a sling could also be more forgiving on your body than trying to carry a cumbersome infant car seat.

Support: It is quite a common myth that you need slings, especially with woven wraps that you need them to be made from blends to be supportive. Firstly, you could have the most “supportive wrap” in the world but it will not be supportive or comfortable if you haven’t tightened it fully as it will leave slack in the carry. For example in a Front Wrap Cross Carry the passes are not needed to be spread for the carry to be classed as a FWCC and if tightened the passes are not needed. They may be useful for warmth or to provide a little head support for a sleeping babe, but if needed to stop it feeling like they are pulling away from you then there is slack that needs removing. Secondly, the term ‘supportive’ is often confused with comfortable and not being diggy on shoulders. Twisting rucksack shoulders for example can be painful. Have you considered sandwiching shoulders or trying a ruckless carry. A 100% cotton wrap is tested to be able to carry much heavier weights than the baby or toddler that will be carried in it. If needed it could carry an adult. If it was truly unsupportive it would break. The terminology which we use is important.

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Toddlers: The trend for toddler size carriers is an extremely new phenomenon and do you know something? Toddlers do not need a toddler carrier. The issue here again is terminology and often people wanting to ‘get the best value for money’. We tend to refer to a baby as a toddler once they start, well toddling. But babies all start toddling at different ages. My own children started walking at 16 months, my godson 9 months for example. The trend for toddler size carriers has come with the emphasis put on a carrier being knee to knee but as we discussed in A to Z of Sling Myths Part One Knee to Knee is not as important once a baby can bear weight and thus once they have started to walk. Issues of body height and width of the toddler carriers can have a massive impact on your toddler. Is the panel so high that they are no longer visible? Do they like arms out and now can’t do so? Have they had to widen their legs more than they are comfortable with because of width of the carrier? These are all as important as whether the carrier is still knee to knee. Buying a carrier that is simply just too big for your child isn’t value for money but a waste of money while you sit waiting for them to grow into it. Remember most slings hold their value so if you buy one and then need to sell it on to help fund your next carrier that is ok. Most carriers have been tested to huge weight limits so they are not going to break under the weight of your toddler and finally, once a toddler starts toddling they will often want to practise this skill. Your carrying time will often reduce and your carrying needs may change as they want to be up and down a lot. Having a sling which simply fits in your change bag for that ‘up’ moment may be preferable.

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Universal: One size does not fit all when it comes to slings. Every individual baby and adult that comes through my door has an individual carrying need. The vast array of slings on the market (at last count my library had 212) shows that one carrier will not suit everyone. What works for your friend may not work for you and your baby. Our body shapes are different, we have different preferences for shoulder styles, levels of padding, direction of tightening for example. There are ‘fashionable’ carriers available but just with clothing, fashions change. Don’t just assume because it works for your neighbour/friend/partner/a person on the internet it will work for you. Visit your local sling library or baby consultant. If you don’t have one near you hire one from those that do postal hire and try a few until you find the one for you and your baby now.

Vast amounts of fabric: It can be quite daunting when someone unfolds 5m of fabric. However, it is often halved very quickly once wrapped around you once, for example with a Front Wrap Cross Carry. The part of the sling where baby sits is quite small and the tails are used to tie. Pre-tying a sling can help reduce the need to tackle the fabric while out and about. There are also different lengths of wraps available, so spending time finding a wrap suited to your size and build can help. The more you practise the less fabric you will need to use too, so be careful not to buy a wrap that is too long.

Wrapping is complicated: Learning to use a sling is a skill. Learning to wrap is no different to any skill we have needed to learn. All wrap carries are made up of the same limited number of passes. It is learning these individual passes which will help you learn to wrap, as once you know the individual passes it is possible to do any carry. They will take practise, but any skill worth learning takes time to master. Don’t worry if your wrap job isn’t perfect. Perfect wrap jobs are few and far between and often found in instruction manuals only. If you feel like giving up after the first few attempts at wrapping, remember how difficult you found installing the carseat or folding the pushchair the first few times you did it. After a bit of practice, they become second nature and muscle memory takes over. Soon it will be second nature.

Xtras: A common concern by people using a sling is how do you carry all the ‘xtra’ stuff you need to take with baby and they assume it is not possible. The first thing to consider is are you front or back carrying? If front carrying a rucksack works well as it sits on your shoulders. There are special bags available on the market too. Any bag with a long messenger style strap work if you can get it to go over you and baby. I personally just use a large handbag as it is designed to sit on my shoulders so I rest if on top of the sling I am using. It is also worth considering do you need everything you have in your bag? I have been known on one night out to shove a nappy in one pocket, wipes in another and my phone, purse and keys in another. For longer day trips shopping trolleys can be filled to the brim and pulled behind you.

Y pull: If you look at lots of YouTube videos and even some instructions you will see them demonstrating a Y pull (or L pull) to tighten their sling. Both a Y pull and L pull provide a generic all over method of tightening a sling when you treat the sling like a rope holding full width of fabric in each hand. They are most frequently seen used when wrapping. However, woven wraps are made from hundreds of individual threads which all act independently of each other. It is therefore preferable to tighten each thread by using a strand by strand tightening method to remove the slack. By using a strand by strand tightening method you also avoid putting extra pressure on baby’s spine by over tightening and focus exactly on where needs tightening.

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Zzzzzzzz: We all want our babies to sleep well. Society has told us that we should separate our baby from us and encourage them to self soothe. Unfortunately babies do not always want to be put down. How many of us have got a baby to sleep at the breast, bottle or in our arms, only for them to wake the instant we put them in their cot or Moses basket (Oakwell-Smith). The calming impact of your breathing and heartbeat has gone, the warmth of your body isn’t there. It’s normal behaviour. Using a sling lets baby have their daytime rest with you, it lets them feel secure. Use of skin to skin contact has been shown to help baby fall asleep quicker and lead to longer periods of more restful sleep (Ferber et al 2004), using a sling can facilitate this. One study found an 86% decrease in quiet sleep when infants were removed from their mothers for sleep (Morgan et all 2011). Using a sling can make daytime naps easier, simply as you don’t have to be set to strict routines at home, baby can nap while you shop, walk dog etc. The ‘Back to sleep’ has seen a reduction in SIDS deaths but the majority of deaths still occur when baby is in a room by themselves (Blair et al 2006). By carrying them for their sleep you can stay alert to their breathing and spot signs of distress early. Remember always keep them visible in the sling. You can read more about baby slings and sleep on the ISIS online website.
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A to Z of Sling Myths Debunked Part 1

We have all heard friends, family, colleagues and even random strangers say things about using a sling or carrier which simply is not true. These myths exist usually because of lack of knowledge. This is going to attempt to be the A to Z of Sling Myths debunked. There is a mix of serious and more light-hearted ones. The term ‘sling’ will be used to refer to every type of carrier for purposes of ease. But whichever category they belong to there are 26 myths which need debunking. So let’s start with Part 1: A to M.


All the slings : It is quite common to visit sling boards and be inundated with stash shots from people who have lots of slings. You could easily believe that you are only a ‘true babywearer’ if you have a huge stash slings all neatly folded and stored. This is simply not true. Throughout life people collect different thing and you can be collector of slings if you wish. But equally valid is having one sling that meets you and your baby’s needs. It doesn’t matter if you have one or one hundred; all that matters is you are keeping your baby close.

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Back carrying: There is no best before date on back carrying. If you don’t want or need to do it then you do not need to. It does not make you any less of a sling mummy or daddy than someone who back carries from day 1. It is personal preference. If you choose to start don’t worry if you give up the first few times. Make it a game and practice simply getting your baby on and off your back to begin with. When you do start make sure you and your baby are comfortable, and have a spotter or a soft mattress available.

C Shaped Spine: The spine is not straight but it takes around a year for babies spines to take on the s-shape associated with an adult spine. At birth, babies are in curled up, with their spine in a natural long gentle curve. As the muscles in baby’s neck get stronger, they begin to lift his heavy head, and a curve starts to develop in his neck (the cervical curve). When your baby starts crawl the lumbar curve (lower back) develops. People will often refer to the curled up state of a newborns spine as a C-shape. However, we all write the letter C in different ways and it can be extremely curled up. A curled up position can cause baby’s chin to touch their chest and this holds risks of positional asphyxia. Ideally we should discuss a j-shaped spine where babies head is supported to prevent chin on chest but where lower spine is curved.

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http://www.babyslingsafety.co.uk British Consortium of Sling Retailers and Manufacturers 2010

Dangerous: There are dangers throughout life and using a sling is not inherently dangerous. However, like any form of equipment if you do not know what you are doing, or do not follow the instructions there is the potential for harm. The group of babies most at risk are newborn (with increased risk for low birth weight or premature) babies. To minimise risks to baby it is important to follow the TICKS guidelines (Tight, Inview, Close enough to kiss, Keep chin off chest, Supported back). Ensuring your baby is visible at all times and that there airway is kept clear will help reduce risks. This super article by Dr Rosie Knowles of Sheffield Sling Surgery is an excellent resource for what you need to consider when carrying a newborn in a sling.

Expensive: This myth I read a lot and probably is also associated with ‘Alltheslings’. Using a sling can be as cheap or as expensive as you want to make it. If you want to buy a handwoven or limited edition sling it will cost you. However, there are numerous budget makes available. Woven wraps can be purchased new for around £40-£50 from companies such as Little Frog or Lenny Lamb. This price is comparable to umbrella fold strollers for example, but unlike these wraps tend to hold their value. When buying a handwoven or handmade carrier you are buying someone’s time and skills not just the sling. You don’t however need to own a Limited Edition (where market economics mean price will often go up) or a handwoven/ handmade sling if you cannot afford it. Making your own Simple Piece of Cloth sling is often suggested but when quality fabrics cost approx. £10/metre you are not really getting a sling cheaper. The sling designed and manufactured to be used as a sling will often be more comfortable than the sling fashioned from general use fabric.

Forward Facing Out (FFO): Is not dangerous to your baby. Contrary to popular here say there is no evidence that carrying your baby forward facing out or in a high street carrier is harmful for either baby or adult. Using them cannot cause hip dysplasia, although it can increase risks for those with condition. High street carriers and the FFO position are primarily a concern because they are not always supportive for baby or wearer. There are time limits on this positon although these are regularly ignored. There are there for both of your comfort. Babies should never be left to sleep FFO as in this positon, and if carrier not adjusted correctly for baby’s chin to touch their chest. You can read more about Forward Facing Out here http://blog.norwichslinglibrary.co.uk/a-bad-reputation-deserved/.

Getting too heavy: Surely once they start walking you stop carrying them? Are they not too heavy to carry? These are phrases I hear a lot. My point is that you do not just stop using a pushchair once your little one starts to walk, so why stop carrying? If you would push them or carry them in arms then it is perfectly acceptable and possible to carry them in a sling. For most parents who have carried their children from birth they do not notice their child getting heavier as the adults body adapts to the weight, like it would with any exercise. There is a vast array of sling on the market and many have been safety tested to high amounts. Little legs, even walking legs, tire quickly and having a sling in your bag is a lot more convenient than taking a pushchair just in case you need it.

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Help is required: It is often assumed that using a sling, especially a wrap or back carrying, will require two people. This is simply not the case and could actually be more dangerous than one person doing it by themselves. The reason being the person in charge of the sling knows what they are doing, they know what their next movement is going to be, where the pass or strap is going to go, they know where their baby is. A second person is either guessing what you are going to do or reliant on your instructions, and in some cases going to do their own thing. Who is in control of sling and more importantly baby now? If you need 2 people then you are doing something incorrectly.

Independent: Using a sling or carrier will not make your child clingy. Maslow’s ‘Hiearachy of Needs’ places security as a primary need for development, and this need must be met for a child to grow and thrive. By using a sling you are allowing your child to develop strong attachments to a care giver which will allow them to have the confidence to explore the world alone in long run. Attachment Theory explains how human beings respond within relationships when hurt, separated from loved ones, or perceiving a threat (Waters et al 2005). At the start of their lives babies will have the strongest attachments to those they are closest to, usually the mother, and those with strong attachments will explore more easily than those that don’t (Schacter et al 2009). Therefore do not fear creating a rod for you own back by attending to and following your child’s needs; that is simply not how their brains are designed to function.

Just a minute: We have all seen it. The video of the lady wrapping with a stretchy in super quick time (less than a minute). The problem is if you listen carefully there are voices in the background which give you a clue. It’s been filmed on time lapse. Yes it makes it look easy and quick. And yes wrapping a stretchy can be  quick but it takes practice. What the video doesn’t show is whether wrap is a one or two way stretch or the key elements of tightening a stretchy to make it safe and comfortable on both baby and wearer. Take time to learn how to tie and ask for help from someone trained if you need it. Don’t worry if you don’t wrap quickly at the start. The more you do it, the quicker you will become.

Knee to Knee: The theory behind Knee to Knee is that you can create a more comfortable carry for baby by supporting their legs from their knee pit to knee pit. The proponents of Knee to Knee often suggest that you need a new carrier when your child is not supported in their knee pits but the life span by which a carrier is truly knee to knee is relatively short, and this could cause you to be regularly changing your carrier unnecessarily. Knee to knee is an issue of comfort not safety and a carrier does not become uncomfortable overnight. There are lots of other issues which should be considered when thinking of buying a new carrier. A carrier that is supporting a baby Knee to Knee is helping to support their hip joint and healthy hip development, but for babies that are able to bear their own weight and walking, the process by which their hips have turned to born is complete and any potential there was in casing in harm is removed. Why not have a read of Beyond the Knee to Knee see what other issues need to be considered.

Lifestyle: There is no one type of parent who uses a sling. Although they are often associated with Attachment Parenting you do not need to be an Attachment Parent to use a sling. Many followers of AP for example do not use or a sling, while others use a mixture of sling, walk or pram. As parents we do what makes life easier for us and our children. Using a sling can be a temporary choice for a special occasion, a day trip where it the pushchair is unsuitable, or because baby is ill and wants extra cuddles. It can also be because it makes your life easier to look after other children or go about daily routines. Anyone can use a sling if they feel they want to, it does not mean you follow a set lifestyle or parenting philosophy.

Modern Invention: I have lost count of how many times I have heard “oh that’s clever, did you invent it yourself?” The truth is that for as long as humans and our predecessors have needed to move, our offspring have needed to be carried. This is why a newborn baby will turn their feet towards each other and why they have a grasping reflex; it was to hold on. Humans are clinging young. We cannot run with our parents from birth, do not have pouches where we can be kept safe, or live in nests quiet and out of sight of predators, we needed to cling to our parents to be kept safe. The modern invention is the pram, only becoming fashionable in the 1800s during Queen Victoria’s reign. Each culture around the world has their own tradition of carrying and style of sling or carrying aid. You can read more about the different histories of sling use around the world in the beautiful book “Beloved Burden” or at Sling Babies.

Come back soon to read Part 2 A to Z of Sling Myths Debunked – N to Z.


References

Waters, E., Corcoran, D. & Anafarta, M. (2005) ‘Attachment, Other Relationships, and the Theory that All Good Things Go Together’ Human Development 48:80–84

Schacter, D.L. et al. (2009). Psychology, Second Edition. New York: Worth Publishers. pp.441