The Not-So-Absolute Rules of Babywearing Safety

Infographic of ABC safety tips Quick Babywearing Reminders Sometimes, using a carrier comes naturally. Sometimes, it takes practice. Remembering these ABCs can help you achieve a safe and satisfying fit for you and your child. Airway: Ensure baby’s airway is open by keeping chin off of chest, and allow fresh air to circulate around baby’s face. Keep child close enough to kiss and in view at all times. Body Positioning: Be sure the carrier supports baby in a way that is appropriate to his/her level of neck and trunk control and prevents slumping, ideally with baby’s knees higher than bum and weight borne by thighs and bottom. Comfort: The carrier should be comfortable for you and baby. If you do not feel comfortable and confident with the carry you are doing, have a spotter nearby to help you. If you need help using your carrier, contact your local BWI chapter.

I am a relative newcomer to the babywearing community. I have been wearing my children since July of 2015 and have been a VBE for my local chapter for a mere four months. In that time, I have fervently read about and participated in the online and real life babywearing community. I soaked up as much information as I could, including all the “rules” about safety: T.I.C.K.S., A.B.C., S.A.F.E., C.A.R.R.Y. There were acronyms galore. There were also many other oft repeated “rules.”

“Babies cannot be worn on your back unless sitting unassisted/ at 4 months old/6 months/12 months.”

“Carrying a newborn on your back is only for advanced babywearers.”

“A narrow based carrier will be uncomfortable and may give your baby hip problems.”

“Cradle carry is difficult to do safely so it is not recommended.”

“Stretchy wraps are only good until 15 pounds.”

“Don’t carry baby front facing out because he/she can get over stimulated.”

“Don’t do anything you wouldn’t do while holding your baby in your arms.”

Sometimes these advice didn’t sit quite right with me. If a new mom needs to get that newborn back there, shouldn’t someone help her do it safely? Sure, you could just wait until someone else can do the laundry or hold her baby, but you’ll run out of clean spoons and underwear eventually, amiright?

“But it’s about safety!” they’d say.

“Why take the risk?” they’d say.

I mean, who would advocate for endangering children?

But there is an inherent problem with these one-liner safety tips. We have a tendency to want to boil safety precautions down into short, easy-to-digest rules when the reality is that babywearing safety has one or two absolutes and an expansive gray area of risk assessment.

The very mission of Babywearing International is “to promote babywearing as a universally accepted practice.” For the practice to be universally accepted, we as educators and practitioners, need to remember that babywearers frequently have needs that often do not perfectly fit the rules and typical guidelines. There are children who cannot sit unassisted until well past their first birthday, yet they may be carried on back in a properly fitting carrier that supports an open airway. Babies have been worn on back from birth in many countries all over the world for centuries. Many caregivers find front packs with narrow bases to be the most comfortable and practical option for their needs. I see it so often in online forums and blogs. Perhaps it’s a our paranoia about liability that fuels our overabundance of caution, but these over generalized, blanket “safety” restrictions only serve to further exclude caregivers and make the practice of babywearing less accessible and not universally accepted.

In a recent blog post, U.K. based babywearing educator Dr. Rosie Knowles states:

“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.” [i]

Furthermore, a lot of these “safety” issues aren’t so much about safe vs. unsafe, but safe vs. optimal or “best practice.” Just because a carry or modification isn’t optimal does not make it unsafe, nor does it mean it should not be done or recommended. A carry is not safe if it will certainly lead to positional asphyxiation or poses a fall risk. As is pointed by German based ecologist and babywearing blogger, Katie Nicolai,

“I don’t know when and where it began, but it has become a pervasive “rule” in the babywearing community that you should only start using a soft structured carrier (SSC) on your back when the child can sit unassisted; sometimes the rule gets repeated as no back carries at all until sitting…. What about parents whose children may never sit unassisted? Where does that leave them? And what does sitting have to do with being carried anyway? It seems to me, the “don’t back carry until your child can sit independently” rule ignores what really needs to be addressed: ensuring that the carrier fits and that the child can maintain a clear airway.”[ii]

I know I have certainly repeated some of these not-exactly-true safety rules of babywearing and I wonder sometimes whether I disempowered a caregiver so much that he or she gave up on babywearing. I hope that is not the case and I write this blog post so that we – the babywearing community – can shed this notion that the laws of babywearing are absolute and unmovable rather than a case-by-case assessment of needs, risk and benefit and making sure a caregiver has the knowledge to make that assessment.

Image description: Line drawing of a woman with short hair and classes wearing an infant on her back in a woven wrap.

 

Behind the curtain of BWI is a network of dedicated volunteers (VBEs and CSVs) who share their insights and experience with each other in order to further BWI’s mission and make ourselves better educators. And so, I would like to share some of the collective wisdom of our impassioned BWI educators and their thoughts on babywearing safety.

 

I've completely dropped the "if you wouldn't do that while holding baby" bit, it's just too broad. The reason I babywear is so I can do stuff without "holding" my baby. There are better ways of assessing risk than that.... Does it pose a fall risk to baby? (Handstands anyone?) Is the activity high impact? Could I potentially give my baby whiplash or mimic shaken baby syndrome (pole dancing or running for example)? My goal is to get the caregiver to really think about what they are doing vs. passively follow a generalized rule. - Krystal Fare, MBE, BWI San Antonio
I have also dropped the phrase "if you wouldn't do that while holding baby," because it's ableist. The reason it is ableist is because for some people who use things like crutches and walkers and even wheelchairs, they use babywearing as a way to get from place to place with their baby out of necessity. I know that there are times when my fibromyalgia flares up badly and I have a hard time walking. In those instances it's easier for me to strap on the baby and use handrails/grocery baskets/walls, etc. to stabilize myself than to try to balance holding the baby and not holding a rail or something. Instead, I just give specific instruction like, I usually say what can happen. Like cutting grass, a rock could catapult up and smack the kid in the forehead or something. Further, when wearing and cooking always be aware of things like grease popping or curious hands reaching around. - Brittany Brown Marsh, MBE, BWI of Hampton Roads
We shouldn't be telling people not to do things they wouldn't do while holding baby. It is not at all accurate. You should tell people that when it comes down to it, they should use their best judgment. Would you be comfortable having your baby around hundred pound weights that they could get crushed by? Do you want your baby spinning and going upside down? Do you want your baby being jostled and shaken? As far as cooking goes, I will wear while cooking anything that doesn't pose a risk of hot things splashing up onto baby. Again, all about using your best judgment. - Jamie Fenn, VBE of BWI of Seattle
There's a very wide range of "meh, good enough" in between babywearing practices that are ideal or optimal, and those that are alarming or unsafe. And in that very large zone, it's the primary caregiver's place, not ours, to judge whether the risks of using a particular carrier in a particular carry position for a particular activity are worth the benefits, whatever they are. An educator’s job is only to point out what those risks are, and to recommend alternatives where possible. - Holly McCroskey Lewis, VBE, BWI of Bay Area
"A baby carrier is not safety equipment. Meaning, it's a convenience and enjoyment device, not a substitute for safety gear. Anything that can happen to your baby while held in arms can happen in a carrier. So it's not: a car seat, a life jacket, a bike seat, a helmet, a fireproof suit, a safety harness for yoga or pole dancing, etc.” - Bernie Nguyen Florip, CSV, BWI of Southern Maryland
“Perhaps the most debated topic within the babywearing industry focuses on the topic of safety, and whether certain practices pose an inherent safety risk. As a babywearing educator frequently addressing questions regarding baby carrier safety, I often notice some confusion regarding “optimal” versus “safe” practices. Certain positions or carriers could be considered suboptimal, or less than ideal, but are not unsafe. The term “unsafe” is often used carelessly, especially when attempting to dissuade a certain practice or carrying method…. Optimal practices are those that we deem from anecdotal evidence or studies from related disciplines... but would not necessarily impact safety based on a lack of evidence of a safety threat. This is an area in which a great deal of research is lacking, yet many assertions are made without any conclusive data that a suboptimal position causes harm. - Stephanie Kerr, MBE, BWI of O’ahu [iii]
“Hacks like the scarf trick for frontpacks or the rolled blanket insert for some soft structured carriers are things we teach when appropriate to the situation -- carrier, baby, and wearer -- based on applying our experience with a very wide range of carriers, babies, and wearers, and an understanding of what risks are associated with modifying various types of carriers in various ways. Yes, when you suggest a rolled blanket insert it's a good idea to mention that of course the carrier manufacturer recommends using only their own brand of purpose-made insert -- but that the rolled blanket is a tried-and-true cheaper solution in certain situations (explaining what those are). Very minimal risk, given a baby of the right developmental stage and the right type of carrier, well worth the benefit of getting a safer fit in the carrier at hand, without having to go out and buy a special-purpose item that won't be used for very long.
 Every hack is that way. For that matter, so is every carry position, every wrap or meh dai finish variation, every unusual adjustment to deal with a special fit situation, and so on. What are the risks? What are the benefits? What are the alternatives? BWI is all about making babywearing accessible to ALL caregivers and universally accepted, and often that means suggesting things that aren't in any instruction manual because we have to help people just make it WORK. We don't just tell people what they can and can't do, by following some sort of list of official rules promulgated by BWI or by carrier manufacturers. In order to have rules like that, we'd need a huge body of scientific research to base it on, which doesn't exist and we can't wait for it. We need to ensure that every wearer we teach understands that they are responsible for making their OWN judgments about which risks to take. We provide them with the best possible information and advice about how to evaluate the risks and benefits of a given carry, carrier, carrier modification, wearing method, etc., and THEY decide how to apply it to their own lives.
 Understand the PRINCIPLES of carrier fit and carrier design, and you can figure out what modifications are sensible and which are not.” - Holly McCrosky Lewis, VBE, BWI of Bay Area
Image description: Illustration of the back view of a man wearing a toddler in a soft structured carrier.

I am certainly not an expert on babywearing nor am I a scientist or a wearer with decades of experience stemming from generations of carrying tradition. I am, however, a passionate proponent of making sure this valuable parenting tool is accessible to all. I believe in giving caregivers all the information they need to make their own decisions on what is best for them and the children in their care. So I will end with an excerpt from an exceptionally well written blog post by Dr. Knowles:

“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 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.”[iv]

Laura Vitanova is a VBE with the Wichita, Kansas chapter of BWI. She is a paralegal, wife and mother of two sweet little boys.

[i] Knowles, R. (2017, Mar 30) The “rules” of babywearing. Retrieved from www.sheffieldslingsurgery.co.uk/2017/03/30/the-rules-of-babywearing/

[ii] Nocolol, K. (2016, Oct. 10) Ableism in the Babywearing Community, Back-wearing. Retrieved from http://bindungtraegt.de/ableismback-wearing/

[iii] Kerr, S. (2015, Aug 3) Babywearing Research – Part 2: Relevant Research, Retrieved from https://babywearinginternational.org/2015/08/03/babywearing-research-part-2-relevant-research

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[iv] Knowles (2017).

2 Responses

  1. Great article! So wonderful to see prominent voices speaking up about inclusive language. I love that BWI is giving this attention. We really have a long way to go toward “a universally accepted practice,” and we shouldn’t stand in our own way.

    P.S. In your citation for me, please correct the spelling of my name. Thanks!

  2. How lovely to read this; the US and Europe (UK and Germany) all speaking together <3 thanks for the citation!

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