This article was written in September 2006 by M’Liss Stelzer, RN and edited by Holly McCroskey. This article was an early effort to educate babywearers on the important of proper positioning to avoid positional asphyxiation, a serious concern with infants before their heads and necks are properly developed (around 4 months of age). Positional asphyxiation can occur in a baby carrier, as well as in other holding devices for babies including car seats, swings and strollers.
Often parents assume that if the baby has difficulty breathing he will fuss or cry. The majority of infants will protest if they are struggling to breathe; however newborns, babies born prematurely or infants with low tone or developmental delays may not communicate their distress.
When cradling a newborn in a carrier it is important to make sure the infant is positioned properly.
• Baby should not be curled tight chin to chest because this position partially closes baby’s airway. (With correct positioning there should always be at least one finger’s width of space under baby’s chin.)
• Sling fabric should not be draped across baby’s face. For slings made from thin, airy fabrics please check the airflow of the fabric by placing it over your own nose and mouth. No matter how breathable the fabric looks, if it is difficult for you to breathe through the fabric it will be difficult for baby as well.
• Baby should not be rolled so that his face is pressed tightly against the parent’s body. Position baby’s face upward when he or she is not actively nursing and when nursing ensure that baby’s nose is not blocked.
An infant should be repositioned if he is having any sign of respiratory difficulty. Symptoms include: rapid or labored breathing, grunting or sighing with every breath and/or restlessness.
NOTE: The positioning recommendations in this article are for infants 0 to 4 months of age or until baby achieves good neck and head control. Once baby has good head control the neck muscles are generally strengthened sufficiently to support baby’s airway, even if baby becomes slightly curled or slumped in a baby carrier (or car seat, swing, bouncer etc.). However, please use common sense and monitor your baby frequently no matter his age and weight.
Happy and safe babywearing!
RING SLING Positioning
One of the most common mistakes new moms make with ring slings is to try to put the baby in parallel to the rails. Which ends up basically folding the baby in half.
To keep baby upright and supported against the parent’s chest tighten the top and bottom rails as well as the middle of the sling. The top rail is used to support baby’s neck and head.
MEI TAI Positioning
Baby should be placed on the parent’s chest, the carrier brought up behind baby’s back and the shoulder straps draped over the parent’s shoulders. While supporting baby with one hand, reach back and grab one shoulder strap and with a firm, but gentle pulling motion, snug the strap until it is fairly tight.
Repeat with the opposite strap. (This may also be done with one hand pulling both shoulder straps at the same time.) The shoulder straps should then be brought around and tied securely behind baby’s back. If there is enough length the straps can be crossed, brought around back. If there is enough length the straps can be crossed, brought around the parent’s back and tied.
Mei tai was not tied tight enough, baby started to slump and his body dropped deeper into the carrier body.
Baby properly supported by the carrier body and shoulder straps tied firmly across baby’s back.
It is very easy to tie a wrap incorrectly so there is not enough support on the baby’s back.
A good test is to wrap and then press a hand against baby’s back. If baby moves closer (her tummy is moved against your tummy and she uncurls some) then the wrap isn’t supporting baby’s back enough. The wrap should then be retied so that baby is in an upright/straight position instead of curled.
|Wrap is too loose at baby’s back||Snug and safer positioning in a wrap.|
(Thank you to Maya Wrap and New Native for funding, the many vendors and individuals for contributing carriers and donations, as well as all the mothers and their babies for their participation.)