by Elizabethon March 06,2012 in Core ArticlesFeaturedFeatured BlogResearch


by Elizabeth Antunovic (©2010 Boba Inc.)



Introduction

Europe seems to host the most pediatricians who recommend that, in order to avoid pressure on their underdeveloped bodies, newborns and infants lay flat on their backs in a stroller and not be carried. Yet, laying a young infant on his back alone in a stroller is actually physically and emotionally stressful and can be developmentally inhibiting. Being carried or worn in an upright position with proper leg support is not only developmentally sound but often preferable to mothers and babies alike. Upright carrying optimizes the physical, emotional and intellectual growth of your baby.

Infant Spine Development

Our spine is not perfectly straight, even though it may appear so from the front or back . When you look at a person from the side, four slight curves are visible, forming an elongated “S” shape. These curves help keep us flexible and balanced. They also help to absorb stresses placed on our bodies through daily activities that impact our spine like walking, running and jumping.

We weren’t born with these curves. Normal curves of the spine develop gradually as a means of adapting to gravity. At birth, babies are in a state of flexion, still curled up, with their spine in a natural long c-shaped (convex) curve. At first, a baby does not have the strength to hold his head up, nor the balancing curves in his spine to do so. But gradually as the muscles in his neck get stronger, he begins to lift his heavy head against gravity, and a curve starts to develop in his neck (the cervical curve) to help balance his head. When your baby starts to creep and crawl the lower back (lumbar curve) and the muscles that support it develop. Only by about the first year does your baby attain these curves in his spine (Leveau, 1877).

At Birth: The spine of an infant is C-shaped (a convex curve). He has neither the balancing curves nor the strength to his head upright.

First Several Months: As your infant works against gravity his muscles start to develop. Strong neck muscles help an infant hold up a heavy head forming the neck (cervical) curve of the spine.

Six Months to One Year: As an infant learns to crawl and stand, the lower back (lumbar) curve and his muscles develop so that he can stand upright. When he walks away from you on his own, only then are all of his curves developed.

 

The Stresses of Laying Flat

Laying your infant flat on his back stretches the c-curved spine into a straight line, against his natural shape. Research shows that keeping an infant’s spine straight is not a sound physiological position. In addition to stressing the baby’s spine it can also negatively influence the development of your baby’s hip joints (Kirkilionis, 2002).

 

Laying Horizontal Causes Physical Deformities

Not only is spending most of the day flat on your back bad for your hips but infants who lie frequently on their backs in a stroller may end up with plagiocephaly (deformed skulls, flattened on the back or side) and deformed bodies with poor muscle tone (Bonnet,1998). Research backed by the American Academy of Pediatrics states that “with prolonged immobilization on a firm mattress or a flat bed (as in a stroller), the constant influence of gravity flattens the body surface against the mattress producing positional disorders and infants with decreased muscle tone (Short, 1996)”.

Plagiocephaly in an infant corrected by helmet to reshape her head

Plagiocephaly in an infant corrected by helmet to reshape her head

This baby is laying flat on her back. This can stress her skull, decrease muscle tone, and be stressful on her little hips and spine

This baby is laying flat on her back. This can stress her skull, decrease muscle tone, and be stressful on her little hips and spine

 

Existence in Containers

Sometimes carseats out of the car can free our hands and help us out as an extra set of hands but they are developmentally inhibiting for babies.

Sometimes carseats out of the car can free our hands and help us out as an extra set of hands but they are developmentally inhibiting for babies.

This does not mean that laying flat for a couple of walks around the block in a stroller is going to wreak havoc on your baby’s physical development. But the truth is that the average Western infant between three weeks and three months of age is carried a little more than two and a half hours a day (Heller, 118.) We end up carrying the baby to the car in a container, through the store in a container, to eat lunch in a container, back to the car in a container and home in a container*. Sometimes from there to the swing that we can click right into without touching the baby so we can make dinner, into the bouncy seat while we eat, and soon after to sleep in a crib. The west has diverged from eons of child rearing and has gotten to the point so that objects are defining our baby’s existence more so than our bodies.

“To remove the newborn baby from his mother and place it on its back or on its front on a flat surface, often uncovered is to fail to understand the newborn’s great need for enfoldment, to be supported rocked and covered from all sides, and that the infant may only gradually be introduced to the world of more open spaces. From the supporting, continuous, tangible presence of his mother the infant will gradually come to move some distance toward the outside world”. (Montagu, 294)

*Please note that the author does not mean to imply that a baby carrier should replace your car seat for transport while in the car. Never drive or carry your baby in the baby carrier while in a moving vehicle.

 

The Fetal Tuck

Newborns are almost impossible to stretch out unless wrapped or swaddled. When you place an infant flat on his back, his thighs will usually be pulled up towards his chest (Schon, 2007), or when sleeping straddled and bent in a frog position. “The fetal tuck, the natural position of babies is the most calming and the most adaptive.

Infants use less oxygen which conserves energy and waste less calories. They digest their food better. It is also the best position for thermoregulation because of reduced stomach exposure. Also, we have more efficient temperature regulating cells and more fat on the back side of our bodies as well. When we hold our infants stomach- to- stomach we are protecting all the receptor and vital organs (Montagu, 1986).

The instinctual flexed widespread legs that an infant maintains when picked up, coupled with the palmar plantar reflex that helps an infant to cling to his mother, suggests that infants little bodies are adapted to be carried upright and oriented toward their mothers.

Babies should be carried in the flexed position that they naturally assume.

Babies should be carried in the flexed position that they naturally assume.

Newborns are virtually impossible to staighten out.

Newborns are virtually impossible to staighten out.

By holding your baby with his knees flexed flat against your chest and supporting the his bottom you are supporting your baby in the natural position that his body instinctively assumes to ensure that he is comfortable, warm and safe.

By holding your baby with his knees flexed flat against your chest and supporting the his bottom you are supporting your baby in the natural position that his body instinctively assumes to ensure that he is comfortable, warm and safe.

 

The Trouble with Car Seats

This baby is enjoying a nap outside near the peonies. Although the car seat does support her spine and head and neck while she is napping, when she is awake the straps prevent her from working her muscles to hold up her own head. Many babies spend most of their waking hours in restrictive seats like these.

This baby is enjoying a nap outside near the peonies. Although the car seat does support her spine and head and neck while she is napping, when she is awake the straps prevent her from working her muscles to hold up her own head. Many babies spend most of their waking hours in restrictive seats like these.

If the stroller positions the baby in a somewhat upright position (such as in infant car-seats) it may be gentler on the baby’s c-shaped spine in that it is not stretching it flat. But carseats are not a much better option for transporting your little one. Research by the International Chiropractic Pediatric Association shows that car seats are not the ideal transport for your infant when not in the car, due to “restricted postural options which can impact your baby’s developing cranium and spine” (International Chiropractic Pediatric Association).

By keeping the spine in a c-shaped configuration, these contraptions can actually prevent and inhibit the natural curves forming. Babies can have a hard time acquiring adequate muscle strength to hold their big heads up if they don’t get much of a chance to deal with gravity.

 

 

Positive Physical Development

This baby is moving with his mother.

This baby is moving with his mother.

When infants are held upright, however, they are allowed to practice compensatory movements, enhancing muscular strength and allowing for more control over their fine motor skills. When the mother walks, stops, or turns an infant’s body naturally works against the pull of gravity to maintain his position.

 

The force of gravity is a positive element in infant development allowing infants to learn from early on to hold their heads up and keep their bodies clinging to the mother and balanced in equilibrium.

 

Discord with Upright Carrying

So why do some still claim that the horizontal position is better for your infant? The physiological arguments as to why a baby should be transported in a horizontal position for his first months of life seem to stem from the assumption that the upright position may be stressful to his underdeveloped spine and pelvis.

Although some pediatricians are advocates of natural parenting, many don’t have that much hands on experience with baby carriers. They may be acquainted with the upright carriers from the eighties and nineties with the typical lack of adequate head/neck support, tight or chaffing leg holes, resembling a parachute harness and a complete lack of leg support. Perhaps they have seen so many babies facing out when carried upright that they assume all upright carrying is nonsupportive.

The image above is perhaps the carrier that many doctors imagine and classify as unsafe or harmful. It is a nonpysiological carrying devices.  Front facing carriers unlike, wraps, slings, mei-tais and soft structured carriers, do not provide proper leg support which can make their pelvis’ tilt backward and place them in the dangerous “hollow back position”.

Not facing the carrying adult, and facing out their center of gravity is off. Pressure is placed on the baby’s shoulders and the chest area, often retracting the shoulders and hollowing the back even more. Facing out is a nonphysiological position that places pressure on the inner thighs of the baby and the base of the spine. Upright carrying facing out is stressful on babies.

The wider base of the above carrier would provide some spinal support (maintaining the natural convex “c-shape”) if the baby was turned facing the father and his bottom was seated in it. Instead the baby’s spine is straightened and often hyperextended (concave “hollow back” shaped) due to weak abdominal muscles and lack of leg support.

Although the baby does benefit from being carried close to his mother, facing out in this position there is no leg support, improper spine and hip support, and no head or neck support if the baby falls asleep.

This baby is leaning on his dad for some extra support. Although it stabilizes him, it is less than ideal to spend the day transported in this position.

This baby is leaning on his dad for some extra support. Although it stabilizes him, it is less than ideal to spend the day transported in this position.

With no leg supoort and facing out this baby is unstable, forcing him to assume a hollow back position (as shown with red line) to compensate.

With no leg support and facing out this baby is unstable, forcing him to assume a hollow back position (as shown with red line) to compensate.

When an infant is carried, he should be oriented toward his mother, Ideally the fabric of the baby carrier should extend to the back of his knee (or have footstraps) which appropriately positions the pelvis and spine.

When an infant is carried, he should be oriented toward his mother, Ideally the fabric of the baby carrier should extend to the back of his knee (or have footstraps) which appropriately positions the pelvis and spine.

 

Swaddling Infant Legs linked to Hip Dysplasia

Babies love to be contained and enclosed but straightening their legs goes against their instinctual position of flexed widespread legs. This baby is swaddled so that the legs are wrapped loosely and not forcefully straightened.

Babies love to be contained and enclosed but straightening their legs goes against their instinctual position of flexed widespread legs. This baby is swaddled so that the legs are wrapped loosely and not forcefully straightened.

Although there are myriad psychological, emotional and physiological benefits from the swaddling style of the Navajos, there is clear evidence that swaddling the legs so that they were bound together and not allowed to flex at the knee or at the hip, has lead to hip abnormalities (Crisholm, 1983). In the case of the Navajos, stress to the hips of the infant was not caused by the upright positioning but from improper leg support, by not allowing the legs to spread or the knee to freely bend (Van Slewen, 2007). By not allowing the head of the femur to sit in the socket, the socket often does not develop properly, causing Developmental Dysplasia of the Hip or DDH (Crisholm,1983).

Carrying a young infant laying in the horizontal position with legs together in a baby carrier (like a sling or a wrap) provides adequate spinal support, but it is not the optimal position for hip development or prolonged carrying. This is especially if there is congenital dysplasia present in the infant.

The American Academy of Pediatrics released a review of swaddling under Van Slewen in 2007, which reaffirmed that infant’s legs should not be tightly swaddled.   In 1965, the incidence of DDH was high in Japan when a swathing diaper was used widely by the population. The swathing diaper kept the hips together. Eight years later in 1973, Japanese doctors advised mothers to avoid “prolonged extension of the hip and knee of infants during early postnatal life”. Soon after experts reported a marked decrease in infants with DDH (Van Slewen, 2007). The International Hip Dysplasia Institute in 2012 released new information suggesting that parents avoid baby carriers that force the legs to stay together.

 

Harmful Hollow Back Position Due to Lack of Leg Support in Carriers

Native American Baby in a Papoose. His legs are straightened into a nonphysiological position which may cause him to arch his back. Restricted movement may affect his hip development.

Native American Baby in a Papoose. His legs are straightened into a nonphysiological position which may cause him to arch his back. Restricted movement may affect his hip development.

The use of papooses by the Native populations which also inadequately support the legs and retract the shoulders, places the spine in a compromising “hollow back” or hyper-extended position. With unsupported legs and very weak abdominal muscles the pelvis tilts back in the infant and hyper-extends his back. The infant then absorbs the pressure produced with each step that the mother takes on his hyper-extended spine. This is stressful on an infant.

The development of spondylolisthesis, the slipping of the vertebrae to compensate from repeated stress (usually on a hyper-extended spine) is pretty common in gymnasts and weight lifters. It is also unusually high in the Native Athabascan populations where nearly half may be afflicted.

Yochum and Rowe suggested that the Native Athabascans that choose to carry their infants in a papoose may explain the high prevalence of (isthmic) spondylolisthesis in their population. Since no one has ever been born with spondylolisthesis, Yochum and Rowe dismiss the possible genetic element as the cause. Instead, they point to the papoose (a nonphysiological carrying device) as a more favorable explanation to the cause of the disease (Wong, 2004).

Although different in appearance, any modern baby carrier that does not support an infant’s legs (in a flexed abducted position oriented toward the wearer), any front facing carrier with leg holes is no more developmentally sound than a papoose, as these carriers retract the shoulders and create the stressful “hollow back” position. Lacking proper leg support, papooses, cradle boards and front-facing baby carriers with leg holes are all very similar, pinning the shoulders back and placing pressure the base of the spine.

 

Supporting the Legs

The cloth the mother has tied properly supports her baby’s rounded spine. The baby is in a seated position and thighs are pulled to hip level.

The cloth the mother has tied properly supports her baby’s rounded spine. The baby is in a seated position and thighs are pulled to hip level.

Upright baby carriers that support the legs, carrying a baby as a mother would naturally would in arms, does not compromise a baby’s spine or hips (Kirkilionis, 2002). When an infant’s legs are flexed and straddled, the instinctive position that his little body assumes when picked up, the head of his femur (bone of the thigh) fills out the hip socket (acetabulum). The hip socket is filled most evenly when the legs are pulled up to roughly 100 degrees and spread roughly 40 degrees at the same time (Kirkilionis, 2002). DDH does not occur when an infant’s legs are supported. Actually this is the position that doctors advocate as treatment for babies with hip dysplasia.

Interestingly enough, babywearing is customary among the Netsilik Inuit people. Netsilik mothers don’t use papooses but carry their infants in their amautis of their parkas. The babies assume a seated straddling position on their mother’s back inside their coats (Montagu, 1986). No studies indicate prevalence of either DDH or spondylolisthesis in this northern Inuit baby carrying group. Their hips and spines develop normally.

A mother using either her arms or a simple piece of cloth, supports her baby’s legs in a flexed (with the knees bent) abducted (away from midline) position supporting the hip and the spine. Instead of fabric at the crotch which contributes no leg support, or swaddling the legs which is too restrictive, ergonomic carriers put the baby in the position that supports the legs just as a mother’s arms would. The flexed abducted position is what infants are hard-wired to assume when picked up. (Schon, 2007). It is what nature intended- legs spread around the mother’s hip, back or torso with knees bent in a seated position.

The fabric is pulled to the back of the baby’s knees offering proper leg support. The legs should be pulled to at least hip level for optimal positioning and proper hip development.

For a toddler, footstraps may offer tired legs a place to rest and prevent the fabric from digging into the back of his leg.  With his thighs up at hip level, his back naturally rounds and subsequently takes pressure off his pelvis and lower back.

A mother’s arms support the baby’s bottom and legs. Subsequently, pressure is taken off the spine and the weight of the baby is evenly distributed in an ergonomic position.

A mother’s arms support the baby’s bottom and legs. Subsequently, pressure is taken off the spine and the weight of the baby is evenly distributed in an ergonomic position.

This baby is supported all over. Proper spine position, oriented toward mother, proper leg support, proper head/neck support when sleeping.

This baby is supported all over. Proper spine position, oriented toward mother, proper leg support, proper head/neck support when sleeping.

Since you can’t adjust the width of the seat of a soft structured carrier, footstraps offer full leg support to older babies who still want to be carried.

Since you can’t adjust the width of the seat of a soft structured carrier, footstraps offer full leg support to older babies who still want to be carried.

 

Improving Respiration

Proponents of horizontal positioning in early infancy may be concerned with whether the infant actually receives adequate levels of oxygen while being carried as compared to in a stroller. According to Dr. Maria Blois, premature infants placed in an upright position on their mother’s chests had improved respiratory patterns and are more regular than in an incubator.

Blois also reports“reduced episodes of sleep apnea (temporary cessation of breathing) and bradycardia (slowing of the heart rate). Transcutaneous oxygen levels do not decrease indicating that oxygen saturation is not compromised”. These studies were done on premature infants some weighing as little as three pounds, placed upright on their mother’s chest. The preferred position for these tiny three pound babies is upright, usually secured by a piece of cloth. They thrive upright on their mother’s chest and are almost allowed to leave the hospital earlier than little preemies left in incubators.(Blois,72). If the upright position is the preferred position for a three pound preemie, it doesn’t make sense that it could be harmful to a newborn.

 

Preventing Ear Infections

Lying horizontally is not only a poor option for your baby’s spine, hips, and cranium, it can also be a major contributing factor inner ear infections in infants. Gastric reflux of contents into the middle ear causes ear infections. Gastroesophageal reflux disease or GERD can be pretty prevalent in infants as sphincters tend to take a while to fully close.

Parents of infants diagnosed with GERD are advised to be carried upright to ease the symptoms. When infants are placed lying in the horizontal position, not only are the symptoms exacerbated, but gastric juices can enter the immature Eustachian tubes easier making reflux from the throat into the middle ear more probable. The same may occur when bottle fed infants are fed positioned flat on their backs and not slightly upright as milk may enter into the middle ear. A slight upright tilt prevents milk from entering into the middle ear.

The build up in the Eustachian tube can cause inflammation and a buildup of bacteria and subsequently an infection. Wearing your baby upright can actually be a preventative measure against ear infections and can help ease the symptoms of GERD (Schon, 2007).

 

Tuning Balance

Native Americans are typically very secure in space are actually known for their comfort with heights and apparently tend to have little problem washing skyscraper windows. Most traditionally raised Native Americans babies are swaddled or spend most of their infancy either in cradleboards or on their mother’s hips leading to enhanced vestibular development.

Native Americans are typically very secure in space are actually known for their comfort with heights and apparently tend to have little problem washing skyscraper windows. Most traditionally raised Native Americans babies are swaddled or spend most of their infancy either in cradleboards or on their mother’s hips leading to enhanced vestibular development.

Another benefit of carrying your baby is that carried babies receive a lot of vestibular stimulation whereas lying babies do not. Our vestibular system helps us out with our sense of balance and our security in space. When a mother holds her baby, the baby moves back and forth with mom’s walking and side to side from her swaying or rocking. Mom may stop and turn and reach to grab something or she may moves gently smoothly. These varied movements force her baby to respond appropriately to keep himself balanced. All of these movements tune her baby’s vestibular system.

When pushed in a stroller the movement is either forward or backward planar movement and not very varied. When changed from the upright position and the containment of his mother’s arms to the horizontal position laying down uncontained a baby may produce random movements and suddenly flail his arms and legs as if to save himself from falling. This is called a baby’s Moro Reflex. It acts as a baby’s primitive fight/flight reaction and is replaced later in life by an adult ‘startle’ reflex.

Carrying, rocking and swaying stimulate an infants’ vestibular apparatus and helps them to feel secure in space. Most babies today spend most of their day apart from their mothers in a container or in a stroller leaving them prone to vertigo, and a feeling of physical insecurity in space in general. Interestingly enough, the fear of flying and the fear of heights which plagues many of today’s adults can often be traced back to not being carried as an infant. Carried babies feel secure and are less apt to develop space related phobias. (Montagu, 1986)

 

Constantly Learning

Babies have reason to feel secure. They physically need to be in close contact with their mothers. They giggle and coo and drink in all of our expressions. Upright on mother they are able to view the world unobstructed from a safe place and can learn about all around them at their own pace. Not only are babies better off physically, in the upright position they are happier and calmer when held upright. In her book The Vital Touch, Dr Sharon Heller states,

“The more time that babies spend vertical, the more time that they are alert and calm. Even newborns that spend most of their time sleeping, stop crying and perk up when picked up and placed on our shoulder. Interestingly, how alert a newborn is relates to where he is. Upright in an infant seat, he is less alert than when upright in arms… Vertical positioning as optimal in infants makes perfect sense. Think of how much time our infants spend horizontal- flat on their back in a crib or a buggy. Might this affect their alertness? There’s a good chance… Researchers found that infants too young to sit independently learn more when placed in a vertical position.”(Heller, 94)

 

Stimulating the Senses

Moving through the day and experiencing life together.

Moving through the day and experiencing life together.

And what an incredibly stimulating environment. Not only can the infant learn about the world around her from all the different sights she sees, she is in the state of mind to do so. When an infant is calm but alert, that’s when all the information is allowed to permeate into his being. He finds out about the world and his place in it.

Our body is a sensual cornucopia where smiles, aromas and laughter mingle amid undulating caresses that put the entire sensory world at our baby’s fingertips. Our baby gets tactile or cutaneous stimulation from our skin touching hers and proprioception from the pressure of her limbs flexed into our body. She gets tactile, olfactory, and gustatory stimulation if we nurse, of our milk, and vestibular stimulation from the gentle stimulation of our movements and, when held upright, from her efforts to right her head and maintain her balance. She gets visual stimulation when she looks all around her, auditory impulses as we whisper endearments, and kinesthetic stimulation as we change her to the other side… when we put our babies in a container, and especially if out of sight all of this sensory nourishment is lost.” (Heller,112)

 

Easier System Regulation

An infant’s body physically needs his mother present to help regulate his own body.

An infant’s body physically needs his mother present to help regulate his own body.

The mother/infant relationship actually provides physiological regulation of the infant’s autonomic system. A 1992 study showed that when an infant is taken away from his mother he experiences a “decreased heart rate, temperature decreases, sleep disturbances and EEG changes”- representing an impairment in the regulating processes of his own little body (Archer, 1992). Upon being separated from his mother, a baby’s immune system weakens. His body literally stops producing as many leukocytes. But when mother rejoins him, he strengthens again (Montagu, 1986).

 

Roots of Misinformation

Far from “creating a tyrant”, holding your baby close gives him a feeling of emotional security.

Far from “creating a tyrant”, holding your baby close gives him a feeling of emotional security.

With all the studies and the clear physical benefits of carrying a baby upright on mother’s chest it’s hard to understand a pediatrician’s ambivalence on the matter or outright scorn when his patients choose to do so. Perhaps the reason for not supporting upright carrying may be that they want to discourage mothers from “spoiling” their babies, or to prevent the mother and baby from getting too close or attached to each other.

Straying from wearing our babies may be linked to the old school of thought in which dates back to 1928, when the famous behaviorist Doctor John B. Watson published The Psychological Care of Infant and Child, setting out to change the course of humanity and make infants independent. His theory was that we were all born basically a blank slate, ignoring any evolutionary hard wiring or any inborn biological tendencies, and that in order to “form” an independent child it was necessary to prevent the newborn baby from creating dependent habits. In other words, if you hold on to your baby he will cling to you and never let go. He will be needy. Not only should you withhold from carrying your baby but cuddling, kissing and rocking him too; if you show affection, your baby will expect it.

So many of our grandparents and parents were influenced by this mechanistic train of thought, pressured by the experts to believe that if they picked up their babies when they cried that that they would create a tyrant of a child and become enslaved. Unfortunately this psychology had has a profound effect upon pediatric thinking and practice, and even pervades into conversations between mothers and doctors today. (Montagu, 1986)

 

Evolutionary Need for Touch

Touch is essential.

Touch is essential.

Most mothers are still pressure to carry out the harsh parenting methods that were inculcated into our grandparents and our parents. Yet, these mechanistic methods only go back so far. Anthropologist James McKenna claims that with our babies more often in a type of container than in our arms, they are at “odds with evolution”.

“Virtually all of our biochemistry and physiology are fine-tuned for the conditions of life that existed when we were hunters and gatherers, in which babies were held by their mothers,” McKenna writes. Our culture may be changing, but our evolutionary need for touch remains the same. Babies’ brains have evolved to expect closeness and proximity-to be held-for their safety, their psychological growth, physical growth, mental growth, to aid and stabilize their physiological processes and keep their immune systems strong” (Field, 69-74). “Touch is not an emotional fringe benefit. It’s as necessary as the air we breathe” (Heller, 5).

 

Making Strollers The Exception

Let’s make carrying your baby the rule of thumb and strollers the exception. Not the other way around!

Let’s make carrying your baby the rule of thumb and strollers the exception. Not the other way around!

Even though most Western parents cannot conceive of life without a stroller, they are not as gentle on an infant to as we assume them to be. Placing an infant alone on his back for long periods of time is not what we as humans are hard-wired to expect. Lying horizontally in early infancy is not easier or less stressful on an infant’s spines, skulls, or necks. Upright on mother’s body, mom adjusts to all her baby’s movements, and he to hers, moving like perfect dance partners. The two create a rhythm together, physically, and psychologically and move together in sync. Even the most state of the art strollers can’t provide the warmth that a mother’s body does, her comforting smell, the varied movement, and the sensitive motherly responses that are so essential to her baby’s healthy growth and development, especially during such a critical period when his brain is growing more than any period in his life. No toys can match the joy that an infant gets from his mother’s face. Alone, gazing up at a fabric liner with which the manufacturer chose to line the stroller is no comparison to the rich environment he witnesses and observes himself when he moves together through the day with his mother.

Strollers are not “bad” per se. To go further, babywearing and strollers need not be mutually exclusive as long as an infant is content and his cues are responded to when he signals that he needs to be held (seated and facing his mother is preferable to encourage interactions and communication) (Zeedyk, 2008).

 

Conclusion

Laying babies flat on their backs in a stroller is actually not easier on their necks, spines, hips, or their minds. Nature intended for babies to be carried. Upright positioning with proper leg support is the preferable position for your infant and is gentle enough not to physically stress even tiny three pound babies. A mother should trust what her heart tells her heart. By holding baby close to her heart she will not only be choosing the most beneficial and physically supportive method of bringing baby along with her, she will be providing the optimal environment for his psychological and emotional growth as well.

 


References

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Blois, M. (2005). Babywearing. Pharmasoft Publishing.

Bonnet, E.. (1998 ). In Points made during discussions regarding the carrying of Infants and small children, Published in Krankengymnastik 50 Jg (1998) No.8

Crisholm, J, & . (1983). Navajo Infancy: An Ethological Study of Child Development. Aldine Transaction.

Field, T.(2003). Touch. First MIT Press.

Heller, S. (1997). The Vital Touch: How Intimate Contact With Your Baby Leads To Happier, Healthier Development. Holt Paperbacks.

International Chiropractic Pediatric Association. Baby Wearing: Suggestions for Carrying your Baby. http://www.icpa4kids.org/research/children/babywearing.html

Kirkilionis, E. (2002). Carrying an Infant: More than the Possibility of Child Transport. Kosel.

Le Veau, B.. (1984, Dec). Developmental Biomechanics: Effect of Forces on the Growth, Development, and Maintenance of the Human. Physical Therapy. www.physicaltherapyjournal.com/cgi/content/abstract/64/12/1874

Montagu, A. (1986). Touching: The Human Significance of the Skin. Harper Paperbacks.

Morningstar. (2005). Reflex Control of the Spine and Posture: A Review of the Literature from a Chiropractic Perspective.

Chiropractic & Osteopathy. www.ncbi.nlm.nih.gov/pubmed/16091134

Newman, P. H. THE ETIOLOGY OF SPONDYLOLISTHESIS. Journal of Bone Joint Surgery. 45(1963), 35-59.www.jbjs.org.uk/cgi/content/abstract/45-B/1/39

ROWE, Y. (1987). ESSENTIAL SKELETAL RADIOLOGY. Baltimore: Williams and Wilkins.

Schon, R. (2007). Natural Parenting-Back to Basics in Infant Care. 5(1), 102-183. from Evolutionary Psychology from http://www.epjournal.net/filestore/ep05102183.pdf

Short, M. (1996). The Effects of Swaddling versus Standard Positioning in Very Low Birth Weight Infants. Neonatal Network. 15(4).from http://www.cebp.nl/vault_public/filesystem/?ID=2156

Van Slewen et al,. (2007, Oct). Swaddling: A Systematic Review. Pediatrics. 120(4), 1097-1106.from

http://pediatrics.aappublications.org/cgi/content/full/120/4/e1097

Wong, L. C. (2004, Jun). Rehabilitation of a patient with a rare multi-level isthmic spondylolisthesis: a case report. 142-151. The Journal of the

Canadian Chiropractic Organization from www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1840041

Zeedyk, S.. (2008). What’s Life in a Baby Buggy Like? The Impact of Buggy Orientation on Parent-Infant Interaction and Infant Stress.

University of Dundee/National Literary Trust, Nov. 21, 2008). from www.literacytrust.org.uk/talktoyourbaby/Buggy_research.pdf

 

67 comments
SarahPaulson
SarahPaulson

So what brands of wraps or carriers are the ones pictured that carry the baby correctly? The pictures are too small to see the label

DB
DB

Why in all of your examples are men used only to display what is done incorrectly and women only what is done correctly? As an engaged father I would like to see less gender bias in your examples.

Eszra01
Eszra01

This is very interesting. I want to hold my future children as often as possible. The only problem is that if they are held to much through out the day then I've seen evidence of late crawling, to the point the never even try to move from their tummy time. Healthy happy baby I'm just gonna be scared if he turns a year old in October and hasn't yet even scooted.

For me I have found things that to help with a baby sleeping flat and to reduce and prevent flat head. Personally I like the stuff out for babies, but I do want to hold my child as long as I can. I will try my hardest to do so, but the only problem is with how I see my future I may not be able too as much. Like when I work out and when I'm working at anything.

AmandaWallace
AmandaWallace

@Jenfur  I think that there is alot of sound research put into this article and if your unsure you should read the citations where the author got their information from  so you know the article isn't biased or the things quoted are not dated . I agree on not following blindly but you also need to look at the whole information not just what you are told , wither its the article or your doctors .Doctors have been wrong in the past , telling people that ex-rays were  safe for pregnant mothers and we know now  they aren't safe ,they  leeched people etc.Your baby did better because she was more upright in her carrier .Just like when babies feel better burped up right your baby did better in her carrier upright .I find  slings are only one shouldered and can't properly balance your back causing pain because your other side is trying to redistribute the weight . A front  carrier that are shown  will distribute the weight better . I had back problems because I did not have strong back muscles and i lifted things wrong .then I worked out my back muscles and learned how to lift things properly and my back stopped hurting . I would have done some strength training  for your back and it would have helped . Just because your baby seems fine,doesnt repute a fact based article that states their sorces

Valverdemo
Valverdemo

I find myself pregnant after 17 years and it's overwhelming all of the gadgets and gizmos that have come on the market for new parents. In 1996, I had a Graco stroller, a car seat (that stayed in the car), walker and high chair for my daughter. As an infant I carried her pretty much every where. I was in great shape, lol! My elders would admonish against "spoiling her" or holding her "too much" but I waved them off. I always thought, of course a baby wants its mother's arms! Or any arms. Being held feels good, that's why we snuggle with our loved ones. Now I've gone cuckoo trying to find the right stroller that holds my Chicco Keyfit30 but reading this article reaffirms that I already have what I need. There are some amazing new products out there today but my advice would be to go with instinct and not convenience. :)

mily
mily

Hi I have a toddler 22 months and he was long exposure to car seat when he was infant and developed a flat head by then that was resolved, but since then he seems like his back is not well, he only sleep on his tummy, he hates to lay down on his back , he has a bad sitting position when on his car seat and other thing, I was wondering if he may need an evaluation to avoid further damage to his back, please let me know what kinf of doctor should I see, cause his pedi. Dr. Does not has any concerns about it. Thanks.

mammasmilks
mammasmilks

Howdy would you mind stating which blog platform you're using? I'm planning to

start my own blog soon but I'm having a hard time making a decision between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your design and style seems different then most blogs and I'm looking for something completely

unique. P.S Sorry for getting off-topic

but I had to ask!

charlotteo84
charlotteo84

I have read the section on how babies should not sleep flat on their backs, but what then, is your advice on how they SHOULD sleep at night time? In the day there are many options - in mothers arms, slings etc  but what about at night? What SIDS research coincides with any other night time sleep positions that you may be able to recommend? it's all well and good telling parents what we should not be doing, but how about backing this up with how we should be doing it? A response would be greatly appreciated.

intactavist
intactavist

C'mon now, lets see some cloth diapers on those baby's!!  And thanks for the informative post!  Baby's were meant to be held!!

DoulaCamilaPuerta
DoulaCamilaPuerta

Hello I am part of the boba family, and want to have the entire article translate in spanish, is this possible? I can translate some parts, maybe the pictures and their text, but it will be important to share alla the information on  the article. I will be waiting for your answer. Thanks

Jenfur
Jenfur

You know I did try a type of sling with my daughter with

her facing me but it was not very comfortable for me and hurt my back. She was in a carseat a lot for a couple months too because of her reflux being so bad she actually slept better in it. So I'm not really sure how well there "research" is that sound because my daughter is fine and early with her development with the choices I made and I listened to her doctors. They actually do research these things and do study's, like how to "lay" them down to sleep on there back or on there side because of a choking hazard. The first few weeks of there life they spit up at lot. Listen to your pediatricians, not sites like this.

Heidimeek
Heidimeek

Is this why my children all would only sleep on their tummies?  I know that everyone recommends the back for safety but mine would just cry forever and ever on their back.  Once on their stomach they fell asleep soundly and were very excellent sleepers.

VonnGreysgrandma
VonnGreysgrandma

for  more information I would suggest http://www.consumerreports.org/cro/baby-carriers/buying-guide.htm,

I miss the old Snuggli that allowed me to walk down the street holding my toddlers hand while breast feeding the newborn. Probably wasn't safe enough but then again I remember when there were no car seats. A lot of EXPERT advise has come and gone since my kids were little. The most important thing is that parents pay attention to and learn their individual baby's cues. Our children teach us to be the parent they need.

Reds
Reds

First of all let me say I am supportive of inward facing baby wearing, however, I'd like to point out that when you are doing a research article first, it should be unbiased and simply present the facts from both sides, not smash one of those sides, and second, you should be citing more relevant, up-to-date peer reviewed research.  Information from 1960-something or 1980-something has likely been re-researched, and it would be beneficial to your claims to cite the newest supported research.  I do believe forward facing is less-safe for a developing baby, but I find your article to be questionable at best and would like to see current information presented to those who are looking for it.  As a previous poster said, this article seems to be for the sole purpose of fear mongering.

Momknowsbest
Momknowsbest

This article is fear mongering and meant solely to sell a product. If you want to baby wear buy a Maya Wrap ring sling. Or a kangaroo wrap but don't purchase what this company is offering. Don't support a company that is unethical in their sale tactics. This article sickens me.

Momknowsbest
Momknowsbest

Don't believe everything you read on the Internet. Do your own research and make sure the sources of information are reliable. By reliable I mean current peer reviewed studies.

JT
JT

This article is very informative but it should tell you proper alternatives to these "dangerous" positions.  Like Katelbarra said, what would be a good sleeping position?  

KateIbarra
KateIbarra

So what do you recommend as the best night time sleeping position? The AAP says flat on the back, which I find most newborns despise. Any thoughts?

excited1sttimemother
excited1sttimemother

Love the article! I am definately way better informed now and will use what I have learned here to get the proper carrier for my baby!

Not to be rude or anything but why did so many people get so upset about there not being any pictures of men carrying their baby properly? I saw one under the "Constantly Learning" section. There is a picture of a man properly carrying his child. Also, please do not correct my english, I already know I stink at it and am not claiming to be perfect! Thank you =D

I love the idea of carrying my baby close to me and bonding with him or her. My husband however is not to excited about using the wrap and thats ok. As women I think we just automatically say mother or speak in that form because its who we are. I highly doubt this article was written to put men down. If anyone does respond to my comment please do so in an adult, civil manner. I would greatly appreciate it!

KimS
KimS

It's interesting that you don't cite a single 'correct' position with the father in the picture, and speak always of 'mother' rather than 'parent'.

ajandfour
ajandfour

We have quads. They are now 15. Your article doesn't consider families with multiple births. My children were in strollers. There was no other way with four. I don't see any negative consequences in my four from the use of strollers.

Kazmom1999
Kazmom1999

Uh - any suggestions for twins?  Mine are now 13, but when they were little we help them as often as we could, but it is not easy to do ANYTHING and hold them both and despite the recent commercial for Walgreen's, one on the front and one on the back is no easy task either!!  :-)  Enlisted the help of dad an awful lot for shopping trips - he either carried one and I had one in a pouch or he stayed home with both! 

Mr P
Mr P

If I could make a small suggestion -- please learn the difference between the transitive verb "to lay" and the intransitive verb "to lie."  Babies "lie" on the bed, but their mothers "lay" them on the bed.  Intransitive verbs don't have a direct object, transitive verbs do.  It's a basic point of English grammar.  Pretty important if you're going to write for an audience and your subject has to do with "lying" and "laying."

JJ
JJ

While some of the information in this article is accurate, it's used in the context of a WHOLE lot of fear-mongering about what will happen if you don't use a baby carrier frequently, and is an obvious attempt to sell their product.  I use a baby sling for many hours out of the day but not everyone likes them, can physically use them, or find their baby likes them.  It is only in VERY rare and extreme circumstances that laying in a stroller/crib/carseat would cause any negative outcomes for baby.  This article leaves the reader with no choice but to conclude that any parent who doesn't make frequent use of "baby-wearing" is irresponsible and risking the health of their child.  This is simply not the case

Ana Sophie
Ana Sophie

This wrappers, carriers, mothers have been using them thousand years ago and all throughout the world, they have different names, in Latinamerica they are called "rebozos" and they use them to carry the baby in many positions but always close to them and facing them never facing the other way becasue that is how the baby feels secured and nurtured. This is not an american invention it came from the Aztecs millions of years ago. It has been perfected through the years, and has been adopted by Europe and Westerners. It has the same purpose to carry your baby in the right position and to enhance the physical and emotional development.

Lauren
Lauren

I appreciate this article, but I find it hard to ignore that the only two "what not to do" pictures are of men carrying their babies incorrectly.

Enon
Enon

As an expectant father, I am slightly insulted by the fact that this entire article mentions only that the child is carried and nurtured by the mother.  I know others have addressed the lack of pictures of fathers (short of the "what not to do" pictures).  I plan to carry my child with my Camouflage wrap when doing work around the house.  I hope that future articles you will write may focus more on both parents nurturing the child.  I do appreciate the article content and the support of research.

motherofthree
motherofthree

@SarahPaulson This is posted by the Boba baby carrier company. Thus, I am sure all 'proper' carriers according to this article are from the company writing the article. You can buy this carrier, if you believe the bias, in the upper right hand corner of the page. Other carriers with similar wraps are Moby, Katan, and RIng wrap.

motherofthree
motherofthree

@DB  My thoughts exactly, and every time they mention the 'right' way to carry, it is toward the mother. Terrible news for single dads or gay couples. The father of my children loves wearing them, which is great news for me, although he does prefer the more structured carries. I believe most of the issues brought forth here are bias toward the maker of this carrier and when anything is used without moderation.

guest12345
guest12345

i@DB  I may be wrong, but perhaps it's because they don't have breasts to cushion the babies so It's uncomfortable for both father and baby while in their natural position. 


CheeeziActs
CheeeziActs

and when you know better, you do better. Quit worrying about what you did with your children and look forward.

bobafamily
bobafamily moderator

@DoulaCamilaPuertaThank you for asking! Our distributor in Spain might have this translated already, I will ask! Can you please email me at bethanybobafamily.com?

AmandaWallace
AmandaWallace

I think that there is alot of sound research put into this article and if your unsure you should read the citations where the author got their information from  so you know the article isn't biased or the things quoted are not dated . I agree on not following blindly but you also need to look at the whole information not just what you are told , weither its the article or your doctors .Doctors have been wrondg in the past , ex rays safe for pregnant mothers and we know now  they aren't safe , leeching people etc. @Jenfur

JoAllton
JoAllton

Agree that the research is old and needs to be up to date (i.e. no older than 10yrs!!).

JJSM
JJSM

@Momknowsbest Yeah, I did find it telling that they NEVER mentioned slings when everything they're saying is true of positioning a baby in a sling too (I use a ring sling, but I hear the same is true of the other kinds of slings). Even when it was close to a sling they always said "fabric" as if it were an unfinished length of cloth, which was usually not true of the object in the pictures!

MaritzaRodriguez
MaritzaRodriguez

@KateIbarra  its funny because when my son was born in FLorida, they told us in the hospital on his back, but when my daughter was born 3 yrs later in the dominican republic, they told us in the hospital, on her side! So, who knows now adays, its best maybe to do what we see best for the baby

MeanMama
MeanMama

@Mr P Thank You!!  I am so confused by which lay/lie to use that I have restructured sentences just to avoid using the word.  I know I learned it somewhere along the way but have forgotten, by using a baby as an example it is more applicable to my life (I have 5 kids!).

I realize this could be read sarcastically, but I am sincere.  I appreciate you clear explanation and example.

aphrodite73
aphrodite73

@Mr P Shut up. It's not that serious. Lie/lay is commonly misused. 

EmilyTurner
EmilyTurner

Oh because they're young they know not what they do? Sweetie I had my son four months ago at the ripe age of 20. I wrap my son and often put him in a sling on myself. Not a seat or chair. So nice try. I may be young but im not stupid.

LM
LM

I have personally seen quite a few babies with the rear of their heads flattened from being laid flat and or int he carriers for too much of the day. Most of them being younger mothers that use them because of the ease, as opposed to putting them into to something more ergonomically supportive. A sling is only very rarely properly used, and many times infants are very uncomfortable in them because they push the babies head to their chest closing the airway instead of opening it. (at least until they are older)

KimS
KimS

@Lauren I noticed that, too - and the author only refers to 'mother' and not 'parent'.  Odd.

Ana Sophie
Ana Sophie

It is funny..the pictures of all the moms have their babies facing them, near their chests, hearts, faces, wrapped around their arms or even when carrying the baby on their backs the baby is facing her, always. Now check the two dads, always facing out--the other way, away from them, there is no bonding or nurturing, when the babies are close to the mothers, they can talk to them, cuddle with them, they can touch them naturally, like the way it was intended.

Catherine
Catherine

Can you tell me where you found your cameo wrap and name or brand? My husband is wanting one. Happy baby wearing :) thx

Beth
Beth

 @Enon

 The child is carried and nurtured by the MOTHER before birth...not the FATHER...so it is only fitting to be in the same position after the baby is born. Not that the father doesn't have a role, he does...to provide for the child's wellbeing, to teach and train the child, to correct the child, etc. But it has been and will always be the MOTHER who will nurture and care for that baby like no one else can...

bobafamily
bobafamily moderator

 @Enon Thank you for your comment. We sincerely appreciate your comments and  will take note of that for future articles!

KimS
KimS

@aphrodite73 and?  Why does common misuse excuse it in any way?  Surely common misuse means that there is more of a reason to correct it - because people don't even know they're doing anything wrong.

Additionally, if you are going to publish yourself, you should strive to write as well as possible.  Spelling and grammar errors reflect badly on you.  If it were me, I'd be grateful for the correction.


Finally, Mr P's grammar lesson was helpful and politely written.  Your 'shut up' comment is rude and childish.  Perhaps you could learn something from Mr P.

KimS
KimS

@Ana Sophie - this is less do to with mothers and fathers and all to do with the choice of photos. 

KimS
KimS

@Beth Pardon?  What a sad way to think.  Of course fathers can nurture and care for their babies - the problem is women who push the fathers away, not allowing them equal bonding, or making them feel like it's somehow wrong to want to nurture their child.
How awful that you want to relegate men to financial support and discipline.

Enon
Enon

@Beth no one can disagree with the nurturing that takes place before birth, unless however, the mother is doing drugs, drinking, eating unhealthily, smoking, etc. and thus causing harm to the baby.  After birth, however, the nurturing is not necessarily solely the mother's department.  I have two friends that are gay men.  They have had a child since the week he was born.  Do you honestly think that they are not capable of nurturing, loving, providing the best care for that infant?  Men are EQUALLY capable of nurturing an infant.  The male role in child raising also is not only to be the "police".  My mother was a disciplinarian who corrected me with a firm hand.  Raising a child is TEAMWORK with equal roles, which was the reason for my original post.  After birth, our child will be spending more days with me than in daycare or with his/her mother because of my job.  I think it would be cool if Boba had a line for men that was a little more manly in design and color so that more men would be more willing to use one as opposed to a stroller or the front facing style of harnessing system.

KimS
KimS

@Ana Sophie Beth is only supporting the role of father within her strictly defined gender stereotype, as breadwinner, teacher and disciplinarian.  She clearly says that mothers should continue to carry and nurture the child, because they carry the baby before it is born and goes on to say 'it has been and will always be the MOTHER who will nurture and care for that baby like no one else can'.


Chriscanberra
Chriscanberra

@Ana Sophie It would appear, Ana Sophie, that not only are you as ignorant as Beth but you are illiterate as well as you obviously didn't read her post correctly! Yes, Beth did make those comments, she then went on to state that a man's role is as a teacher and disciplinarian and that it is the mother who nurtures and cares for the baby, it is an outdated and sexist line of thought. Why don't you both do the world a huge favour and crawl back into the dark ages where you came from?

Ana Sophie
Ana Sophie

Wow! you--Crhiscanberra, Michelle, and Enon are the ignorant ones: You totally misinterpret what Beth commented. It is not bias, it not stereotypes, nothing to be horrified about. Beth is supporting the role of the father, read her comment again. She is just stating that when the woman is pregnant the baby's position in the womb is naturally nurtured by the mother, when outside, this wrapper or carrier as they call it, has the purpose of the baby being secured and safe like "in the womb" same position, something than males don't have, right? That is all, nothing else.

Chriscanberra
Chriscanberra

 @Enon  @Beth Well said Michelle (and you too Enon).  I was a little horrified at Beth's comments.  My wife and I have a baby girl due in 11 days and I can guarantee that Dad will be providing as much of the nurturing and love as he can, I am more to my family than a bread winner and disciplinarian, I'm a devoted and loving husband and Dad and intend to continue earning those titles.

Michelle
Michelle

 @Enon  @Beth  Enon, Don't listen to beth she is obviously ignorant and entrenched in outdated gender role stereotypes. Good for you for wanting to be a hands on dad! Beth can stay home all day doing dishes while her brat children to go awol until her husband gets home since "dad is the disciplinarian."