Babywearing Basics and Safety Tips

By Ann Marie Rodgerson, Vice President, Babywearing International

“Babywearing” is the term used to describe wearing your child in a soft carrier. There are a wide variety of carriers available on the market today. A 1986 study in Pediatrics found that infants that are carried more cry less than other infants; a 1990 study in Child Development found that infants carried in soft carriers showed a high degree of positive attachment at 13 months, and countless parents around the world have found that wearing their baby in a cloth carrier allows them to tend to their daily tasks while also caring for their infant.

When choosing a carrier for your newborn or baby, you should look for something that will hold your baby in a position you would naturally carry her in your arms. When you place baby in a carrier and then embrace them as though you were holding her in your arms, there should be mimimal movement from the position the carrier uses. Ideally, baby should be in an upright position, high on your chest (close enough to kiss the top of her head). Baby’s legs should be in a spread squat position where her bottom is lower than her knees. This position helps to prevent an important but not often addressed concern — positional asphyxia. This occurs when baby’s head lolls forward and his chin presses to his chest. This can kink the baby’s airway preventing him from getting enough oxygen. This can occur in swings, carseats, strollers, bouncy seats, and baby carriers. When wearing your baby, always be aware of her airway. Some slings available on the market can place baby into this chin-to-chest position with little option for repositioning. If you’re new or confused about the many babywearing options available, read on as I review the different types of carriers and tips for safe positioning.

Pouch Slings

A pouch sling is a tube of fabric, usually custom fitted to the wearer, thus making this style of carrier one that can’t be shared. Even adjustable pouches must be adjusted before putting them on, as the adjustment is to create a non-adjustable pouch that fits snugly. Pouch slings can accomodate both front and hip carries well. For brief periods with older infants, they can be used for back carries. I generally use the back carry position for a “get grabby hands out of the way” moment rather than as a regular carrying position. While a pouch sling seems like a good choice because it has nothing to fiddle with, it does not make a great choice for newborns. It is difficult to achiece ideal positioning with a newborn in a pouch, especially because mom’s size fluctuates a good deal during the postpartum period. The pouch sling becomes a nice quick-carry option around 4 months. An improperly sized pouch is dangerous because baby cannot be properly positioned or secured. An advantage of the pouch sling is it’s size – many moms like to keep a pouch in their diaper bag for emergencies and quick use.

Ring Slings

A ring sling is a length of cloth with two metal rings sewn into one end. The cloth is fed through the rings to make a pouch for baby who can be positioned on front, hip, or for brief periods on the back with an older infant or toddler. This is one of the two types of carriers that can provide ideal newborn positioning. Once mom becomes comfortable with both nursing and wearing the sling, rings slings are also great for nursing on the go. Ring slings are very adjustable, making them easy to share among caregivers and a great option for newborns. They allow the wearer to get baby in and out quickly which can be handy for a newborn who needs regular changes. Some parents find that the one shoulder carry of the ring sling becomes less comfortable with an older heavier infant, though many parents return to them during the “up, down” phase of early toddlerhood.

Mei Tais

A mei tai is a traditional Asian baby carrier. It is essentially a square or rectangle piece of cloth with four straps that are tied around the wearer. It can be used on the front or back easily. You can do hip carries with a mei tai, but it wouldn’t be my first choice. There have been huge variations of the basic mei tai in the last five years, including hoods, headrests, toy clips, and many add ons. They can be a little tricky to achieve ideal positioning with newborns. Because of this, some wearers choose to leave baby’s feet inside the carrier. Make sure the baby’s weight is on her bottom and not her feet if you choose to carry with legs in. You can also use a ribbon to narrow the width of the bottom portion of the carrier to better fit it between baby’s legs. A mei tai is a good choice if you only want to buy one carrier that lasts from birth to toddlerhood and want to be able to share the carrier between caregivers.

Soft Structure Carriers

A soft structure carrier is essentially a mei tai with buckles. Most also have added a heavily padded waist belt to transfer more weight to your hips. Soft structure carriers are designed with back carries in mind, but can be used on the front successfully by many parents. Many can also do hip carries, but like a mei tai, I don’t think it is the most comfortable choice. Soft structure carriers are designed with older babies and toddlers in mind. Some offer infant inserts to try and make them work for newborns, but they still cannot achieve ideal positioning. Paired with a ring sling or wrap, this could be a great choice for your older infant or toddler.

Wraps

The final type of carrier is a wrap or simple piece of cloth. You can purchase commercially available wraps or you can make your own. It is wrapped around the wearer in a variety of ways to produce the most comfortable and ergonomic carries. Wraps come in two types: stretchy or woven. A stretchy wrap can be used for front or hip carries, but should NEVER be used for back carries. A back carry in a stretchy wrap is a dangerous choice because baby could push against the fabric causing it to roll down and release baby. A woven wrap is the one carrier that does everything well — front, back, hip, newborns, toddlers, you name it. However, that versatility comes with a higher learning curve on how to wear a wrap. Parents can learn to use a wrap via online videos  or from their local babywearing group.

To learn more about babywearing, visit Babywearing International at www.babywearinginternational.org, or online forums like www.thebabywearer.com, or from your local babywearing group.

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Ann Marie Rodgerson is the Vice President of Babywearing International. Upon entering parenthood, Ann Marie failed to find a successful carrier option for her daughter despite her best efforts. She was delighted to discover Babywearing International of DC-MD-VA after the birth of her second child and set about learning as much as she could to help prevent other parents from the same frustrations she experienced as a new mom.  She is now helps parents around the greater DC area to wear their babies safely and comfortably while regularly wearing her middle and youngest daughters.

Breastfeeding Tips: Making Work Work for Your Baby

By Jeannette Crenshaw, MSN, RN, IBCLC, LCCE, FACCE and Allison Walsh, IBCLC, LCCE, FACCE

Committed to breastfeeding but concerned that going back to work or school might make breastfeeding too hard? Breastfeeding can make it easier to stay connected. With a little planning, you can do it! Here are some simple ideas that have helped other moms:

  • Focus on learning to breastfeed and making lots of milk.
  • Delay returning to work as long as possible.
  • Plan to go back to work part-time at first, if you can.
  • Plan to start work at the end of the week, to ease into your new routine.

The Countdown*

Before your baby is born:

  • Take a breastfeeding class.
  • Talk with your childcare provider and your employer about your plans to continue breastfeeding.
  • Consider childcare close to work or school, where you may be able to breastfeed during lunch breaks.
  • Choose a healthcare provider for your baby who supports breastfeeding.
  • Join a support group for breastfeeding mothers.

Once your baby is born:

  • Focus on learning to breastfeed and making lots of milk. (You don’t need to start pumping yet!)

2 weeks before returning to work:

  • Rent or buy a double electric pump, if possible.
  • Begin pumping and storing milk.
  • Have someone else feed the baby with the new feeding method.
  • Find clothes that make pumping easier, such as two-piece outfits and tops that button in the front. (Prints hide leaks better than solid colors.)

4-7 days before going back to work:

  • Leave your baby with the caregiver for a short practice session.
  • Work out an emergency plan for the unexpected, such as a sick child, car trouble, or traffic.

The night before you go back to work:

  • Pack your baby’s bag, and a healthy lunch and snack for you.
  • Gather your pump, cooler, and milk storage containers.
  • Lay out your clothes for work. Pack extra cotton breast pads and extra tops or sweaters in case of leaking.

Going to work:

  • Allow enough time so that your morning breastfeeding is relaxed and not rushed.
  • Plan ahead for the evening meal. For example, take food from the freezer or place something in a slow cooker.
  • Nurse your baby at home and again at the caregiver’s to keep up your milk supply.
  • Nurse or pump at work at least 3 times in 8 hours for a young baby.

Picking your baby up from the caregiver: 

  • Plan to stop and nurse your baby as soon as you get to the caregiver’s.
  • Leave the milk you pumped while at work with the caregiver for the next day.
  • When you get home, nurse your baby again and enjoy reconnecting.

Every morning:

  • Give yourself enough time so that your morning breastfeeding is relaxed.
  • Plan ahead for the evening meal.

Did You know?

  • Hand washing is the best way to help keep you and your baby well. Wash your hands for 15 seconds before nursing and pumping.
  • Your breasts are never empty. Your baby can get milk if you’ve just pumped.
  • Try pumping in the morning. Milk volume is greater. (Some women pump on one side while nursing on the other.) 
  • Three short pumping sessions, about 10 minutes each, are more effective than one long one.
  • Gentle massage while pumping may help you pump more milk.
  • Start at the lowest suction setting on your pump and increase to a setting that removes milk and feels comfortable. (Pumping shouldn’t hurt.)
  • When you and your baby are apart, pump often to maintain your milk supply. Avoid waiting until your breasts feel full.
  • Weekends are a great time to enjoy breastfeeding your baby while building your milk supply. Leave pumping and other feeding methods for workdays.

Storing and Using Pumped Breastmilk — A Guide

To Store

  • Store breastmilk in a clean, airtight container. Use hard plastic or glass with tight fitting, solid lids or disposable feeding bottle liners or breastmilk storage bags. Leave ¼ of the container empty if you plan to freeze.
  • Store it in the coldest part of the freezer, under the icemaker or in a back corner.
  • Label the milk with the date and your child’s name. This is important when leaving pumped milk with the caregiver. Expert opinions vary on how long you can safely store breastmilk.**
  • Keep fresh breastmilk at room temperature up to 4-6 hours.
  • Keep fresh breastmilk in a cooler with frozen gel packs up to 24 hours.
  • Store breastmilk in the refrigerator between 3 to 8 days.**
  • Store breastmilk in a refrigerator freezer for 3 to 6 months and in a deep freezer with manual defrost for 6 to 12 months. (A freezer is cold enough to store breastmilk if it keeps ice cream hard.) 

To Thaw

  • Refrigerator thawed: Place container of frozen breastmilk in the refrigerator to thaw gradually.
  • Warm-water “quick” thawed: Place container of frozen breastmilk in a bowl of warm tap water. Once the breastmilk is liquid, use it right away or refrigerate.
  • Never microwave! “Hot spots” in the milk may burn your baby and the microwave destroys some of the infection fighting benefits of your milk.
  • Keep thawed breastmilk in the coldest part of the refrigerator. For example, the back of the refrigerator is colder than the door. Do not refreeze. Use thawed milk within 24 hours or discard.

To Use After Refrigerating or Thawing

  • Warm cold breastmilk by holding container under running warm water or in warm water for a few minutes.
  • Gently mix breast milk before feeding because breastmilk components separate when thawing.
  • Discard leftover milk if the bottle has been in the baby’s mouth.

To Transport

  • Keep breastmilk as cold as possible. Use insulated carriers and reusable frozen gel packs (not ice cubes).

To Clean Your Pumps

  • Rinse pieces that came in contact with breastmilk with cool water.
  • Wash pieces with warm soapy water, rinse, and air dry on a clean towel or wash pieces in the dishwasher.

 

*You will need to adapt this schedule if you work or go to school at night.

**This information should be considered a supplement to, and not a substitute for, care by a health care provider.

Safety Warning Issued on Sleep Positioners

 

This past week, the Consumer Product Safety Commission (CPSC) and the Food and Drug Administration (FDA) warned consumers to stop using infant sleep positioners. During the last 13 years, the agencies have received 12 reports of infants between the ages of one and four months who died when they suffocated in sleep positioners or became trapped and suffocated between a sleep positioner and the side of a crib or bassinet. The suffocation typically occurred when the infants rolled from a side to stomach position. CPSC has also received dozens of reports of infants who were placed on their backs or sides in sleep positioners and then found later in potentially hazardous positions within or next to the sleep positioners.

There are two primary types of infant sleep positioners:  flat mats with side bolsters or inclined (wedge) mats with side bolsters. Manufacturers of both types typically claim that their products help keep infants on their backs and reduce the risk of Sudden Infant Death Syndrome (SIDS). However, the FDA has never cleared an infant sleep positioner to prevent or reduce the risk of SIDS, and CPSC and FDA are unaware of any scientific studies to support this claim. 

For more information, including photos of infant sleep positioners, go to http://www.cpsc.gov/cpscpub/prerel/prhtml10/10358.html. You can report a problem with an infant sleep positioner through the FDA’s MedWatch program at http://www.fda.gov/Safety/MedWatch/HowToReport/default.htm or with the CPSC at https://www.cpsc.gov/cgibin/incident.aspx.

Choosing Ideal Child Care for Your Baby

The following is a guest post from Denise Pelky, an infant teacher for the University of Michigan. Denise helped to start the infant program two years ago. She has a BS in Early Childhood Education. Denise also has been a childbirth educator through her local community education program for the last 30 years.

As you enter the child care center that you are considering, stop for a moment and take in the atmosphere. Your initial reaction to the sights, sounds, colors, and smell of the center should be positive. Is there someone to greet you pleasantly and show you the space and answer your questions? Is the Director available and are they able to discuss any concerns you may have?

Infants

When you enter the infant classroom, the room should be warm and inviting. There should be natural light along with soft electric light. The colors should be muted or natural and there should be natural materials, such as wood, instead of a lot of plastic. Look for comfortable rocking chairs for the adults and several well-chosen toys out for the babies to play with. It is important for your child’s senses that the room not be too cluttered or noisy.

The teachers should be engaged with the babies, some should be on the floor with the babies either reading, playing, or singing with them. At least one teacher should greet you and invite you to come in and sit down (even though they may be busy with a child, they should be able to calmly answer questions and give you information about the program).

A quality baby program should include the following criteria:

  • Several books available for the baby to hold and look at. The teacher should stress that books are read to the baby throughout the day. Ideally, there should be books that portray multi-cultural diversity.
  • Music and singing should be on an ongoing basis. Songs should be sung to the babies, not just background music played during the day.  
  • Babies should be allowed to set their own schedule and be fed when they show signs of hunger. The sleep schedule should be according to the baby’s rhythm.
  • Activities should be geared toward the baby’s age and ability. There should be sensory experiences and small/large motor skill activities along with art, cognitive, and language development activities.
  • An activity plan for the week should be posted and include the above criteria.
  • Teachers should include infant massage, baby yoga or Brain Gym in their plan. They should be well versed in these important sensory activities for babies.
  • Signing with babies should be an ongoing language development skill that teachers use with babies. It should be used consistently and for the  many daily routines that go on in the baby room. Baby sign language promotes literacy, language development, communication and helps with frustration. It is a very important activity in a quality infant program.
  • The infants should have some outside time every day (depending on weather), including playing in sand and water. They should be given rides in strollers so that they can be out and about in the neighborhood.

Ask questions about the ratio of teachers to babies. States have different licensing laws, but ideally it should be one teacher to three infants. Ask about what their plan is for fires and tornadoes. Do they have evacuation cribs and do they practice fire drills? What is their sickness policy and how do they contact you? Ask how often they sterilize the toys and how they sanitize the diaper area. Do they wear gloves during diaper changes? How do they assure that bottles do not get mixed up and how do they warm milk? Are they familiar with feeding babies pumped breastmilk?

Of course, the most important criteria to look for is the quality of the teachers in the room. Sit in the room for an hour and observe their interactions with the babies. Are the teachers warm and inviting? Does the teacher reach out for the baby and talk directly to him/her? Does the teacher smile and play games with the baby? Do they welcome questions and answer your concerns with patience? Are the teachers respectful of cultural differences? Do they stress the importance of building a relationship with the baby and with your family? Does the teacher ask you questions specifically about your baby and do they have paperwork for you to fill out so that you can detail information about your baby?

Remember that you are the parent and that the teachers will never take your place. However, you do want the teachers to bond with your baby and develop a caring relationship. Feel free to ask them questions and to listen to their suggestions; you can decide if their feedback works for you and your family. This should be a reciprocal relationship and both you and the teachers should be respectful and trusting. After all, you are leaving your precious baby and you should feel confident in knowing that they are being well cared for and loved.