Safe Positioning in Slings

Consumer Reports blog this week announces the heartrenching death of 6 day old Derrik Fowler in an Infantino Slingrider. He died of positional asphyxia- when a baby asphyxiates due to the airway being compressed by the weight of his own head.

This happens when babies are poorly positioned in all types of products: car seats, baby chairs & yes, baby carriers. When babies chins are touching their chests, their airway is compressed. They lack the muscular control to lift their heads to prevent asphyxiation, placing them in an extremely dangerous situation- one Derrik's parents must be devastated about.

I cannot imagine their feelings when they learn that his death was completely preventable. In 2006 & 2007, informal tests were done on the respiration rates & oxygen saturation rates of babies in Infantino Slingriders. They were performed by a former RN & babywearing educator. She sent her findings, along with supporting information, to Infantino & to the American Consumer Product Standards council. Further detail can be found at www.thebabywearer.com

While the Infantino sling is obviously a disaster waiting to strike again, poor positioning in any carrier places infants at risk. It is essential that babies faces are never covered by the fabric of a carrier & that their heads are angled back, keeping their chins well away from their chests. The photos on the Infantino product site are a good indicator of the unsafe positioning that must be avoided.

While some brands of carrier are designed in a way that does not allow the possibility of safe positioning, many excellent brands that do allow for it are used in a position that I no longer consider safe or biologically correct- the cradle hold.

There are a number of reasons I will no longer teach this position. In most photos of babies placed in the cradle position, the baby's chin is down at its chest. It is very difficult for most parents to safely position the baby while it is in the cradle hold.

Second, the cradle position does not place the baby in the position it expects to be in- vertically, between its mothers breasts. Dr Nils Bergman, a physician & researcher who has extensively studied the immensely beneficial practice of keeping babies in their habitat- vertically, between the mothers breasts, says: "The baby is in the right place and therefore has the right behaviour."

As a Lactation Educator (LE) & a Babywearing Educator, I often help parents resolve difficult breastfeeding problems by simply recommending Kangaroo care- ie, time spent skin to skin, vertically, between the mothers breasts.

When babies begin a nursing session in the vertical position (moving themselves over to actually nurse), they are best able to effectively coordinate their suck/swallow/breathe reflexes (for more information on these concepts, see the work of Dr Suzanne Coulson , Kittie Frantz, Dr Michel Odent as well as Dr Bergman)

If babies orient vertically, I believe placing them at an angle, or horizontally, can disorient them. In my experience, this can lead to, or exacerbate, breastfeeding difficulties.

The cradle position continues to be taught by manufacturers & educators, but I recommend you avoid using this positioning. It makes it difficult to position the baby safely & appears to contribute to breastfeeding problems.

Instead, newborn babies should be positioned tummy to chest, with their legs in a frog position, knees higher than bum. The carrier should support them well enough that they are not slumping down in it, potentially compromising their airway.

Babywearing is a wonderful tool that gives babies the minimum they expect- to be carried by their mother. It is also a learned skill that requires a bit of background knowledge to safely perform. Please always be certain that your baby is safely carried.