BabyWearing Institute

Babywearing Blog

Safety Guidelines for Babycarriers

Posted on November 3, 2012 at 1:15 PM

Safety Matters


· Carrying baby wrapped tight upright with chin off chest!

· Facing the parent, never out!

· Baby carrier needs to allow for natural movement.

· Center of gravity close to mom or dad.

· Secure on upper body!

· Bottom or Crotch piece widths

· Calves out, knee bend

· Never pick up baby by arms!


Much can be said and written about being safe when carrying our children. There are some general rules we need to pay attention to at first, because babywearing is just being re-discovered, but soon checking on our babies is second nature.


Carrying baby wrapped tight upright with chin off chest!

Most importantly we need to be aware of our baby’s airway. We need to make sure baby’s chin is up away from his chest. Having baby’s chin rest on his chest kinks baby’s airway and can have detrimental consequences. This chin-chest danger needs to be checked frequently, not only in baby carriers but also in car seats, swings, activity saucers, and so on. The kinked airway is referred to as positional asphyxiation and can happen in all directions. A baby carrier needs to offer sufficient head support to allow for safe babywearing. Babies carried are much less likely to suffer positional asphyxiation than those left in car seats or swings for long periods of time. The natural movement of the parent stimulates all senses and helps the baby’s circulation. Indegiouns people carry their children upright from birth and there are no records of fatalities due to positional asphyxiation.

Evelin Kirkilionis Ph.D., a leading human behaviorist and babywearing expert noted:


“The upright supported posture allows even very small babies moving patterns that are usually not seen until two to three months later. Free from the chore of controlling and holding his little head while trying to stabilize against gravity, an infant secured in a wrap for example can hold and turn his own head early on.”


Carrying baby upright with proper head support, held well on both sides of baby’s body along with the support of the natural rounded back is by far safest carrying way for all ages. Parents can sense the baby’s needs immediately, being close enough to baby’s face to notice any discomfort and in a position to take action without delay. Conscious Babywearing can safe baby’s life!


Facing the parent and never out!

Facing the parents and never out is another safety measure to assure baby’s healthy hip and spine development. Baby feels secure being straddled around the parent, being active in helping stabilize himself against mom’s or dad’s body. Baby feels good having a tiny bit of control when to look out and explore the world and when to focus on mom’s face instead. Facing baby out completely takes any kind of control from the baby and forces baby into a position and activity their brains are not able to make sense of at that age.

It also pushes the baby into a hollow of the back, the natural rounding of the spine, called Kyphosis, is not possible. This in turn influences the slight tilt of the pelvic floor which is also not possible, positioning the hip ball in a place that causes undo pressure on the hip socket in an unfavorable place. This pressure can cause slight deformation in the hardening of the socket.


No long term study have been done on the influence of bad hip positioning related to hip problems. Research would require parents to purposely put their children in harms way to prove there is a relation in the hip and leg position and hip problems later on. What we do know is that children who spent a lot of time on their tummies with straight legs will end up with major hip problems. Since some of the baby carriers on the market adopted this same straight leg position it is logical to assume this kind of carrier is not safe for baby’s hip development.  Cradle positions also assume a position unfavorable for the hip development.


Baby carrier needs to allow for natural movement.

There are many baby carriers on the market but not all of them support baby properly and safely. A good baby carrier will allow for baby’s natural movement. As we already showed, a baby carrier supporting baby upright is safest. On top of that a baby carrier needs to allow for baby’s natural movement. This helps baby develop muscle tone along with keeping baby safe as baby will not be forced into a forced position. Baby carriers that are very deep, bag like, or stiff are not supportive of the correct and healthy development of the baby.



Center of gravity close to mom or dad

Baby carriers are often secured with straps or belts that can be adjusted with buckles. Some are fabric simply tied. Whatever carrier you choose because of fit and comfort, you need to make sure it will allow you to have baby securely tied to you body. You and your baby need to be one movement. Baby should not flop around in the carrier, neither be pushed into the carrier when you turn quickly, stop or speed up. The best way to check a good fit is to lean forward. If the baby is on your front and falls into the back of the carrier, the fit is too loose. Try adjusting the carrier to be closer to your center of gravity. If that is not possible, the baby carrier is not a good fit for you and your baby.


Secure on upper body

For parent and baby to be close and experience each other through all senses, a baby needs to be carried in front of the chest, not the belly. Although some positions are referred to as belly to belly, the proper positioning is in front of your chest. A baby carrier needs to be adjustable to the individual size of the baby and the person wearing the baby. Wearing baby above the belly button is much easier on the pelvic floor. Carrying something heavy too low can lead to incontinence in women. The legs of the baby need to be straddled around the body of the person wearing the baby, not hang straight below. A baby carrier worn improperly too low puts baby at risk for developing severe hip problems since the hip ball is continually pushed out of the socket every step the babywearer takes. Baby’s hips are not developed enough to allow for the legs to move backwards, only forward movements are possible, meaning legs in front of the baby, never behind. Any carrier that puts this natural development in question is not suitable for babies.  As we have been instructing in our classes for years, make sure baby’s head is close enough for you to kiss comfortably on the forehead.


Bottom or Crotch piece widths

The crotch piece or also called bottom piece, needs to extend to the hollow of baby’s knee on both sides. Some baby carriers have adjustable crotch pieces, other don’t. Carrying a baby with legs extended is definitely harmful.

Dr. Fettweis, a leading osteopath in Europe said:

             “When being carried, the calves from the hollow of the knee on need to be able to hang down. Under no circumstances should knee joints be permanently stretched out. In this position the ischiocrurale muscle (the muscle group stretching from the backside of the thighs by the ischium to right under the knee joint), are stretched. This perma nent stretching is the reason that breech babies are more likely to have hip dysplasia. This position needs to be avoided as it can very well be dangerous to the hip joint.”


A bottom or crotch piece of the baby carrier that is too small also poses a risk for your baby. The legs dangle and the hip ball pushes away from the socket. This is not an optimal position for the hip to harden properly. Baby also rides on the most sensitive area of his little body, which can lead to infections (especially for boys) or deformation.

A dangling child is also very uncomfortable and burdensome on the person wearing the baby. There are many of these baby carriers on the market. As far as I can tell most of them are only being used for very short periods of time and often parents feel baby doesn’t like to be carried or it is simply too uncomfortable for the parents. That is why these type of baby carriers can often be found for a great discount on auction sites, garage sales, or radio/TV classifieds and they all state they are hardly used,  only used a handful of times, etc. Picking a baby carrier that supports baby and parent correctly can be tricky but once you understand the development of babies it becomes easier and easier. You will also see baby sink right into the carrier as if it is a second womb when the baby carrier is correct.

I frequently see babies, whom I was already told do not like to be worn, relax into the proper carrier and be fast asleep before we are even finished explaining everything about it. Babies love to be worn close to the parent’s heart but only if the carrier is comfortable and offers them the security and safety they need.

If you have tried different carries but none seem to work, see if all the safety guidelines were in place in the baby carrier. Most likely they were not and baby just reacted to not being comfortable and able to relax. A relaxed baby in a properly supported carrier is in what we call a quiet alertness state. Baby is calm, feeling secure but learning.


Crotch piece by far too narrow for baby's healthy hip development and comfort.

Calves out, knee bend

As Dr. Fettweis remarked above, Werner Sagmeister, Dr. . is also concerned with the trend of having baby’s legs wrapped up in a carrier. Having legs in does not allow for the pelvic floor to be tilted in the optimal position.


“From an anatomical perspective it is of uttermost importance for the healthy development of a baby's hips, pelvic floor, and spine, that the legs are outside of the baby carrier. Through this so called spread-squatting position one derives the physiological correct CCD angle (Centrum-Collum-Diaphysen-angle), which counteracts a possible underdevelopment of the hip and pelvic structure.


The safest position for baby’s development is upright, sitting on a seat stretched to the hollow of the knee on both sides with calves outside the carrier and a proper back support.


CAUTION: Check your baby’s legs often to make sure they are warm and blood circulates freely. Should the calves and feet appear to have a little bit of a different color, shift baby in the carrier. Should there be severe fabric pressure spots from the carrier  it is because baby is not sitting in the fabric but rather on the edge. Give baby a tush push (gently hold baby’s knees in your hands and carefully push them back into the hip socket, moving baby into the fabric and preventing baby from dangling on the edge.


Another reason for calves out in proper supported position is that babies in utero have their hips flexed and externally rotated with the knees flexed and feet turned inward. As a result of this scrunched position, the torsional forces associated with this position, all newborn infants exhibit some degree of external femoral torsion and internal tibial torsion, both of which is normally corrected spontaneously with subsequent growth. However, certain sleeping or sitting positions in carriers can exert torsional forces  or internal tibial torsion on the growing lower limbs and either prevent the spontaneous correction of those deformities present at birth, or even create new torsional or tibial deformities. This deformation can be seen in toeing in or toeing out. Correct hip position (90 degree spread apart and knees higher than the buttock) and legs below the knee out of the carrier will work to help the spontaneous correction of either tibial or torsional forces.

Basically the hip is stressed in certain places and cannot correct the forces of the flexed limbs spontaneously because the pressure continues outside the womb.




Never pick up baby by arms!

One of the most common arm injuries that occur in young children is called radial head subluxation or also called nursemaid's elbow. This happens when the normal anatomical alignment of two of the three bones which form the elbow joint is disrupted.  This often occurs when the arm is pulled while being extended, as is the case when swinging a baby onto your back for a back carry.

The bones of the upper arm and forearm meet at the elbow. When one of the bones in the forearm (the radius) separates slightly from the bone in the upper arm called the humerus, a ligament called the annular ligament may slip into this joint. Then when the bones come back together, they pinch this ligament between them causing the pain of the nursemaid's elbow. It occurs in children from a few months of age to about five years. At five years, the annular ligament is usually strong enough to keep from slipping and it is rare to this this injury in children older than five years old. To keep your baby safe, do not swing your baby onto your back holding him by the arms. Always scoot baby around your hip or lift baby under armpits, always keeping one hand holding baby, over your shoulder. Certified babywearing educators in your area can help you master the back carries.








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