Babywearing: benefits, types and how to use a carrier safely
A sling or carrier lets you keep your baby close while leaving your hands free. Used correctly, it can be a practical part of daily life in the first year. Used incorrectly, it carries serious risks. This article brings together the key guidance from the NHS and RoSPA so you know what to check every time you carry your baby.
Types of baby carrier
There are several styles to choose from, each with a different way of fastening and distributing your baby's weight:
- Wraps. Long pieces of fabric that you tie around your body. They require practice to get right but offer a very snug fit once mastered.
- Ring slings. A length of fabric threaded through two rings, worn over one shoulder. They are easy to adjust and good for quick trips.
- Soft structured carriers. Padded carriers with buckles and straps, similar in appearance to a hiking pack. These tend to be straightforward to put on and take off.
- Mei dais. A traditional Asian-style carrier with a panel and four ties that wrap around your waist and shoulders.
Whichever style you choose, the most important factor is that it keeps your baby held firmly against your body in an upright position, with their weight spread evenly across your shoulders, hips and back.
The TICKS safety checklist
The NHS recommends following the TICKS guidelines every time you use a sling, to reduce the risk of suffocation. Go through each point before you set off:
- T - Tight. The sling should be snug enough to hold your baby close against your body. Loose fabric allows your baby to slump into a dangerous position.
- I - In view at all times. You should be able to see your baby's face without moving or adjusting the carrier. If you cannot see their face, something is wrong.
- C - Close enough to kiss. Your baby's head should be high enough on your chest that you can dip your chin and kiss the top of their head easily.
- K - Keep chin off the chest. Your baby's chin must not be allowed to rest against their chest. This is the most critical safety point (see the risk section below).
- S - Supported back. Your baby's back should be comfortably upright, not curled or slumped. The carrier fabric should support the full length of the spine.
The main risk: suffocation
The primary danger with baby slings is suffocation. The fabric of a sling can press against a baby's nose and mouth, blocking their airway and causing suffocation within a very short time. This risk is highest when a baby is placed in a curved or C-shaped position in the carrier, nestled low on the parent's body near the stomach rather than high on the chest.
Young babies do not yet have the neck strength to lift their heads away from an obstructed position. If a baby's chin drops onto their chest, even by a small amount, the resulting angle can restrict the airway significantly. Because this can happen quickly and silently, checking the TICKS points frequently throughout a carry is essential, not just at the start.
The risk is higher still for babies who were born prematurely or with a low birth weight. RoSPA advises that parents of these babies should speak to a health professional, such as a health visitor, before using a sling.
Feeding in a sling
NHS guidance is clear on this point: it is not safe to feed your baby while they are in a sling. Feeding requires repositioning the baby's head and body, which means the TICKS checks no longer apply as they did. If your baby needs to be fed, take them out of the sling first, feed them, and then re-secure them in the carrier using the TICKS checks before setting off again.
RoSPA also advises against breastfeeding or bottle feeding while babywearing, for the same reason: correct positioning cannot be maintained during a feed.
Choosing a carrier that fits
A well-designed carrier distributes your baby's weight evenly across your shoulders, hips and back. A carrier that concentrates weight in one area, or allows your baby to hang too low, is harder to keep TICKS-compliant and more tiring to wear. Before buying or borrowing a carrier, try it with your baby present if at all possible, so you can check the fit properly.
Look for a carrier that keeps your baby in an upright position against your body. Carriers that allow a cradled or horizontal position require extra care to ensure the chin is not pressed down and the airway is clear.
General tips for safe use
- Check all fastenings, buckles and ties before each use. Look for signs of wear or damage to the fabric.
- Check the TICKS points at the start of a carry and again regularly during it, particularly after bending down or after your baby has moved.
- Avoid carrying your baby in a sling while cooking, near open flames or near hot liquids.
- Take your baby out of the sling before feeding.
- If you are unsure about your technique, seek guidance from a trained sling consultant or your health visitor before carrying your baby for extended periods.
Frequently asked questions
What is the TICKS checklist for babywearing?
TICKS stands for: Tight (the sling should hold your baby snugly against your body), In view (you should always be able to see your baby's face without moving the fabric), Close enough to kiss (your baby's head should be high enough for you to kiss it easily), Keep chin off the chest (the chin must not press down onto the chest), and Supported back (your baby's back should be comfortably upright throughout the carry). NHS guidance recommends running through these checks before each journey.
What types of baby carrier are available?
The main types available are wraps, ring slings, soft structured carriers and mei dais. Each has a different method of fastening and a different learning curve. Whichever type you choose, look for one that keeps your baby upright against your body and distributes weight evenly across your shoulders, hips and back.
Is it safe to feed my baby while they are in a sling?
No. NHS guidance states clearly that it is not safe to feed a baby while in a sling. Feeding changes the position of the baby's head and body, making it impossible to maintain the TICKS checks. Always remove your baby from the carrier before feeding, then re-check TICKS when you put them back in.
Are baby slings safe for premature or low birth weight babies?
Extra caution is needed for babies who were born prematurely or with a low birth weight. RoSPA recommends seeking advice from a health professional, such as a health visitor, before using a sling with these babies, as they may be at higher risk if positioning is not exactly right.
What is the main safety risk with baby slings?
The main risk is suffocation. A sling's fabric can press against a baby's nose and mouth and block the airway. This risk is greatest when a baby is in a curved or C-like position, positioned low on the parent's body, with the chin resting on the chest. Because young babies cannot lift their own heads away, they cannot signal distress in this situation. Checking the TICKS guidelines regularly throughout a carry is the most effective way to prevent this.
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