Hips and Spines

Have you ever noticed that when you lie your new baby on their back, their legs don't stick straight down like an adult's legs do. A baby will naturally tilt their pelvis forward and hold their knees up high, and their legs wide at a 90° angle. This position holds a baby's hip socket in its deepest position, and it is thought that the natural spread of their legs is the perfect distance for being held comfortably on their mother's body.

So why is this important?

The hip joint is a ball and socket joint, and at birth a baby's hips are not full developed. Over the first year, the cartilage in the hip joint gradually develops into bone. At birth only about 2/5 of the ball joint is covered by the socket, and eventually the joint will develop to cover 3/5 of the ball joint. Nature has provided babies with the best position for this development to happen, with their knees high, and the ball held deeply within the socket.

How is this relevant to slings?

An ergonomic sling will hold a baby in their natural position, with their knees up high, their legs spread at about 90°, and the ball held deeply within the hip socket. By holding them in this position, we are respecting their natural 'default' position, and are allowing the hips to develop as nature intended.

When held in an upright position, a baby does not have the strength to hold their own knees up high for very long. When held upright in our arms, a young baby will usually hold their legs tucked up next to their body, and a parent's arms will naturally support them in that position. However, when held upright in a narrow-based carrier, where there is no support under their upper thighs, a baby will struggle to bring their knees up, and will not have the strength to keep them there. Unsupported legs will not allow the hip joint to sit deeply within the socket.

This is an area where there is not a lot of research. However, we do know that in situations where a baby has been forced to hold their legs in an unnatural position e.g. when a baby is breech late in pregnancy, there is a higher incidence of hip problems, such as hip dysplasia. Therefore, it makes most sense, when given a choice between a sling which respects our baby's natural leg position, and one that doesn't, to choose the one that does.

So what about a baby's spine?

A baby is born with a curved spine, which gradually develops and straightens over a baby's first year. In the same way that we would opt for a slings that respects a baby's natural hip position, it also makes sense to choose a sling that moulds around a baby's curved spine, giving gentle support to the entire curve of the spine, rather than a very structured carrier which forces a baby's spine into a straighter position.

So what's the deal with 'facing outwards'?

This regularly seems to be a topic of debate and discussion on sling forums and Facebook groups, but there is little research into this area. However, we can see that the majority of carriers with a forward facing option have a very narrow base, making it impossible to support a baby's hips as discussed above. Also, remember that by sandwiching an outward facing child between a structured carrier and the wearer's body, can force a baby's spine into a straighter position. However, a couple of carriers are now coming onto the market which offer an ergonomic position for carrying facing outwards, by have a structured seat under the child, lifting their knees and tipping their pelvis (e.g. Ergo 360, plus others in production from other companies).

Children definitely go through developmental stages where they are more interested in looking around. Wearing a baby on the hip, or high up on the back (if the child is developmentally ready) can offer a child the chance to look around, whilst still holding them in a deep-seated position. With the emergence of new slings, offering an ergonomic solution to allow a baby to face outwards, just remember a couple of simple things:

- A baby needs to have good head and upper torso control before facing them outwards.

-Babies should never be asleep when facing outwards, as their head is unsupported, meaning their head is likely to fall forward, potentially compromising the airway. It is also near impossible to check on a baby's sleeping face when they are facing away from the wearer.

-Keeping periods of forward-facing to short bursts is preferable, so that a child doesn't become over-stimulated. Babies learn about the world by watching their caregiver's facial reactions to new situations, which is difficult when facing outwards. Also remember that any carrier with a child facing away from the wearer (even an ergonomic one) will be holding a baby's weight further from the wearer's centre of gravity, so is likely to be harder on the wearer's body.

Whatever type of sling you choose to use, I hope you enjoy the cuddles and closeness with your baby! If you'd like to learn more about ergonomic carriers, check out the 'Sling Types' section of this website, and visit you local sling library to try some out!