Article on Spinal Stress

Infant Carriers and Spinal Stress by Rochelle L. Casses, D.C.

This is a great article that answers many questions most who are new to babywearing will have. Have a read! Click on the link!

I am not sure anymore if copying and pasting (with reference to the original link) is against copyrights. Sorry about the inconvenience but do click, it's worth the extra minute ;)

Potential Danger of 'Bag Slings'

by M’Liss Stelzer
Former Registered Nurse,
now babywearing educator and mother of two

"With the majority of fabric carriers it takes only a few minor adjustments to get baby safely and comfortably positioned however, it appears that ‘bag slings’ (like the Infantino SlingRider, Lamaze Close Comfort, etc.) have several significant design flaws that could place an infant at risk of respiratory distress or oxygen deprivation.

First, the design of these bag slings causes baby to curl chin to chest, larger babies more so because their heads are positioned further up in the carrier. This position kinks baby’s airway causing the baby to work harder to breathe.

For more information on the importance of maintaining an infant's head and neck in an aligned position see the articles:
“Baby car seat ‘cot death’ concerns”
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/6216892.stm

“Simple Car Seat Insert to Prevent Upper Airway Narrowing”
PEDIATRICS Vol. 112 No. 4 October 2003, pp. 907-913

Second, bag slings are roughly triangle shaped; flat bottom and two sides that slant upwards toward the elastic top. This “triangle” means that the pouch fabric is always angled very close to the sides of baby’s face. If baby rotates even slightly he ends up with his nose within a ¼” of the side, or even pressed against the side of the pouch. Once baby has his head pressed against the side of the carrier and/or against the parent's body there is a risk of him becoming oxygen deprived or even suffocating.

Third, it is difficult for the parent to closely monitor their infant unless he/she pulls open the top of the sling. Bag slings are generally deep, plus they sag when baby is placed in it, further increasing the depth of the carrier. The gathered top, and the fact that the sling hangs so low, obstructs the parent’s view of baby. If a newborn were to have difficulty breathing, and/or rotate until his nose and mouth was pressed against the side of the carrier, the parent may not be aware of the baby’s respiratory distress for some time. Compounding this problem is the difficulty of feeling the baby's distress through the thick fabric of the sling.

Fourth, although one bag sling is designed with large mesh panels placed near the infant’s head, others are not. There is a possibility that, with only a very small opening at the top of a non-mesh sling, an infant may not receive adequate amounts of fresh air. There is also the concern that carbon dioxide levels could rise the longer the infant remains in the sling.

For more information on the dangers of re-breathing see this article:
“About Carbon Dioxide Poisoning and SIDS”
www.sidsprevention.com/co2andsids.html

Compare bag slings with a shallow fabric pouch or adjustable open-tailed sling (or mei tai or wrap). In these types of carriers an infant is easily monitored and visualized. Also, a newborn's head is effectively sandwiched between the sides of these carriers, preventing the infant from easily rotating his/her head into the sides of the carrier."

Please, please seriously consider before you purchase a 'bag sling'. The last I saw, these slings are promoted as "NEW!" and "MUST BUY!" in our Malaysian market.

Read more on the different tests being done on these slings. These are definitely worth a read especially if you are planning to buy a 'bag sling' (more so if you already own one)

http://www.thebabywearer.com/forum/showthread.php?t=205359

A pouch or a ring sling? You decide!

Many have voiced their curiosity over the pouch and the ring sling-which is better?? Seems like those are the main consideration for us Malaysians... probably because these are the only type of carriers that is available in the market? Of course, we have other carriers available like the Baby Bjorn, Ergo, Sweet Cherry etc. I won't comment on those as I'd never personally try them out.

While it is a matter of preference, as I have discussed earlier in Carriers Comparison, I just cannot stop searching for more answers since many of you raised the same issue being in between choices when it comes to a ring sling or a pouch. Nevermind my personal preference, for your benefit, I have found a very detailed and shall I say very good and unbiased comparison from one who is dedicated and sells both of them:

http://www.thebabywearer.com/index.php?page=pouchslingcomparison

This shall do it this time. Hope you find it useful ;)

Again, the most important here is that you enjoy babywearing... so, just go ahead with what you feel is right for you. Some would even find just tying a piece of selendan or sarong or even a bedsheet works (but, please, get something that's at least 6 feet or approximately 2 metres long.. longer is you are bigger in size) ! If you want to try that out, be sure to check this:

http://izaown.fotopages.com/?entry=215903

Again, there are many other ways to tie.. this is just one of them. Shucks... I am wishing someone could take those pictures for me.. still working on the photos for my instructions page. If I do get the chance, I will post on the other different methods to tie the selendang or the sarong.. hopefully, soon. ;)

Poetic Babywearer

Came across this in The Baby Wearer's Forum... simply must share it with you...

Ode to Healthy Babywearing

Use your sling wisely & use it well.

Are you doing it right?

Here's how you tell: Smile for your little one, holding her close and near

Check that her breathing is soft and clear.

Is there a round seat for her rump?

Legs below and her head above?

Carry your baby with comfort & love.

-L.Walthery

Infant carriers and spinal stress

Came across this very interesting and meaningful article on the effect of baby carriers as I was researching for information on baby carriers (before Peekaroobaby is conceived)... tried hard to find it again to be posted here... Hope this helps in choosing the right carrier for your child =)

"As we are finally realizing the benefits of "wearing" our infants while we perform our daily activities, we must be careful not to compromise the integrity of our child's spine through the use of improper carriers. Spondylolisthesis (specifically, Type II/isthmic) is a condition that can result from excessive stress in the low back, such as a baby's spine might experience in certain carriers on the market today. It is relatively uncommon, but when aggravated is extremely painful. This article explains which styles of baby carriers promote healthy spine development in an infant and describes the unnecessary stress and resulting spinal condition that can result from using certain carriers.


A healthy adult spine has four curves when viewed from the side, located in the neck (cervical spine), mid-back (thoracic), low back (lumbar) and base of the spine (sacrum). Upon entering the world, a newborn has only two curves in her spine: the mid-back and the base of the spine. These two curves are called the primary or kyphotic curves. They have an apex or "hump" at the back of the body. The curves in the neck and low back develop later and are termed secondary or lordotic curves. The curve in the cervical spine develops as the child begins to lift his head and the neck muscles are strengthened. The curve in the lumbar spine results as the child starts to crawl. The lordotic curves have an apex at the front of the body. These four curves — two primary and two secondary — are extremely important in the spine (both adult and child), for this is how the body handles the stress of gravity. If these curves do not exist, the body's center of balance is shifted, causing undue stress on the spinal column and spinal cord.


A baby's spine is placed in a compromising position in many of today's popular carriers. If the carrier positions the infant upright, with the legs hanging down and the bodyweight supported at the base of the baby's spine (i.e. at the crotch), it puts undue stress on the spine which can adversely affect the development of the spinal curves and, in some cases, cause spondylolisthesis.


Spondylolisthesis is defined as the forward slipping of a vertebra on the one below it. The degrees of severity are determined using the Meyerding grading scale, with grade 1 being the least amount of slippage and grade 5 being complete slippage off the vertebra below. This condition may have a related stress fracture at the pars interarticularis, a structure at the back of the vertebra that takes most of the stress inflicted on the spine when it is arched backwards. When present, a spondylolisthesis occurs at the fifth lumbar vertebra 90% of the time and at the fourth lumbar vertebra 9% of the time.


Spondylolisthesis is documented in approximately 5% of white males, but is prevalent in native Eskimos (as high as 60% of the population is affected). There has been much discussion on the high percentage of affected Eskimos as to whether it is a genetic predisposition or related to environmental factors (i.e., papoose carriers). Knowing how dynamic and vital the biomechanics of the spine are, I believe that environmental factors are the cause. If the trend continues in the U.S. to carry infants in carriers (or place them in walkers, jumpers, etc.) that place their spines in a weight bearing position before the spine is developmentally ready to do so, I believe we will see an increase in the incidence of spondylolisthesis.
Spondylolisthesis has been referred to as congenital anomalies of the spine, but there is no supporting embryological evidence for this assumption.1 There are factors that predispose a person to this condition, such as weakness in the posterior structures of the vertebra, failure of muscles and ligaments to absorb forces, anomalies of the lubosacral spine, and activities that place high stress on the posterior structures of the spine. Little is known about spondylolisthesis. More research needs to be done specifically addressing the weight bearing position of some carriers. In the meantime, we can take preventative steps by choosing alternate carriers, both for ourselves and as gifts for others.

What I have found to be the ideal carrier is the sling. There are many variations of the sling, but one should look for the following in any type of carrier:

1. Before an infant can hold her head on her own, the carrier should support the neck. A sling cradles the infant just like your arms would, unlike vertical carriers which can actually allow a whiplash type injury.
2. The carrier should not place the infant's spine in a weight bearing position too early. (The young baby should be horizontal or inclined, with the spine supported along its length.)
3. When a baby wants to be more upright to see the world around him (usually around age 4 to 5 months), the carrier should allow him to sit cross-legged, so his weight is dissipated through his legs and hips, as opposed to the style that has the legs hanging down, where the young spine has to bear the entire weight.

When considering the purchase of a baby carrier, you can often just ask yourself if you would be comfortable in it. Would you feel like you were in a hammock (a sling), or in a parachute harness, with your legs hanging down? Laying in a hammock is better for all of us.

Other benefits of sling type carriers include easy accessibility to breastfeeding, ability to wear baby facing toward or away from wearer, ability to wear sling on back, front or side.

You may be wondering, "What about backpacks? Are they bad? At what age or stage of development is it okay to carry a child in a backpack? What should you look for when buying one?" Wait until your child can sit alone well before carrying him in a backpack. The seat of the backpack should support the child's entire bottom — not just between the legs, leaving the legs to dangle. One that has a foot rest is preferred.

The choice of infant carriers is a small thing when compared to all the other concerns that face parents, but it is a decision that can have lifelong effects. By choosing a sling type carrier for your baby, you may be preventing a lifetime of backaches and other spinal stresses.

Rochelle and Scott Casses own a chiropractic clinic in Carslisle, Pennsylvania, USA. Their 11-month-old son Palmer has accompanied them to work since he was born. Rochelle and Scott schedule their appointments so that while one of them is with a patient, the other handles reception duties and cares for Palmer. Rochelle says, "The patients really enjoy seeing Palmer, and he enjoys the interaction each day." A section of their office serves as a playroom for Palmer as he becomes more mobile. (1996)

REFERENCES
Hensinger, R. N.; Spondylolysis and Spondylolisthesis in Children and Adolescents; Journal of Bone and Joint Surgery, August 1989 71A: 1098-1107
Shahriaae, H.; A Family with Spondylolisthesis; Journal of Bone and Joint Surgery, December 1979 61A: 1256-1258
Tower S. S. and Pratt W.; Spondylolysis and Associated Spondylolisthesis in Eskimo and Athabascan Populations; Clinical Orthopedics, January 1990
Wiltse, Leon; Fatigue Fracture: The Basic Lesion in Isthmic Spondylolisthesis; Journal of Bone and Joint Surgery, January 1975 57A: 17-22
This article was originally written for The Continuum Concept Letter (now defunct)..."