Which Babywearing Position Is Best For My Baby?

Posted by Megan Petchel & Julie Monson on Mar 15, 2022

Carrying your baby not only allows you to be hands free making it easier to do things, but it also encourages bonding between the two of you. Most of these versatile carriers allow you to carry your baby inward facing, outward facing, on your hip, and on your back. As convenient as this is, knowing the healthiest position to carry your baby in is important so that you can maximise on the benefits and reduce any concerns when using a carrier.

The healthiest way to carry your baby, especially for the first 6 months, is having them against your tummy facing you (also known as inward-facing) according to the International Hip Dysplasia Institute. However, it is not as simple as popping your baby in a carrier facing you. This is because your baby’s hips must be in a frog position (also known as an “M” shape) as this encourages normal hip development. In addition to the position of their hips and legs, it is important that your baby’s back be curved or bent and their head should rest on your chest to support normal development of their spine.

Preventing something is always better than trying to treat it and so being aware of how to protect your infant's hips reduces the likelihood of long term complications from developmental dysplasia of the hip (DDH). It also promotes the correct development of their spine.

WHAT IS DEVELOPMENTAL DYSPLASIA (DDH) OF THE HIP?

The hip joint is commonly known as a ball and socket joint. This means that the head of the long bone in your thigh is like a round ball that fits snuggly into your pelvis which would be the socket part. When the socket is not deep enough to cover the head of the thigh bone, there is a possibility that the ball could easily pop out of the joint which is known as a hip dislocation. It can also lead to instability of the hip joint.

This is most likely to happen during infancy as a baby’s hip socket is naturally shallow and soft. Hip instability or dysplasia is the most common abnormality in new-borns and can range in severity. Interestingly, girls are 4-5 times more likely to have hip dysplasia as their ligaments are more relaxed.

Image used with kind permission from healthyhipsaustralia.org

WHY IS IT NECESSARY TO REDUCE THE RISK OF HIP DYSPLASIA?

Identifying hip dysplasia as early as possible reduces the amount of damage to the joint. If it is left untreated, there is the potential for irreversible damage causing pain, arthritis and loss of function later on in life.

WHAT IMPACT DOES BABY WEARING HAVE ON THE DEVELOPMENT OF YOUR BABY’S SPINE?

Dr. Andrew Dodge, a chiropractor, shares that ensuring that your baby’s back and spine are correctly supported, according to where they are developmentally, is important while carrying them. When your baby is born, they are still in a curved “C” like position with their hips bent and their knees folded into their chest as this is how they were able to fit comfortably in your womb.

As your baby begins to develop during the first few months, their joints begin to relax and the muscles on their back strengthen. The development of these muscles allows them to start supporting their head which promotes the correct development of the spinal curve in their neck. The two lower spinal curves of their spine develop as they begin to crawl. These correctly formed spinal curves provide the required structure need they need for movement (such as crawling and walking), weight-bearing activities (such as standing and crawling) and proper neurological development.

Placing your baby in a position that they are not yet ready for can challenge certain muscles before they are ready. This can negatively affect their spinal curves as there is the potential for the spine to curve too much or not enough. These positions which are not yet developmentally appropriate can result in increased pressure in certain places of the spine and have been linked to structural as well as neurological changes.

Image used with kind permission from healthyhipsaustralia.org

WHY IS IT NECESSARY TO ENCOURAGE THE CORRECT SPINAL CURVE DEVELOPMENT?

An increased lower back curve can contribute to physical changes of bones and joints and create instability. A child who experiences instability in their lower back may also have difficulty with controlling their colon, bladder and pelvic muscles as the nerve supply is likely to be compromised by the structural changes. Should one curve in the spine be increased, your body will change other curves or bones to compensate and ensure balance. This can potentially increase the risk of developing scoliosis, which is when the spine curves sideways.

WHAT IS INWARD-FACING CARRYING?

Inward facing carrying as mentioned above is the healthiest position to carry your infant for the first 6 months. In this position, you are tummy-to-tummy with your infant and they are required to use their inner thigh muscles to grasp around your tummy.

WHAT ARE THE BENEFITS OF INWARD-FACING BABY CARRYING?

The list of benefits associated with carrying your baby inward facing includes the following:

It encourages bonding between you and your baby and can increase your feeling of competence.
It helps to regulate your baby’s temperature, heart and respiratory rates, especially for premature infants.
It positively contributes to normal hip joint development which is vital as your baby’s hips develop rapidly during the first 6 months after which development slows down in the following 6 months
The gentle movement and secure feeling a carrier provides reminds your infant of being in your womb.
It helps regulate your baby as they are close to you and feel safe and secure.
The motion of being worn promotes digestion for your baby.
It encourages breastfeeding and makes nursing easier and more discreet when you are out. ·
There is less time spent where pressure is placed on the back of your infants head as would be experienced in car seats or swings. This reduces the chance of them developing an abnormally shaped head (plagiocephaly). ·
Research suggests that babies who are carried have better visual and auditory alertness. It promotes cognitive and speech development as your baby is included in more experiences and conversations

ARE THERE ANY DRAWBACKS OF INWARD-FACING BABY CARRYING?

Not all babies are comfortable in a carrier especially facing inwards.
As your infant grows, they may become more interested in their surroundings and try to turn their heads to see what is going on. This could place strain on their neck muscles.

WHAT AGE IS IT APPROPRIATE FOR ME TO CARRY MY BABY INWARD-FACING?

The general agreement is that a baby of any age can be placed in a forward-inward facing carrier. This includes new-born infants, however it is strongly dependent on the type of carrier you are using as not all carriers are safe for new-borns. This is the recommended position for at least the first 6 months of their life to promote healthy hip and spine development.

While it is safe for you to carry your infant facing you, there are strongly recommended guidelines that should be followed to ensure their airway is never obstructed. These rules follow the acronym T.I.C.K.S:

T is for Tight

The carrier must firmly support your baby. If your carrier is not tight enough, your baby may slump down and this could restrict their breathing.

I is for In View At All Times

It is vital that you are able to see your baby’s face every time you look down. This ensures that their nose and mouth are not covered by you or the carrier.

C is for Close Enough to Kiss

Your baby should be close enough to your chin that if you were to tip it forward you would be able to kiss your baby’s head.

K is for Keep Chin Off the Chest

Making sure that your baby’s chin does not rest on their chest helps protect their airway. There should not be less than a finger space under your baby’s chin.

S is for Supported Back

Your baby should be carried upright in the carrier and be close to you so that their back is supported in a natural position and their tummy and chest rest on you.

WHAT TYPE OF CARRIERS ALLOW INWARD-FACING BABY CARRYING?

Two types of carriers encourage this type of baby wearing: ·

Wraps:
Wraps are a well-known and popular way of carrying your baby especially when they are small. They are generally made of one long piece of material that is wrapped in a specific way to support your baby. Although they can be tricky to use in the beginning, they can be appropriately adjusted to promote healthy hip development. No additional inserts are required when using it with a new-born.
Soft structured carrier:
A soft structured carrier could be described as your “typical” baby carrier. They have broad and padded straps which go over your shoulder and a padded waistband which fits comfortably around you. This creates a pocket of fabric in front for your infant to slip into. Most soft structured carriers require your baby to be 4-5 months old for inward facing as they have better head and neck control. Certain brands of carriers offer an infant insert which can be placed in the carrier allowing you to use it for a newborn.

WHAT ARE THE BENEFITS OF INWARD-FACING BABY CARRYING FOR THE PARENT?

The advantages of baby wearing are not limited to your baby. There are definite perks for you too:

Carrying your baby using a carrier leaves your hands free to do necessary daily tasks and play with older siblings.
It takes the load off of your arms as carrying a baby in your arms can be tiring.
It allows your baby to sleep with you while providing you the freedom to move around.
Baby wearing provides you with extra exercise.
Unpublished studies show that inward-facing carrying is the most ergonomic and functional way to carry your baby.

WHAT ARE THE DRAWBACKS OF INWARD-FACING BABY CARRYING FOR THE PARENT?

Carriers which are not adjustable may place added strain on your back, neck and shoulders.

VERDICT:

This is the “go to” way of carrying your infant in a carrier as it can be used for all age groups should your carrier allow it. This position promotes healthy hip and spine development if used correctly and it prevents overstimulation of a new-born.

WHAT IS OUTWARD-FACING CARRYING?

In this front carrying position, your baby's back is against your tummy and they are able to look outwards and face the world rather than facing you. This method of carrying an infant has been surrounded by a fair amount of debate through the years. The argument rested largely on whether carrying your baby outward-facing allowed their hips to be in a healthy position or not.

Experts argued that when carrying your baby in this position, their legs were prone to dangling and there was no support for them to bend their hips and knees. Another concern which was raised is that in this position, your baby’s back is straight which can negatively impact the development of correct spinal curves.

However, as time has progressed, carrier developers and manufacturers have become more aware of this and have adjusted their carriers to support the “frog-like” position required for healthy spine and hip development. The outward-facing position is therefore safe and healthy for your baby if you use an ergonomically designed carrier.

WHAT ARE THE BENEFITS OF OUTWARD-FACING BABY CARRYING?

If correctly executed by using a carrier which promotes a healthy hip position, the outward-facing carrying position can be beneficial for the following reasons:

It allows your baby the opportunity to view the outside world and see things from your perspective.
This can promote cognitive and speech development as your baby is included in more experiences and conversations.
Being close to you can help your baby feel safe and secure in new surroundings.

Are there any drawbacks of outward-facing baby carrying?

Not all carriers are able to support a healthy hip position.
There is the possibility of your baby’s hips and spine not being sufficiently supported in this position which can negatively impact their spine and hip development.
It is a little more difficult to position your baby outward-facing so that they are in a seated position with their knees tucked up and higher than their hips.
There is the possibility that your infant could become overstimulated in this position as a result of all the new things to see and hear.
It is more difficult to identify if your infant is becoming overstimulated as you are not able to see their face.
Your baby has nowhere to turn if they become overwhelmed and are not able to look at you for reassurance.
It is not a safe-position for your infant to sleep in as their head which is heavy would likely flop forward and this can compromise their airway.
It is difficult to support a curved spine when carrying your baby in this position.

WHAT AGE IS IT APPROPRIATE FOR ME TO CARRY MY BABY OUTWARD-FACING?

Carrying your baby in an outward-facing position requires your baby to have sufficient head and neck control as there is no place for them to rest their heads. This generally occurs around 4-6 months of age. However, your baby’s hips are still developing fast until 6 months of age. Therefore it is recommended that outward-facing carrying be delayed until your baby is at least 6 months of age.

When carrying your baby outward-facing there are specific points which need to be considered to ensure your baby is in the healthiest position:

Their legs are properly supported and are not dangling. To do this, the fabric seat of the carrier must support your baby’s bottom and thighs fully across the seat. In other words it should extend from the back of one knee to the back of the other.
Your baby’s knees are tucked up higher than their hips which helps maintain a “frog-like” position.
Your baby’s pelvis or bum is tilted forwards or tucked in.
Your baby’s back is slightly rounded.

WHAT TYPE OF CARRIERS ALLOW OUTWARD-FACING BABY CARRYING?

Wraps:
There is no scientific evidence or research which indicates that using a wrap for outward-facing carrying is unsafe or unhealthy for your baby. However, there is also no evidence supporting the use of wraps to carry your infant safely in this position. Most important to keep in mind if you choose to use a wrap for outward-facing is that the position your baby is in meets the recommended checklist guidelines.
Soft structured carrier:
Not all soft structured carriers allow you to carry your infant facing outwards. When choosing a soft structured carrier to use for outward facing purposes, make sure that it has been designed for that method of carrying and contributes to healthy hip and spine development. Most carriers will indicate on the box in which positions it may be used for.

WHAT ARE THE BENEFITS OF OUTWARD-FACING BABY CARRYING FOR THE PARENT?

The advantages of baby wearing are not limited to your baby. There are definite perks for you too:

This way of carrying your baby still leaves your hands free to do necessary daily tasks as well as play with older siblings.
Baby wearing provides you with extra exercise.

WHAT ARE THE DRAWBACKS OF OUTWARD-FACING BABY CARRYING FOR THE PARENT?

Outward facing carriers have been reported to add more strain on the parent’s back, neck and shoulders than when compared to inward-facing.

This is likely because in an outward-facing position your infant’s weight is more evenly distributed and their centre of gravity is closer to yours.

VERDICT:

The type of carrier you choose to allow your baby to face outward can either strongly support healthy joint development or it can increase the risk of unfavourable outcomes. It is also important that you do not rush to use this type of carrying as it is imperative your baby has sufficient head and neck control. The longer you wait to use this method of carrying, the more time your baby has for normal hip development.

WHAT IS HIP CARRYING?

Carrying your baby on your hip using a carrier allows your baby to rest on your hip while still encouraging healthy hip development. It is an easy position to get your baby into as they will naturally squeeze their thighs around you whilst the carrier supports their pelvis.

WHAT ARE THE BENEFITS OF HIP CARRYING?

Using a hip carrier is not only convenient but there are also benefits resulting from it:

This position allows your baby to have a full view of their surroundings as they are able to look backwards, forwards and sideways.
Your baby is still close to you and is able to see your face for reassurance or security.
Your baby is able to snuggle into you if they become overwhelmed or overstimulated.
It supports healthy hip development as it allows your baby to naturally assume a “frog-like” position.
It is often the most loved position by your baby.
It provides an ideal environment for your baby to follow and engage in social situations which helps develop their speech, cognitive and social skills.

ARE THERE ANY DRAWBACKS OF HIP CARRYING?

It can only be used when your baby has sufficient head and neck control.

WHAT AGE IS IT APPROPRIATE FOR ME TO CARRY MY BABY TO BE CARRIED ON MY HIP?

You are able to start carrying your baby on your hip once they have sufficient head and neck control which usually occurs during 4-6 months of age. They will also have more strength to grip their legs around you.

WHAT TYPE OF CARRIERS ALLOW HIP CARRYING?

Hip carrier seat:
A hip seat carrier fits around your waist only and provides an ergonomic seat for your baby to rest on. There is however no back support and require your arm for support when they are younger.
Ring slings:
A ring sling is a large piece of woven fabric with rings sewn onto the shoulder part which creates a sling for your baby to sit in. The rings are secured on the opposite side that you will be carrying the baby. As the structure of these slings can change each time you use it, it is important that you check the position of your baby’s hips to make sure they are “frog-like”.
Wraps:
Similar to ring slings, baby carrying wraps can also be used to support a hip carrying position. Using a wrap for hip carrying can be tricky to coordinate and achieve.
Soft structured carrier:
Some soft structured carriers allow you to carry your baby on your hip. Should you wish to use a soft structured carrier for your baby, make sure that the carrier you are using allows for it.

WHAT ARE THE BENEFITS OF HIP CARRYING FOR THE PARENT?

Carrying your baby on your hip can also have benefits for you:

There is less pressure and weight placed on your shoulders.

WHAT ARE THE DRAWBACKS OF HIP CARRYING FOR THE PARENT?

The majority of the weight is only carried on one side of your body. Therefore the other side compensates for the additional strain and this can contribute to back and neck pain.
You may not be able to use both of your arms as the carrier may be in the way.

VERDICT:

Carrying your baby on your hip with the support of an appropriate carrier is a great alternative to outward-facing carrying. It is easier to attain a healthy hip position and it allows your baby to have a wide view of the world and still be able to snuggle into you should they become overstimulated.

WHAT IS Back carrying?

Carrying your baby on your back is an age-old method which has been used for centuries in many cultures. This is a favourite position especially for toddlers as they enjoy being able to watch what you are doing over your shoulder.

WHAT ARE THE BENEFITS OF CARRYING YOUR BABY ON YOUR BACK?

Using a back carrier is not only convenient but there are also benefits resulting from it:

It provides your baby and toddler with a view over your shoulder which allows them to watch what you are doing.
If done correctly using the right type of carrier, it can promote healthy hip joint development.

ARE THERE ANY DRAWBACKS OF CARRYING YOUR BABY ON YOUR BACK?

It should only be used when your baby has sufficient head and neck control.

WHAT AGE IS IT APPROPRIATE FOR ME TO CARRY MY BABY TO BE CARRIED ON MY HIP?

Some resources indicate that it is safe to carry your baby on your back from almost any age. However these resources also indicate that it should be done with the necessary care and caution of protecting their airway as well as spine and hip development.

The majority of resources state that you should wait until your baby is at least 6 months of age as they then have sufficient head and neck control to support themselves in an upright position.

WHAT TYPE OF CARRIERS ALLOW BACK CARRYING?

Wraps:
A long woven wrap or sturdy piece of fabric is often used to provide your infant with the necessary support in this position. It may however take a little practice to ensure your baby’s hips are in the correct position. ·
Soft structured carrier:
This is often the go to carrier for carrying your baby on your back. Once more it is important that you make sure the carrier you are using is designed for this purpose and that your baby meets the required age and weight before using it.
Hiking carrier:
This is a hard structured carrier that can only be used for back carrying and typically used for carrying your baby while hiking. These can only be used from around 9 months old.

WHAT ARE THE BENEFITS FOR YOU OF CARRYING YOUR BABY ON YOUR BACK?

Carrying your baby on your back can also have benefits for you:

It enables you to be hands free whilst still having your baby close to you.

WHAT ARE THE DRAWBACKS FOR YOU OF CARRYING YOUR BABY ON YOUR BACK?

You are not able to see your baby’s face to gauge their reactions to situations or make sure they are content.

VERDICT:

Carrying your baby on your back makes it extremely helpful to get things done, however carrying your younger baby like this may be less convenient as they will frequently need to feed and be changed. Making sure your baby has sufficient head and neck control and that the carrier you are using is recommended for back carrying and supports a healthy hip position can make this a safe and useful method.