Babywearing is SAFE-Baby Carrier Industry Alliance (BCIA) Position Paper

This is an amazing time to be a parent.  And for me one of the things that has truly "made" me the mama that I am is babywearing.  I would have never discovered attachment parenting, I probably would not have breastfed my kids for as long as I did (and still am) had it not been for my ability to do this while babywearing.  And I surely would not be in the business of babywearing (retailer and educator) had the practice of babywearing not been part of our parenting. All that being said, I feel that it is very important to post the following.  It is an excellent document from the Baby Carrier Industry Alliance (BCIA).  The BCIA exists to increase awareness of the value of quality baby carriers and to support those in the baby carrier industry.

The following is the Baby Carrier Industry Alliance's Position Paper on Babywearing and Kangaroo Care with Endorsments from Leading Experts in Babywearing.  Please read and know that babywearing is a very good thing and it is a safe practice that can make a world of difference for you as a parent and for your child.

I also encourage you to consider donating or becoming a member of the BCIA (at whatever level you can afford) to ensure that we as consumers will continue to have good quality, mom-made and parent tested slings and soft carriers to wear our babies in!

Thanks everyone, Natasha~

BCIA POSITION PAPER Over the last year, much misinformation and unwarranted fear has been cast on sling style carriers through announcements by Consumer Reports and the Consumer Product Safety Commission (CPSC), as well as the recall of the Infantino Slingrider. The Baby Carrier Industry Alliance (BCIA) is aware of research supporting the overwhelming benefit of baby carriers and knows that the view that sling carriers are unsafe is wholly inaccurate. In fact, the chance of an individual being struck by lightening is twice that of the mortality rate of children while being worn in baby slings.

Using a soft baby carrier (“babywearing”) supports baby and mother’s biological need to be together. For mothers, it facilitates initiation and ease of breastfeeding as well as helps mothers form attachments to their babies, care for themselves and their babies during the newborn stage and avoid postpartum depression. In addition, babywearing is practical, comfortable and convenient for caregivers. For babies, it decreases infant crying, colic and infant acid reflux disease. It promotes healthy physical development of the spine, vestibular system, vision and other systems in babies. It optimizes the mental development of babies because worn babies have an enriched environment which, in turn, helps their brains to develop better. Babies in slings spend more time in the quiet alert state known to be optimal for learning and development. Further, it helps babies develop socially and keeps babies safe from the multitude of surrounding hazards of every day life.

For a parent to realize these benefits, it is essential that the carrier(s) used mimic in-arms carrying and allow the baby and mother to be in maximum contact with each other. The baby should be cuddled directly against the caregiver’s body, with the baby’s head ABOVE the caregiver’s chest, near the caregiver’s collarbone. Ideally, physical obstacles between parent and child should be eliminated, allowing for proper skin to skin contact, also known as kangaroo care, and breastfeeding. While there are alternate baby holding devices available to parents, nearly all of them fail to meet all of these requirements the way that traditional babywearing and sling-type carriers do.

Over the last 20 years, there have been an estimated seven million sling-type carriers sold in the United States and additional untold numbers imported by immigrants or improvised by parents of various cultures. As an industry in its infancy, the baby carrier industry needs leadership to grow past the grass roots, “do-it-yourself” stage. With over 100 years combined experience in the baby carrier industry, the BCIA is uniquely positioned to lead the way.

As parents and leaders in their field, members of the BCIA are conscious of safety with regard to their carriers and are constantly working to improve safety and comfort for both baby and caregiver. In April of 2007, several of the leading US manufacturers approached the American Society for Testing and Materials, now called ASTM International, with a request to participate in developing standards for sling-style carriers. They have worked with the ASTM since April of 2008 and are very close to achieving their goal of a sling standard.

This standard will join the standards for cribs, strollers, hand-held infant carriers, bouncer seats, play yards and other nursery products as a way to protect the public from unsafe products. As with many of these standards, the BCIA hopes that any mandatory standard will conform to this ASTM industry standard. The BCIA will also join with the CPSC and other representative manufacturers on educational campaigns promoting the safest environments for babies and toddlers.

Babies under the age of four months, with their immature respiratory systems and lack of muscle strength and control, are especially vulnerable to death and injury. This susceptibility is magnified when they are left unattended. Keeping babies close and under direct supervision, such as when they are carried in a sling-style carrier, is the best way to ensure their well being.

The Consumer Product Safety Commission (CPSC) recently issued a warning about the dangers of using baby slings, due to the occurrence of three infant deaths that the agency attributed to baby slings. As parents, we are deeply saddened by these tragedies and extend our heartfelt condolences to the families affected. As educators, we are dismayed that the CPSC has mistakenly lumped all carriers together and inadvertently tainted our industry as a whole. The carrier in question is structurally distinct from baby slings in general and the BCIA is working to clarify this difference. Sling-style carriers have an exceptional safety record. While the death of any baby is tragic, the small number of deaths in sling-style carriers only serve to emphasize the safety of these products.

Baby slings are the optimal place for babies to spend time safely developing and bonding to parents in a nurturing environment. Research shows that this caregiver attachment and stimulating, safe environment are critical to early childhood development. Parents, educators, advocates, manufacturers, and our civil servants need to stand together to maintain the rights of babies and allow parents to buy, make and use baby slings. 

BCIA Mission: The Baby Carrier Industry Alliance (BCIA) is an alliance of industry leaders that was organized to share standards across the industry, promote educational outreach, participate in research and help small businesses comply with standards. The BCIA works with the ASTM and CPSC to ensure that parents and babies continue to have access to the safe, quality baby carriers that emulate in-arms carrying, providing the greatest benefit to both caregivers and children.

The Baby Carrier Industry Alliance (BCIA) is firmly committed to the development, health and safety of all infants. We believe that sling-type carriers and other traditional baby carriers are superior to any alternative products in which a baby might spend his or her time. Our mission is to promote a parenting mode called “babywearing” which is the practice of using a fabric carrier, more or less constructed, to hold a baby or young child securely to the torso of an adult, typically the parent. The goal of BCIA is to protect children by ensuring that the products that facilitate this practice remain widely available to consumers and are safely used.

ENDORSEMENTS FROM LEADING EXPERTS on BABYWEARING

Maria Blois, MD 7/2010 Author, Babywearing: The Benefits and Beauty of This Ancient Tradition “My heart goes out to those parents who have lost their babies while trying to hold their babies close in a sling. The CPSC warning is very important if it can help us prevent even one death. It is important to understand that any baby carrier or holder can be used in an unsafe manner and certain carriers can promote improper positioning simply by their design. This does not mean that the act of babywearing is unsafe. On the contrary, when done properly, wearing our baby close in a soft carrier can actually help make us more responsive to their needs, ensuring a safer environment. The key to safe babywearing is responsiveness. We must be aware of our baby even while they are in a soft carrier. The soft fabric of a sling means that we are able to use our hands from the outside to check on baby and make sure that baby is comfortable and breathing easily. As a physician, I would welcome good randomized controlled trials supporting the best positioning for infants in baby carriers and the best designs to promote this optimal positioning. Until then, our best guess is that baby should be held upright, visible at all times, mouth and nose clear, and head and neck should be in good alignment. In order to best learn from the CPSC warning, we should know what types of slings were involved and the circumstances surrounding the deaths. Babywearing is wonderful for parents and for babies. Beyond the convenience aspect, the early bonding facilitated by soft carriers is crucial to proper early infant neurological and physical development. Babies need to be in-arms and slings can help us do that. Human beings have been safely wearing their babies in fabric carriers for centuries. Our current efforts should be about education and understanding how to make babywearing safer for everyone."

Dr. Evelin Kirkilionis, Deutsch Hebammenzeitschrift 7/2010 “a child .. placed upright in a suitable baby carrier or embraced firmly and properly in a wrap, supported and upright against the body of the parents, firmly embraced by the fabric, which ensures that even the smallest little one will not sink into himself ending in an over-curvature of the spine, staying out of the danger zone of the little head being forced into a position that will compromise the breathing. The upright supported posture allows even very small babies moving patterns that are usually not seen until two to three month 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.”

Roy M. Nuzzo, MD, FAAOS,FAAOP, POSNA, New Jersey, USA Cultures that carry babies with the child’s legs spread apart, such as riding on the mother’s hip, have, by far, the lowest incidence of hips that go on to be bad. African mothers have the best track record of all. Their protective way of carrying babies is unbeaten – held in an open-legged position by a sling-bandana. Cultures that wrap legs together in one way or another (swaddling, etc.) just plain destroy hips. Swaddling of children leads to waddling adults.

Prof. Dr. Ernst J. Kiphard, Institute for Sport Science, University of Frankfurt/Main “Infants who are carried around everywhere in this baby sling either on the hip, on the stomach or on their mother’s back develop better than those who spend most of their time in a baby cot. This applies equally to their motor, cognitive and emotional development. Parents generally only rock their children when they want to calm them down or reassure them. Eminent pediatricians and orthopedic specialists recommend the sling for the following reasons: the baby’s eyes see very much more of their surroundings. This provides more stimuli for the infant’s brain. The mother’s movements stimulate all skin receptors but also the organs of movement and balance. Every time the centre of gravity shifts the reflexes of both the nerves and muscles are stimulated. The intensive eye- and body contact with the mother or father (because he too should carry the infant) imparts a feeling of safe wellbeing whose psycho-social importance is immeasurable.”

Prof. Dr. med. Büschelberger (Dresden) “The head of the thighbone in a newborn is ideally orientated towards the hip socket – and thus fills it out evenly-when the legs are pulled up to approx. 100 degrees and spread approx. 40 degrees at the same time. When infants are picked up they take up this posture spontaneously and therefore it has to co-operate with their anatomic conditions. As well, the rounded back (kyphosis) doesn’t stretch out immediately after birth. On the contrary, the well-known double-s-form of the spine is developing fully at the beginning of self-supported walking. These anatomic conditions, together with the palmar grasp reflex of the first days in life, suggest that infants are especially adapted to being carried on our body. Thus, it is possible to make a statement about the ideal carrying position: with wide-spread,flexed legs, slightly rounded back and orientated towards the carrying adult."

Eckhard Rolz PhD, South Dakota “The greatest expression of love is holding and carrying your baby. For centuries, humans have carried their children much of the dayundefineduntil the invention of the stroller and the portable car seat. It is the most natural thing to carry a baby close to your body. A child needs physical contact and must be held for proper physical and mental development. In today’s society, we must do every thing we can to help our children be well-adjusted. A baby sling or carrying cloth is the most natural way to facilitate these needs. In addition, parents who carry their children create a special bond between them and the child that will last forever. We have used slings extensively and I recommend them to every mother and father.”

SCIENTIFIC RESEARCH Perinatol, J. (1991). Current knowledge about skin-to-skin (kangaroo) care for pre-term infants. Journal of Perinatology 11(3), 216-226. Anisfeld, E., Casper, V., Nozyce, M., & Cunningham, N. (1990). Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment. Hunziker, U. A., & Barr, R. G. (1986). Increased carrying reduces infant crying: A randomized controlled trial. Pediatrics, 77(5): 641-648. Barr, R., et al. (1991). Crying in !Kung San infants. Developmental Medicine and Child Neurology, 33, 601-610. Bergman, N. J., Linley, L. L., & Fawcus, S. R. (2004). Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns. Acta Paediatrica, 93, 779-785. Carter, S. C. (1998). Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinology, 23, 779-818. Charpak, N., Ruiz-Pelaez, J. G., Figueroa, Z., & Charpak, Y. (1997). Kangaroo mother versus traditional care for newborn infants <2000 grams: A randomized, controlled trial. Pediatrics, 100(4), 682-688. Chomosky, N.(1998). Language and problems of knowledge. Cambridge: MIT Press. K Christensson, T Cabrera, E Christensson, K Uvnäs–Moberg, J Winberg, Karolinska (1995) Separation distress call in the human neonate in the absence of maternal body contact Christensson, K., Siles, C., Moreno, L., Belaustequi, A., de la Fuente, P., Lagercrantz, H., Puyol, P., & Winberg, J. (1992). Temperature, metabolic adaptation and crying in healthy full-term newborns cared for skin-to-skin or in a cot. Acta Paediatrica, 81, 488-493. Douglas, P. S. (2005). Excessive crying and gastro-oesophageal reflux disease in infants: Misalignment of biology and culture. Journal Title, volume(issue), page numbers. Durand, R., Hodges, S., LaRock, S., Lund, L., Schmid, S. Swick, D., et al. (1997). The effect of skin-to-skin breast-feeding in the immediate recovery period on newborn thermoregulation and blood glucose values. Neonatal Intensive Care, 10, 23-29. Ruth Feldman 1 , Aron Weller 1 , James F. Leckman 2 , Jacob Kuint 3 & Arthur I. Eidelman (1994) The Nature of the Mother’s Tie to Her Infant: Maternal Bonding under Conditions of Proximity, Separation,and Potential Loss Gerber, M. (1958). The psycho-motor development of african children in the first year and the influence of maternal behavior. Journal of Social Psychology, 47, 185-195. Gray, L., Watt, L., & Blass, E. M. (2000). Skin-to-skin contact is analgesic in healthy newborns. Pediatrics, 105, 14. Hensinger, R. N. (1989). Spondylolysis and Spondylolisthesis in children and adolescents. Journal of Bone and Joint Surgery, 71A, 1098-1107. Insel, T. R. (1997). A neurobiological basis of social attachment. American Journal of Psychiatry, 154, 726-735. Lamb, M. E. (1982). Individual differences in infant sociability: Their origins and implications for cognitive development. In H.W. Reese & L. P. Lipsitt (Eds.), Advances in child development and behavior (Vol. 16, pp. 213-239). New York: Academic. Landau, R. (1982) Infant crying and fussing: Findings from a cross-cultural study. Journal of Cross-Cultural Psychology, 13, 427-444. Littlefield, T. R. (2003). Car seats, infant carriers, and swings: Their role in deformational plagiocephaly. Journal of Prosthetics & Orthotics, 15(3), 102-106. Ludington-Hoe, S. M., Lewis, T., Morgan, K., Cong, X., Anderson, L., & Reese, S. (2006). Breast-infant temperature synchrony with twins during shared Kangaroo Care. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35, 1-9. Messmer, P. R., Rodriguez, S., Adams, J., Gentry, J. W., Washburn, K., Zabaleta, I., & Abreu, S. (1997). Effect of Kangaroo care on sleep time for neonates. Pediatric Nursing, 23(4), 408-414. Meyer, K., & Anderson, G. C. (1999). Using kangaroo care in a clinical setting with full-term infants having breastfeeding difficulties. American Journal of Maternal Child Nursing, 24, 190-192. Moore ER, Anderson GC, Bergman N. (2007) Early skin-to-skin contact for mothers and their healthy newborn infants. Pelaez-Nogueras, M., Field, T. M., Hossain, Z., & Pickens, J. (1996). Depressed mothers’touching increases infants’ positive affect and attention in still-face interactions. Child Development, 67, 1780-1792. Schmid, S., Swick, D., Yates, T., & Perez, A. (1997). The effect of skin-to-skin breast-feeding in the immediate recovery period on newborn thermoregulation and blood glucose values. Neonatal Intensive Care, 10, 23-29. Schön, R., & Silvén, M. (2007). Natural parentingundefinedBack to basics in infant care. Evolutionary Psychology, 5(1), 102-183. http://www.epjournal.net/filestore/ep05102183.pdf Tessier R., Cristo, M., Velez, S., Giron, M., Ruiz-Palaez, J. G., Charpak, Y., et al. (1998). Kangaroo mother care and the bonding hypothesis. Pediatrics, 102:17. Wahlberg, V., Affonso, D., & Persson, B. (1992). A retrospective comparative study using the kangaroo method as a complement to standard incubator care. European Journal of Public Health, 2(1), 34-37. Wall-Scheffler, C. M., Geiger K., & Steudel-Numbers, K. L. (2007). Infant carrying: The role of increased locomotory costs in early tool development. Skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: a randomized, controlled trial. Pediatrics 113(4):858-65.

Contact: Baby Carrier Industry Alliance PO Box 27 Laveen, AZ 85339 (512) 943-2242