Babywearing: Why I don't DO "FFO".

Twice this past week the debate about wearing your baby in a front or forward-facing-out (FFO) position has come up in two separate babywearing Facebook groups that I belong to. I have weighed in on both of these discussions and felt that since it was coming up so much within these groups, that I should share this information and my thoughts on the whole topic with everyone! In case you are wondering what FFO is or what it looks like. This is what I am talking about. A baby being worn on your front, facing out and often is a stretchy wrap carrier or some version of a Baby Bjorn type carrier.


I have several opinions on this matter and I want to start with just that. What I am about to post here is MY OPINION. It is based on my experience as a babywearer and babywearing educator. It is based on what I know and what I have been taught about basic newborn, infant and adult physiology and it is what I BELIEVE  are best practices when it comes to babywearing. Some will disagree with me and say that because there is no hard and fast peer-reviewed research and evidence stating one thing or another, that we can not say what are or are not best practices in this situation. To those people, I will respectfully agree to disagree and have to go with my gut on this one!

I do not believe that carrying or wearing your baby in a front/forward facing out (FFO) position is a babywearing best practice for the following reasons:

1. HIPS!

Ok, I may be a bit over sensitive about hips in general, given that I have had not one, not two, but three hips surgeries, but this is important! When babies are born their hips are not fully ossified and the outer edges of the hip sockets are made of soft cartilage, much like the cartilage of your ears. According the the International Hip Dysplasia Institute,

"If the hips are forced into a stretched-out position too early, the ball is at risk of permanently deforming the edges of the cup-shaped socket (hip dysplasia) or gradually slipping out of the socket altogether (hip dislocation). Hip dysplasia or dislocation in babies is not painful so this may go undetected until walking age and may also result in painful arthritis during adulthood."

Most forward facing carries and carriers do not support a baby hips and do indeed have them 'dangling' in a legs-stretched out position. And while this may not seem like a big deal for the 20-30 minutes one can actually withstand this carrying position before your back and shoulders give out (more on that later), doing this for extended periods of time and over time can potentially cause harm.

Now you are saying to yourself, but Natasha, Baby Bjorns have been around FOREVER, they can't be that bad for babies. And I will chalk this one up to one of those "when we know better, we do better" kind of situations.  And you are right, they may not be necessarily BAD for babies, but there are so many other carriers that are BETTER!

2. It's not always ALL about the baby.

At no other time in your life will your pelvic floor be as weak as it is than after you have a baby. And just like any other muscle group, it needs work to strengthen it again postpartum to avoid the nasty effects of a weakened pelvic floor, you know, like...incontinence or worse...prolapse!

When you are wearing a baby in a FFO position, the weight of the baby tends to pull away from your body. This make you want to adjust your posture and lean back a bit to compensate for this. What happens next is that this position automatically makes you tilt your pelvis in a way that exerts direct pressure onto your {already weakened} pelvic floor. Not only this,  but your now adjusted posture also puts a fair bit of pressure on your back, shoulders and hips and really, it is no wonder that you don't want to do this for very long!

Using a baby carrier or carrying your baby in a position that keeps them closer to you and in a tummy-to-tummy position (or on the hip or back in similar position) keeps your centre of gravity, well... in the centre and allows  you to have better posture and keep excess pressure off your pelvic floor.

3. We are two pieces of an amazing little puzzle.

Think about this for a minute. We are women. We have breasts and bellies and curves and somehow, no matter what shape or size we are, right down the centre of us is this spot that is the exact square footage needed to fit a baby. Their tiny heads rest on our breastbone and listen to our hearts beating. Their arms and legs curl up and they try to regain the flexed position of warmth and security that reminds them of being in the womb. When you pick up a baby, they automatically pull up their legs into a nice fetal tuck. They are naturally adapted to being carried and just like a squishy little puzzle piece, they are looking to be placed right onto their special spot on your body!

Placing a baby in a FFO position is like trying to put a piece of the puzzle together, but one of the pieces is backwards!

4. Sometimes it is all just TOO MUCH!

Think about walking through a busy mall.

People walking towards you and past you on all sides. Fountains and piped-in music and vendors and snippets of people's conversations all around. I don't know about you, but even for me a trip to the mall can be overwhelming. Now pretend  you are a tiny little baby in a FFO carrier trying to take all this in? It can be a lot for their little minds to process. I often see babies in FFO carriers exhibiting signs of stress and/or overstimulation. This can include balled fists, kicking legs or arms, lots of verbalization and straining to see/turn around to Mama or Daddy.

Babies need to feel secure and safe, especially in new or loud surroundings and often in a FFO position, they simply do not get that.

5. We don't want to lose them.

No, not the babies, the Mamas!

Most mainstream forward-facing carriers do not provide the wearer with proper support for their backs or shoulders. I see a lot of mamas wearing Baby Bjorns or Snuglis or even stretchy wraps with babies that are WAY too big for their carrier and every one of these mamas will tell me that their backs are killing them. I truly believe that these kinds of carriers and carries do more harm to babywearing as a whole than good. I have heard far too many times from mamas who feel that their 5 or 6 month old babies are "too big for babywearing" because they have used a carrier that causes them discomfort or they have not been educated about their options in the babywearing world.

This is a big part of why I am a babywearing advocate and educator. I feel very strongly that babywearing and all the incredible health and wellness benefits that go along with it need to be incorporated on a larger (public health?) scale into prenatal education. It is why I am so honoured to be part of great local prenatal programs like this one and beyond thrilled to see more and more soon-to-be-mamas attending workshops or requesting private consultations.

AND finally, if you look to nature and the way that all other primates carry their babies, you will never see an ape/orangutan/chimpanzee or any other monkey carrying their young in a FFO position!

Babies just FIT onto us tummy-to-tummy (or on our backs). It is why we are built the way we are and why they are born the way they are. Why fight nature?

Happy Babywearing Everyone!