Hips correctly aligned at between 110 and 120 degrees, spine concave (not straight or convex), head off the chest, baby upright: how important is the “optimal positioning checklist” anyway? Important enough to be overwhelmed by? Are you damaging your baby if it’s not perfect? Do you give up now and just do your best to carry your baby about in your arms?
In short: there are safe positions and there are unsafe positions. There are optimal positions and pretty good ones. Three out of four of those categories are fine. Some are better- we should aim for optimal positioning. But if it takes you awhile to get there, as long as your positioning is safe, it’s OK to be imperfect while you’re learning. All parenting is imperfect, we just do the best we can. It’s the same with babywearing.
Safe positioning follows the TICKS guidelines. These guidelines cover front carries only, but are broadly similar for back carries. The TICKS guidelines suggest
T: Tight- the baby sling should be tight around your baby
I: In View at all Times- the sling or your clothes should not cover the baby’s face. You wouldn’t put your baby to sleep in a cot with a blanket over their head: you wouldn’t do it in a sling either.
C: Close Enough To Kiss – your baby should be high enough for you to bend your head and kiss his/her head.
K: Keep the Chin off the Chest- your baby should not be slumped down into the carrier with his/her neck bent over on itself.
S: Supported Back- your baby’s spine should be supported in a natural shape.
Following these guidelines keeps your baby’s airway clear and your baby comfortable. They also provide a great position for you too. You can find a copy of the TICKS print out here.
So what about perfect spine and hip positioning? These are optimal, but aren’t required for your baby’s immediate safety. Good hip positioning with the baby in the ‘m’ or frog-legged position promotes healthy development of the hips. Letting the baby dangle in the carrier can exacerbate cases of developmental or congenital hip dysplasia, but there is no evidence that this positioning causes it in the general population. Ideally, a baby should be frog-legged with his/her knees somewhere around his/her navel.
A rounded spine that is not concave (curving inwards) also promotes healthy spinal development, is more comfortable and natural for the baby. Like suboptimal hip positioning, it can exacerbate existing problems, but there is no evidence that it causes problems.
Good spine and hip positioning is worth working on- it’s more comfortable for the baby and better for its development. But if you’re having trouble making it work first-time, don’t despair. Your positioning may not be perfect, but as long as you are following the TICKS guidelines, it is safe.
Here is a picture of a baby with good hip and spine positioning and all the TICKS guidelines. Bear in mind that a hand-held iPhone isn’t giving the best angle and the seat is very deep because of her age and size: newborns will have a considerably shallower seat: just remember the knees/navel rule of thumb. (Thanks to Mel for pointing out that angle!)
Note the gentle, rounded curvature of the spine (she’s not slumped), her knees are in line with her navel, her head and airway are clear and visible, she’s easily kissable.
There is only one thing you need to worry about when it comes to babywearing positioning: safe positions. Keep working on the rest as best you can and it will soon all fall into place.