As a parent, placing your baby facing out towards the world while carrying them may seem to be the perfect solution to keep them content and allow them to connect with their world. All of this whilst still being close to you which provides them with any reassurance they need. Although it seems to be a win-win situation for both baby and parent, carrying your baby forward facing in a carrier is somewhat of a controversial topic. One of the main concerns raised by professionals is that babies are placed in this position before they are safely old enough to do so.
The earliest a baby should ever be placed forward facing in a carrier is 6 months of age. A baby who is younger than this does not yet have sufficient neck and head control and there is also a concern that their hips and spine are not adequately supported in a healthy position.
There is much more which should be considered when carrying your baby forward facing than simply turning them around in their carrier.
When is it safe to carry a baby in the outward facing position?
There are a few factors which contribute to the fact that it is safest to start carrying your baby forward facing when they are 6 months old.
While some manufacturers indicate you can allow forward facing from 3 months of age, it is important to also take into consideration your baby’s growth and development.
Factors influencing the age at which a baby can forward face are:
- A baby’s head is considerably larger and heavier than the rest of their body. This coupled with the fact that very few of the muscles they need to support their head up have developed sufficiently, means that a baby younger than 6 months of age should not be carried forward facing in a carrier. Not only are their heads too heavy to hold up but their muscles have also not yet been activated to help them.
- Another fact which supports this age is that a baby’s hips develop rapidly during the first 6 months. This means that it is vital that they are carried in a position which supports healthy hip development. Not all forward facing carriers allow for correct hip and spine positioning as they may not support a “frog’-like” position of the legs or maintain a “c” curl of their spine.
- It is also around this time that your baby begins to show more interest in their surroundings as they are awake more. You may notice them trying to turn their head to see things if they are facing you. This is also related to the fact that the improvement in their head control and neck strength allows for their eyes to better focus on objects, begin tracking items and see more colours.
- In order to be able to be carried in this position, your baby needs to be tall enough. A baby who is tall enough for a forward facing carrier is able to place their chin higher than the top of the carrier.
While there are no specific guidelines regarding how long your baby can be carried forward facing in a carrier for, it is generally suggested that they spend a maximum of 20-30 minutes at a time.
What constitutes strong enough head and neck support?
In the first month or so your baby will begin to lift their head up while lying on their tummy. This progresses during the next two months to them lifting their head up higher and starting to raise part of their chest off the floor. By 4 months of age, your baby should be able to hold their head up on their own unsupported. Although this may appear as though they have sufficient head control, your baby still needs to build endurance which will help them be able to maintain that position for longer periods of time.
In order for a baby to be able to support themselves in an upright position, which is needed when facing outwards in a carrier, they need to be able to keep their head up using minimal effort. At the same time, they should be able to turn their head from side to side and up and down with ease while using controlled and purposeful movements. This generally coincides with the time during which they are able to sit using their hands to support them. As they continue to get stronger, generally around 7 months old, they are able to sit independently without relying on their hands.
Why is carrying your baby in a forward facing position not recommended?
There are a few core reasons why this position is not one which is frequently recommended, especially before 6 months of age.
Your babies hips and spine are not in the optimal position:
This is generally one of the main arguments professionals use when indicating why forward facing of an infant, especially one younger than 6 months, should not be done. While there is no scientific evidence to prove that this position is harmful, it is known that the inward-facing position is seen as hip healthy.
To promote healthy hip development, the National Hip Dysplasia Institute, indicates that your baby’s hips and legs should be in a “frog-like” or “M” shape position when they are carried. In this position their hips are bent and naturally spread apart with their thighs being supported completely by the carrier. Their knees are also bent and sit higher than their bottoms while their pelvis tilts back. A carrier that has a narrow seat area is not able to support the length of your infant’s thighs and results in their legs dangling down. The forces which this places on your baby’s hips, especially with extended use, can contribute to the development of hip dysplasia.
To support the natural development of the curves of their spine, it is important that your baby’s back remains in a “c” curl. As they develop head control and neck strength, the natural curves of their spine then begin to develop. Carrying your baby forward facing makes it more difficult to encourage the natural development of spinal curves. When your baby is placed in a position they are not yet physically ready for, certain muscles are challenged too early which can increase the pressure on certain places of the spine. This can result in the curves becoming too deep or not deep enough in addition to other structural changes.
Your baby may become easily over stimulated
One of the concerns of your baby facing outwards too early is that their brains are not yet able to process all of the new things they are seeing and hearing. They are not yet able to ignore or sift through information which is coming in through their eyes and ears and only take note of things which are important or necessary. A busy environment such as a shopping centre can become very overwhelming for a baby especially when they face outwards to the world. As an occupational therapist, having a baby who is overwhelmed with sensory input, can result in them becoming unsettled and difficult to calm down and sleep.
In this position, it is very difficult for your baby to try and reduce the amount of sensory information they are getting as they are not able to turn their heads into your chest. It is also difficult for you to pick up on signs that your baby is becoming overstimulated as you are not able to see their face. For example, a baby who tries to look away or stops making eye contact with you can mean that they are becoming overwhelmed with sensory input.
Another possible sign of overstimulation in your infant is if they start hiccupping (not directly after a feed). If you are able to pick up these signs early on, you can reduce the amount of sensory input they are receiving and use other therapeutic strategies to help your baby regulate again.
This position does not provide your baby’s head and neck with sufficient support:
This is especially concerning should your baby fall asleep while forward-facing in a carrier. Due to the weight of their head and reduced neck strength, there is a natural tendency for their head to flop forward. If this were to happen in the inward-facing position, their head would rest on the carrier's chest and their breathing would not be obstructed. However, if this occurred in a forward-facing position, their chin would rest on their own chest which can compromise their airway.
Therefore there is no safe position for your infant to sleep in when forward-facing in a carrier. It is often indicated in the manual of reputable carriers that your infant must be turned around should they fall asleep while forward-facing.
This position is not as comfortable for the wearer:
The National Hip Dysplasia Institute points out that unpublished studies show that carrying a baby inward-facing is more comfortable for the wearer. This is because the baby’s centre of gravity is closer to the wearer’s as they are higher up.
A baby who is forward-facing in a carrier is in essence suspended from the carrier’s shoulder’s. This is especially true as a baby who is carried inwards naturally wraps and grasps their legs around your waist which reduces the strain on your core muscles.
What are the benefits of carrying your baby forward-facing?
While there are certain things to be aware of when carrying your baby forward-facing your baby in a carrier, allowing them to do so after 6 months of age can be beneficial for the following reasons:
- At 6 months of age, your baby is becoming more aware and interested in their surroundings and so forward-facing continuously allows them to experience new sights and sounds while still being close to you.
- By being close to you they are able to adjust being in the outside world while feeling safe and protected.
- They are exposed to more conversations and social interactions which can promote their speech and language skills as well as cognitive abilities. This includes increased exposure to various facial expressions and body language.
- It allows your baby to experience everyday tasks and activities.
- They are able to experience the world from your perspective as opposed to viewing things from lower down when they are in a pram.
What types of baby carriers are best for forward-face carrying?
Generally speaking, most types of carriers can be used forward-facing as long as they promote ergonomic carrying. An ergonomic baby carrier is one which allows for optimal positioning of your infant as well as comfort.
When using a soft-structured carrier for forward-facing, it is essential that the seat portion of the carrier supports your infant's thighs from their hips to the back of their knees. This will assist in encouraging correct hip positioning. Also be sure to read the manufacturer's instructions as this will guide you regarding the age at which your baby may forward-face as well as any other important information regarding this position
Traditionally, experts feel that wraps are the best way to forward-face your infant as they promote ergonomic babywearing. They are easy to adjust and ensure that your baby’s hips form an “M” shape to promote healthy development.
CARRIERS THAT CAN BE USED OUTWARD FACING
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