This article was first published in the Natural Parent Magazine, Issue 39, Winter 2020. This is one of my favourite photos babywearing with my son, around 18 months old.
Every parent, carer and health professional considers child development with utmost importance, yet what is child development and how can babywearing support it?
Child development “describes the changes in a child’s physical growth, as well as their ability to learn the social, emotional, behaviour, thinking and communication skills they need for life. All these areas are linked, and each depends on and influences the others” (1).
As a physiotherapist, physical development is obviously an area of focus, however provision of holistic care, that is providing support for the whole person, is essential for optimal health and wellbeing. Therefore, addressing one area of development cannot be considered without the others. Fundamental to all these areas of development is a child’s relationship to their carers and other family members. A loving, stable, and responsive connection with these important people provide a child with the safe and secure base they need to grow and reach their potential.
A child’s brain develops at an astonishing speed in the first five years of life, with all their experiences within these early years establishing the foundation for the rest of their life. All children develop at their own pace and babywearing supports development no matter the child’s stage or abilities: All children benefit from the positive effects afforded to them with babywearing.
PHYSICAL DEVELOPMENT
Babywearing best supports the physical development of a child when they are worn in the optimal position for hips and spine, with knee-to-knee support. An optimal position is upright, facing inwards towards the carer’s chest, with postural support changes as the child develops.
Healthy hips
The optimal position is when the hips are maintained in a spread-squat position – by supporting the legs knee to knee in the shape of an M, knees higher than buttocks. You can imagine this as the shape the child naturally adopts with their legs when you pick them up – the smallest of infants to the rambunctious preschoolers bring their knees high into the M-shape, helping them to cling to their carer.
The optimal hip position is described as 40° to 55° hip abduction and 90° to 110° hip flexion. In this position, the ball of the hip joint is pressed evenly into the centre of the hip socket, where it is most stable. Our infants adapt this position as they grow. Newborns hold their hips more bent, thus less spread is needed, and toddlers with straighter hips utilise more spread. As the child clings to their carer in the M position, the muscle action around the pelvis and thighs helps to press these two parts of the joint together, further supporting healthy hip development (2).
This is an important physiological consideration for children with any hip issues. Cultures where babywearing in the M-position is common, reportedly have lower incidence of hip dysplasia in babies than those cultures where infants are swaddled into straight hips and knees positions. For children with hip dysplasia, optimal babywearing supports them in the position provided by the splint or brace and reinforces the healthy hip position (and is a lot more comfortable for the carer too). For children with altered muscle tone, being worn in this optimal hip position is a lovely way to stretch and strengthen muscles and increase range of motion.
Healthy spine
Newborns demonstrate a rounded J-shaped spine which changes to a curved S-shaped spine as they achieve gross motor milestones. First the curve of the neck appears as the child can lift their head and sit independently, then the lumbar curve appears as they learn to stand and to walk. Obviously, the spinal support requirements for a newborn are much different for a walking toddler, however all children require the same support when they are asleep – namely head, neck and back support to ensure they can safely maintain their airways, which is especially important when they snooze against their carer’s chest in a carrier.
Babies are born with soft, pliable skull bones to allow for ease of birthing. This may lead to flattening of the baby’s head on one side (plagiocephaly), which may be associated with muscle tightening around the neck (torticollis). This can be difficult to manage if the baby spends a lot of time lying on their back for extended periods, especially with the resounding success of safe sleeping education programs addressing sudden unexplained death in infancy (3). Time spent in other positions is therefore essential to manage this condition and support physical development.
Tummy time is integral for developing head, neck, trunk, and upper limb control. Babywearing in the optimal upright position is a wonderful alternative for the child who is not enamoured with prolonged periods of tummy time. Babywearing also takes the pressure off the soft newborn skull bones, while allowing for stretching and strengthening of neck muscles. Additionally, movement experienced by the child stimulates the vestibular system within the inner ear and enhances neuromotor development and muscle strength.
Healthy bodies
Being close to a carer helps regulate a baby’s physiology, which is why skin-to-skin kangaroo care from birth is such an important part of caring for healthy babies, premature and unwell infants. The baby’s body temperature, heart rate, blood pressure, breathing, blood glucose and other body functions mimic that of the carer, supporting the child’s sleep patterns and conservation of energy. Gentle touch from a loving carer can help reduce the infant’s stress response, reduce pain and discomfort, and support healing and recovery.
SOCIAL, EMOTIONAL AND BEHAVIOURAL DEVELOPMENT
Babywearing helps a child to feel safe and secure and supports a strong relationship between them and their carer. A child that feels safe and attached to their carer is more likely to be more confident to explore the world around them. It also provides a safe space to return and snuggle into for a reprieve, trusting in the support, encouragement, and connection available to them. Social, emotional and behavioural development are overlapping and positively reinforce one another.
Communication
Babywearing holds a child close to their carer and supports development of communication skills. It is easy to quickly respond to a child who is communicating from the chest of their carer. Subtle communication such as babbling, facial expressions and other small gestures are easily recognised from such an intimate location. Responding to these cues with positive acknowledgement and action supports the communication process between child and carer. Back and forth interactions such as these reinforce speech and language development as the child learns how to indicate a need and have it addressed.
Crying is generally considered to be a late communication cue and babywearing has been shown to reduce crying in children, both frequency and duration. It follows that less crying means more time in positive interactions and promotion of learning. This also means the child can devote more energy to other things, such as exploring their environment and growing strong, healthy brains and bodies.
Learning about sounds, words and language is an essential part of literacy development. Babywearing helps surround a child with words, sounds, talking, storytelling, singing, listening, copying and more, helping to build a solid foundation for later literacy skills. Exposure to all these types of positive communication can support a child to grow their memory, vocabulary, listening and speaking skills, literacy, empathy, resilience and more.
Relationships
Loving connections from birth support establishment of optimal health and wellbeing throughout the child’s life. Responsive communication as outlined above supports the development of warm and loving relationships. Positive interactions between a child and carer develop the child’s confidence, resilience and communication which are skills essential for successful relationships.
In addition to the relationship with their carer, babywearing holds the child amid daily social interactions, almost eye to eye with others and keeps them involved in the activity. Being up close and personal with social interactions encourages communication development – voice, language, tone, postures are all experienced by the child and helps them learn about relationships and communication with others, appropriate or otherwise. During these shared experiences, children can learn all about greetings and farewells, be a part of conversations between other people, observe interactions between familiar people and strangers.
Babies also learn how to manage their emotions through interaction with their carer. They learn by observing the response of their carer to different situations and can be easily calmed and reassured if they get a fright or join in the laughter when things are funny. And if it all gets a bit much, they can snuggle into their carer, close their eyes and snooze.
Babywearing need not be restricted parents nor adults either. Older children love the opportunity to connect with babies and delight in babywearing. They tell stories, go for walks, soothe, sing, dance, play and relish the opportunity to snuggle and teach little ones about the world – and put them to sleep!
Sleep
Sleep patterns of each baby is unique and depends on such things as their developmental maturity at birth and genetic disposition. Infant sleep is influenced by two powerful forces – sleep pressure and the circadian clock (4).
Sleep pressure explains how the longer the period awake, the increasing feeling of sleepiness, resulting in a daytime nap to take the edge off or falling asleep at the end of the day. The circadian clock describes how the body adapts to the 24-hour period of an earthly day, with daylight being a powerful cue to set the circadian clock. Newborn circadian clocks can take up to six months to mature and babywearing can support this by providing exposure to environmental cues which help differentiate day and night.
Wearing a child from birth in a carrier during the day can help them to calibrate their circadian clock more rapidly, by exposing them to all the hubbub of activities of daily living. Environmental cues that signal active days and restful nights can help develop the circadian clock include daylight, conversation, other children’s noise, banging doors, music, snuggles, barking dogs, cooking, singing, and whatever noises represent a family life. The stimulation of the day contrasts to the quiet darkness of night-time and helps regulate healthy sleep. Over time, as the child develops, so do sleeping patterns, keeping in mind that it is biologically normal and protective for babies and toddlers to wake during the night for the first few years of life.
It is safe for your baby to sleep in a carrier in an optimal, supported, upright position, fitted according to the SAFE acronym available at http://thebabywearingpractice.com.au/
Secure – baby is securely attached to the carer’s body
Airways – baby is upright, head is neutral, mouth and nose are unobstructed, chin is off chest
Firm – baby is firmly held in the carrier, with no gaps between baby and carer’s body or carrier
Eyeline – baby is in view and you can see them easily
Summary
In the words of eminent babywearing advocate, Dr Rosie Knowles, babywearing matters (5). Babywearing is a wonderful allrounder in supporting the development of a child. It is a holistic way of addressing all facets of growth for a child, physically, emotionally, and socially in the early years. The child explores and learns about the world in comfort from the security and safety of the carer’s chest, meaning children can go beyond where their abilities can take them and giving them a strong foundation for them to fulfil their potential and contribute to our society.
Kato x
For more evidence-based information and resources on healthy child development, visit