Baby Sling Safety

The Consumer Product Safety Commission issued a warning today about baby slings.

Here it is, emphasis mine:

The U.S. Consumer Product Safety Commission (CPSC) is advising parents and caregivers to be cautious when using infant slings for babies younger than four months of age. In researching incident reports from the past 20 years, CPSC identified and is investigating at least 14 deaths associated with sling-style infant carriers, including three in 2009. Twelve of the deaths involved babies younger than four months of age.

Slings can pose two different types of suffocation hazards to babies. In the first few months of life, babies cannot control their heads because of weak neck muscles. The sling’s fabric can press against an infant’s nose and mouth, blocking the baby’s breathing and rapidly suffocating a baby within a minute or two. Additionally, where a sling keeps the infant in a curled position bending the chin toward the chest, the airways can be restricted, limiting the oxygen supply. The baby will not be able to cry for help and can slowly suffocate.

Many of the babies who died in slings were either a low birth weight twin, were born prematurely, or had breathing issues such as a cold. Therefore, CPSC urges parents of preemies, twins, babies in fragile health and those with low weight to use extra care and consult their pediatricians about using slings.

Two months ago, the Commission added slings to the list of durable infant products that require a mandatory standard. Additionally, CPSC staff is actively investigating these products to determine what additional action may be appropriate. Until a mandatory standard is developed, CPSC is working with ASTM International to quickly complete an effective voluntary standard for infant sling carriers.

CPSC recommends that parents and caregivers make sure the infant’s face is not covered and is visible at all times to the sling’s wearer. If nursing the baby in a sling, change the baby’s position after feeding so the baby’s head is facing up and is clear of the sling and the mother’s body. Parents and caregivers should be vigilant about frequently checking their baby in a sling.

CPSC is interested in receiving incident or injury reports that are directly related to infant slings. You can do this by visiting www.cpsc.gov/cgibin/incident.aspx or call CPSC’s Hotline at (800) 638-2772.

(I can't get the image to look right. Try clicking on it, or follow the link.)

The wording is not as precise as I would have liked; the word "sling" can be broadly applied to lots of soft carriers for infants. I believe they mean for this to refer primarily to ring-style or pouch slings, as pictured, and I wish they had stated this more carefully.

I do agree with this warning, for the most part, with the qualifier about which type of sling is referenced. I support and encourage (and practice) babywearing, but certain styles of sling are not appropriate for the youngest babies, as the CPSC correctly warns.

As stated, there are two mechanisms for suffocation. The first is smothering by the fabric itself. The second is positional asphyxia. In lay terms, suffocating due to being in a position that obstructs breathing.

The scary thing about positional asphyxia is that it's harder for the parent to notice than you might think. Babies can't squirm their way to a better position, and can't really even gasp effectively. They might make a "grunting" noise, but to the untrained ear that sounds like innocent sleeping noises. Turning blue is of course a very late sign of trouble, but if the baby is tucked away inside the sling the parent might not even see that.

Babies are most at risk for this when they are curled up excessively, in a "C" position, with chin to chest. So watch out for any carrier that puts baby in that position. Such carriers should be saved for when baby is bigger. I'm thinking here of pouches like Hotslings, or ring slings like Maya Wrap or Taylor Made or Dr. Sears. These are not dangerous items, but I would not recommend them for the first few months. At the very least, watch your baby like a hawk and check on him frequently.

Other types of carriers are a better choice for newborns. I've been using my Moby Wrap and feel good about my newborn in that. Even so, I check on him a lot. He can occasionally slump over too much into a "C" position, so I watch for that. Other wrap style slings (used in the positions recommended for newborns), or structured carriers like Baby Bjorn (I hate this; it hurts my shoulders. But I do feel like it's safe enough in this regard.), Ergo, and similar carriers are best for the littlest ones.

You want your baby fairly upright and tummy-to-tummy. If you are using a horizontal position, then he needs to face straight up, not toward your tummy (because there will be a layer of fabric there to support his weight and you don't want it on his face.) You want to be able to see his face. If he nurses while in the sling, reposition him when he's done. Again, check the illustrations above.

Another potential danger is baby simply falling out. There have been multiple reported injuries of this type. I'm not really addressing that here. It feels more like an issue of user error to me, honestly. And it seems hard to blame the product. I mean, anyone can drop a squirmy kid from their bare hands. Are we going to put labels on those too? Frequently check the position of your baby as you walk. Make sure he hasn't shifted around and isn't about to fall on his head. Don't engage in vigorous athletic activity. Apparently people have to be told this sort of thing.

I am not always a supporter of safety labeling and disclaimers on every product under the sun. Nanny state, and all that. But if these labels are going to go anywhere, baby products are probably the place to start. So I support some notion of safety standards and labeling requirements for commercially-made slings. And I get the notion of "err on the side of safety." Sure. I haven't checked the packaging on slings lately, including the specific brands I listed above. I don't know if they carry any warning about positional asphyxia or not, but they should.

Here is my concern. Newspaper and website headlines and the evening news can give a false impression and lead to unnecessary fear. My fear is that too many people will hear the take-away message as "Baby slings are dangerous." Period. Any sling, for any baby, ever. Can't you just hear the evening news? "Deadly trap for your baby!!! Tonight at six."

People like Don Mays of Consumer Reports don't help the situation. "Don't use slings at all. There are safer ways of carrying your baby than in a sling." This is an absurd overstatement. He writes: "Clear instructions and perhaps video demonstrations might help prevent mistakes. But, as we all know, consumers may not read the instructions, and misinterpretation or misunderstanding can lead to errors that can endanger precious cargo." Isn't that argument a bit of a slippery slope? Maybe the government should come to your house and read the instructions for you.

So take the warning for what it is, and don't read anything into it that isn't there.

Watch out for the positioning of babies four months old and under. Make sure they can breathe.

And while we're talking disclaimers, I guess I'll make my own. I'm not your doctor. This is not medical advise for you.