Slings, Other ‘Baby-Wearing’ Products Leave Infants at Injury Risk: Study

Slings and other popular “baby-wearing” products have sent thousands of U.S. infants to the emergency room in the past decade, a new study finds.

Researchers estimate that between 2011 and 2020, more than 14,000 infants nationwide ended up in an ER because of an injury related to a baby sling or other carrier. In more than half of cases, the baby fell out of the carrier.

The most common injury was a traumatic brain injury — which includes concussions and more serious head trauma. And while most babies with those injuries were able to go home after being seen in the ER, about 21% had to be hospitalized.

Baby slings are ubiquitous these days, and no one is trying to scare parents away from them, said lead researcher Dr. Samantha Rowe.

The products can allow closeness and bonding, helping to soothe babies and allowing parents to have a free hand, noted Rowe, a pediatrician at Walter Reed National Military Medical Center in Bethesda, Md.

But parents should be sure they know how to use them properly, and pediatricians should know how to offer advice, Rowe said.

She presented the findings at the recent annual meeting of the American Academy of Pediatrics. Studies reported at meetings are generally considered preliminary until they are published in a peer-reviewed journal.

The results are based on data from a national injury surveillance system. Rowe’s team estimates that between 2011 and 2020, 14,024 infants were treated in an ER for injuries related to baby-wearing products.

Young infants accounted for most injuries: More than 60% occurred in babies age 5 months or younger, and almost 84% of those infants sustained a head injury.

According to Rowe, it’s not clear whether one type of product carried more risks than others. But she and other experts noted that fabric slings may present particular issues, versus more-structured carriers.

“Slings with excess fabric require practice securing them before you place your baby inside them,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City. “Practice indoors in a safe, carpeted or padded area on the floor. You should first practice wrapping the sling around your body and then making adjustments to the fabric.”

He suggested first using a doll or stuffed animals for those trial runs.

What’s key, Glatter said, is that babies rest “snugly and comfortably” against the caregiver’s chest, in an upright position. That position, versus a cradling one, allows infants to breathe more easily and have a view of their surroundings, he noted.

A basic rule of thumb is to carefully read the instructions that come with a baby-wearing product, said Christine Vitale, a registered nurse and injury prevention manager at Children’s Hospital of Pittsburgh.

The products might seem simple, she said, but “tweaks” can make a difference. And fabric wraps, Vitale noted, require a particular technique to be used safely. She advised parents to make sure they are buying a product from a reputable source that includes instructions on safe use.

While the study found that infant falls were common, so too were caregiver slips and tumbles. They accounted for 22% of infant ER visits.

Vitale said that adults should resist the temptation to carry items in both hands when they are baby-wearing. “Make sure you always have one hand free,” she advised.

That way, caregivers will be better able to catch themselves, or their infant, if they trip or slip.

Glatter agreed, noting that “distracted walking” — such as using a smartphone — may contribute to some accidents. Add to that the fact that carrying a baby in front of you can alter depth perception and changes the body’s center of gravity.

“If you do bend down,” Glatter said, “remember to bend at your knees, using your hands to support your baby’s body.”

Vitale agreed that parents should be aware that baby-wearing affects their own center of gravity. That may be particularly important, she noted, for fathers. Mothers are more used to added weight because of pregnancy.

More information

The American Academy of Pediatrics has advice on baby slings and carriers.

SOURCES: Samantha Rowe, Capt., MD, pediatrician, Walter Reed National Military Medical Center, Bethesda, Md.; Christine Vitale, RN, MSN, injury prevention manager, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center; Robert Glatter, MD, emergency physician, Lenox Hill Hospital, New York City; American Academy of Pediatrics virtual annual meeting, presentation, Oct. 11, 2021