• Zoe

Feeding and using slings/carriers

I recently attended the online Slingababy baby-carrying and infant feeding course which was such a great experience. It is aimed at those with experience in supporting others in carrying or in infant feeding and it is a super course which I would highly recommend if you support parents at all.


It is very unique to have this overlap in a course and is suitable even if you have no experience in carrying. It is inclusive of all infant feeding options and as well as discussing the theory and why it might be useful. We explored and practised, trying different things with different carrying options and various positions.


One common thing I've heard in relation to this topic is that feeding and slinging or carrying are things that you need to be able to do well separately before trying together.

To be honest this never sat well with me, although I have said this in the past myself, it just isn't helpful to most people and it also wasn't my personal experience either.


Often people come to using slings/carriers for a variety of reasons but one of these might be an unsettled baby and this may be linked to feeding issues such as reflux or tongue tie for example. A sling/carrier can be such a useful tool to help support parents on their feeding journey. And this was certainly the case with my experience of feeding my babies.



BOTTLE-FEEDING

Parents that are bottle-feeding can find the closeness really helpful in boosting oxytocin and feelings of calm and connection. There are two main positions that tend to be used when bottle-feeding and using slings/carriers, ensuring infant's back is supported to enable paced feeding (useful link on paced feeding from Unicef).




The upright/vertical option is more common however seated sideways across the body can be a good position for younger babies who need some head support and it allows for more space if baby doesn't want to turn their head to the side to feed, as often they like trunk and head in line. Some infants also prefer this position. South Essex slings has some super useful videos here using a variety of types of carriers. These images show a variety of types of carriers including buckle carriers and woven wraps.



It is possible in all types of slings/carriers. Some may require more adjusting than others. It is worth exploring different options for you and your child to find the most comfortable.


As your child grows and develops then it is worth thinking about changing positions or angles as they gain head control for example or want to hold the bottle themselves, just ensure that you can see their face and airway is clear at all times.


Images kindly shared with permission from MotherRucker and South Essex Slings,


It can be helpful for those tube feeding as well, using same positions above, depending on the tubes and position, it can free up your hand, using your arm to support baby's head.






KEY CONSIDERATIONS

- It is not a hands free solution

- Carer needs to ensure monitoring airways at all times

- If your child falls asleep, remove bottle and support head ensuring away from any squishable body parts or adjust positioning back to central upright

- Suffocation is a risk to be aware of especially in those with low muscle tone i.e. under 3months or those with health concerns


BREASTFEEDING

Generally you are not going to be able to move your breast quite as much as you might a bottle so it terms of the positioning you are going to be guided by your breasts. It is useful to think about;


- how they are positioned

- their height

- their shape and

- the angle of the nipples

All of which can differ significantly person to person but also left breast to right breast.


Another consideration is access; you do need to be able to easily access your breasts so thinking about what you wear is important. The one top up one top down method doesn't work very easily with waistbands and things across your body, so tops with easy access or that are stretchy, or feeding specific access are quite helpful.

It can be useful to wear a feeding vest, then the sling/carrier and a cardigan or wraparound top over the top. The Can I breastfeed in it is a great website for feeding clothing compatibility sharing clothing that works well for breastfeeding/pumping.

There is a huge amount of flexibility in the positioning much like breastfeeding, it is just that the sling provides some support so you don't have to hold all of the child's weight in your arms. Having some additional physical support can be like having an extra arm!


It doesn't even need to be using something specific to the purpose of carrying, A scarf or shawl can be a useful tool to help as a carrying aid. Here Deborah of South Essex slings shows this with a simple scarf;

Generally breastfeeding in a sling/carrier is NOT going to be handsfree. Much of the time your child will need head support, Of course as they get older and they can support their own head this is less likely to be the case but if they get sleepy they may still additional head support. Your hand or crook of arm or your opposite hand can be used to provide head support.

Zoe feeding a baby across the body position, supporting baby's head with arm, sat on rocks, with the beach in the background wearing a grey babywearing coat with the hood up and sunglasses on. Baby is wearing a hat with a bobble on.


This can mean you have the use of hands or one hand during feeding. which can be useful in many ways. The key aspect when breastfeeding in a sling is to ensure the child's airways are clear at all times and in order to do this their face/head needs to be clear of any obstructions (including covers/back of sling etc). This is extra important once they have finished feeding and are perhaps sleeping. As breast tissue is very soft this may be a suffocation risk, ensuring that your child's face is moved away from this, either by angling or by adjusting their position or adjusting your breast significantly reduces the risk. Of course every body is different and thus the risks differ considerably,


Emma feeding baby (5 weeks old) in a ring sling, across the body image kindly shared with permission


The safest position is to move your child to after feeding is an upright position, however if you are sitting down and do not want to move baby (quite understandably no one wants to disturb a sleeping baby!) simply moving/angling their face away from this area can help and key is to monitor this as it is something that can change moment to moment, for example resting their head on the top of your breast higher up rather than below it.


Positioning can be across the body, rugby hold, or vertical, but it is adaptable to what works for you and your baby.


Reasons it can be helpful with latching is that baby hasn't got specific pressure points rather they are gently being supported all over their body which can help calm them.


It can help to hold baby up high away from delicate areas especially if you have undergone surgery. So the sling/carrier is taking the weight of your child rather than your tummy for example.


Zoe breastfeeding an older baby in a hip carry position upright in a woven wrap.


It is important to remain aware and focused on your child whilst feeding in a sling, by all means play with your older child(ren), do some light jobs, eat lunch, have a drink but it is paramount you are aware and mindful of the risks and mitigate these by staying attentive.


A stretchy wrap is super flexible for feeding in, it is easy to move baby from upright position to feeding across your body and back to upright without taking them fully out of the sling.



The same method can be used with the close caboo which is what I am using in this image. Note this is real life it is not a curated image! Baby was well supported and safe in the pouch of fabric. It is not about how it looks but how it feels to you the person carrying.



A buckle carrier can be adjusted to feed in; across the body or rugby hold for those without head control is likely to be more suitable. Methods vary a little bit as to the type of carrier whether it is an H strap or ruck strap carrier or a cross strap carrier. These videos are useful:


Generally when baby has some head control a vertical position can be a good option as it requires less adjusting of straps and baby's position.




KEY CONSIDERATIONS

- It is not a hands free solution for young babies

- Carer needs to ensure monitoring airways at all times

- If your child falls asleep, support head ensuring away from any squishable body parts by angling or moving things or adjust positioning back to central upright

- Suffocation is a risk to be aware of especially in those with low muscle tone i.e. under 3months or those with health concerns.


This is a super helpful checklist from Deborah at South Essex Slings



SCIENCE OF CARRYING SUPPORTING BREASTFEEDING


There has been little research on this specifically however one study has shown that using a sling/carrier can help support breastfeeding.


Pisacane et al. (2013) found those given slings were more likely to be breastfeeding at 2m and 5m compared to those not given slings.


While breastfeeding rates were similar in the two groups at the discharge from the maternity ward, breastfeeding was significantly more likely among the mothers in the intervention group, ie those given a baby carrier, both at two 47% vs 32% (ebf) and 74% vs 51%, (any bf) and at 5 months of age 8% vs 1% (ebf) and 48% vs 24% (any bf).


So at 5m double the amount in the sling group were still having breastfeeds compared to the no sling group.


Why carrying had this positive impact could be due to a variety of reasons;

- oxytocin release via contact

- responsive to cues quicker

- bio-feedback, smells, noises,

- physically can be like having another hand, offering support so arms aren't taking all the weight

- ability to feed on the move


They found those who carried regularly were feeding their infant's more frequently and also had more night feeds. They only asked mothers to use the carrier for at least an hr a day in the first month. It was self-reported rather than measured. They didn't measure carrying after this period. So it is interesting to see there was a significant difference on infant feeding which they can only put down to the carrier use.


The hormones and interactions involved in feeding and carrying are hugely linked and complex so it is likely through the dyadic nature of building responsiveness as well as the oxytocin releases during soft touch that helped to support infant feeding.


They state that "the use of baby carriers during the first month of life is feasible and can be associated with more frequent day and night feedings and with a longer breastfeeding duration."


There are many other studies which have looked at the impact of breastfeeding on mental health, bonding and attachment via the links with oxytocin as well as stress, trauma and separation all impacting negatively on infant development and maternal mental health so things that will support connection and soft touch are potentially hugely impactful.


It is not the sling or carrier that is magic itself but what it can help facilitate; both through the practical aspects as well as the physiological mechanisms.



Zoe is a trained and insured carrying consultant, based in the Surrey Hills, Supporting you to carry safely, comfortably and confidently. Sharing the science behind carrying, supporting infant development and parents/carers mental and physical health.

For more on the science see other blog posts or my feed on instagram.

Zoe is available for consultations both in person and online to help you get carrying and runs workshops for professionals on infant carrying and the science behind it.

She writes and speaks on attachment, trauma, adverse childhood experiences and how carrying can be a prevention and intervention.