Hip Dysplasia and babywearing?

This is mostly a “catch all” post pulling together things I’ve written other places. So it’s not perfectly organized, but keeps me from having to sift through years of Facebook posts to find these things.  Most of these are from late summer/early fall 2012.

A while ago I posted this (just so that we’re clear that I am REALLY not a fan of the Baby Bjorn original style carrier):

Look, hate the Bjorn because it’s not comfortable for heavier babies. Hate it because it’s an awkward thing. Hate it because it turns people away from babywearing as “too uncomfortable” at a time when babywearing becomes supremely useful. But terrifying parents that they’ve damaged their children’s spines by using a bjorn for a few hours a day for a couple of months? SHOW ME THE GODDAMNED RESEARCH. Bjorns are not the same as swaddling or cradleboards, which CAN cause hip problems.

Yes, there are better, cheaper, whatever carriers out there. But let’s not make parents feel like shit about something that’s probably better for their kid than hanging out in a carseat all day (and we’ve got research on why that’s not a good idea…)

This was posted:

Along with a link to Boba’s blog and a rant about front facing out being awful.

I responded:

I’d really like to see the research specific to the Baby Bjorn that says that that kind of carrier causes hip dysplasia. Swaddling the hips tightly, sure, but the Bjorn is not the same position as a tight swaddle, and swaddling tends to be done 24/7 whereas babywearing (especially facing out) is very time limited in comparison. 

I don’t like the Bjorn for a lot of reasons, but I think it is hyperbole to tell parents they are harming their child by using it, and I’m tired of us not supporting parents in doing what it takes to nurture their babies in a way that works for them. 

It is very easy to get snobby and elitist about “good” carriers vs. bad carriers, but I really just love seeing people wear their babies however is comfortable for them and their baby. If the Bjorn is working for someone, great, I just hope they don’t stop babywearing entirely when their baby gets too big for the Bjorn. 

As for front facing out… People need to get a grip. Overstimulated babies show clear signs of overstimulation. They yawn. They hiccup. They rub their eyes. They cry. They go to sleep. If your baby is not doing those things, your baby is probably not overstimulated, and front facing out isn’t hurting him. One of the arguments FOR babywearing is that babies get more stimulation being up at parent-level. So again, making parents feel bad because it’s not a position you like? Really not cool. 

I’ve been babywearing for more than 19 years, and doing babywearing education for 18 years, and I have seen some wacky and dangerous carriers. The Bjorn is merely short-lived and potentially uncomfortable. 

The spine-and-hip development argument started with an opinion by a chiropractor, and what has followed from that is essentially a circle-jerk of people referencing each other, NOT research, not anything scientifically defensible. What we do know is that babies in arms tend to cry less and be happier than babies who are not worn. We know that we get more done without making our babies scream while we do it when we wear our babies. We know that babies airways need to be protected. We know that we should stay alert and aware of our babies while they are being worn. We do not know if the few hours a week most Bjorn users use the carrier are actually harmful, but the odds are low that they are.

If there was good, solid research showing the bjorn was harmful to spinal development, there would be a huge fuss from doctors and we’d be scrambling to differentiate the bjorn from other carriers in the eyes of the public. There is not. So until there is, give families a break, and be glad that that baby on the left is grinning…. and what the dad is doing looks like fun too. The baby on the left is attached to mama, and that’s the important thing, no?

 

 

So then….
I contacted the International Hip Dysplasia Institute to ask them about what research they had to support their claim that Bjorn-style carriers cause hip dysplasia, since their graphic was being used all over the Internet to support that claim. Here is their response:

From the IHDI Medical Advisory Board –

Thank you for contacting us and expressing your concern.

The International Hip Dysplasia Institute does not endorse or advice for or against any type of infant carrier. As you have noted, there are many benefits from baby wearing that must be weighed against any potential for harm to the hips. You are correct that there is no evidence for or against baby carriers as a cause of hip dysplasia. It is regrettable if our statments are being used inappropriately as “evidence” as you have indicated. However, there is ample evidence that hip dysplasia is influenced by environmental factors including swaddling. More than 90% of hip dysplasia is discovered in adolescents and young adults as early onset arthritis. Those individuals did not have neonatal hip instability that is the widely recognized form of early dysplasia. This suggests that the hips in the arthritic variety do not develop properly at some point in time although they were not detectable during infancy. Breeds of dogs that are susceptible to hip dysplasia have normal hips at birth and do not develop the arthritic form of hip dysplasia when they are prevented from walking until six weeks of age. In human studies, hip dysplasia is more common in Northern climates and in those born during winter months. Thus, there are potential influences for hip dysplasia besides swaddling. Our advice is to maintain the hips in a natural position for the first few months of life while the joint is forming, ligaments are often loose, and muscle contractures are still present.

We hope that this response is helpful to you. Should you have any further questions or concerns, please don’t hesitate to ask, we will help in any way that we are able to.

Regards,

Susan Pappas
Assistant to Charles T. Price, MD, FAAP
Director International Hip Dysplasia Institute

So there you go. I’d buy swaddling as something that exacerbates hip dysplasia, but swaddling and bjorns are entirely different, stress-wise.

Another post…

So it’s driving me crazy how the babywearing community seems to have turned into piranhas about this carrier or that carry being “unsafe” or “bad” simply because they don’t fit some perfect ideal of what babywearing should look like in that person’s mind. Y’all know how much I love babywearing, but carriers are TOOLS.

Babywearing is something that may approach religion for some, but for most is simply a convenience. If I’m just hauling the baby from the car to the couch, I may stuff my kid in the top of a mei tai, standing in it, hanging half out of it with one hand holding him in. Is is perfect babywearing? No. Would it be safe if I took my hand off him or was trying to wear him for hours? No. Is it functional for the 40 steps from the car to the couch? Sure.

There are MANY carriers out there that are not perfect. For me, wraps are not perfect, especially for back carries. My teenager could tell you how many times she’s rescued the baby off my back with me with a sour expression on my face because something went horribly wrong while I was trying to get a specific back carry to work. I have mobility issues right now. While I *can* bend more than most people, I really shouldn’t because it damages me. So there are back carries that just aren’t functional for me. Does that make wraps “bad carriers” or “inherently unsafe” just because I can’t get it right? No. It just means they aren’t the right carrier for ME with this baby, at this stage in my life with this mobility level.

And don’t get me started on front facing out. After watching my friend Kimberly carry her daughter on her hip facing out(without a carrier), and watching many men carry their babies sitting facing out on their arms like their arm was a chair, I cannot abide the argument that front facing out is “unnatural” and I get stabby when people start ranting about how it overstimulates babies or will somehow warp their hips for life. How about instead we talk about how to wear babies in a way that is in touch with what they need? How about we talk about being in tune with signs of overstimulation (hiccuping, yawning, looking away in tiny babies, getting hyper in older babies, rubbing eyes, griping) and that an overstimulated baby should be turned around? How about we discuss getting babies into a well-supported position instead of scaring parents that somehow they’ve damaged their babies? Trust me, they haven’t.

I will say this. There is no one right way to wear babies. There is no one perfect carrier that works “best” for every situation or family. People need to get off their high horses and get some perspective.

Some gorgeous babywearing photos have been posted recently, and the comments are full of how those parents are doing it wrong. GET A GRIP, PEOPLE!!!! Just because you don’t like wearing your ergo on your hips and your baby throws a hissy if he can’t see over your shoulder doesn’t mean that smiling baby on his daddy’s back is somehow miserable because he’s “too low”. Talk about off-putting. You want more people to wear their babies? How about you don’t criticize every detail of how they wear their babies? Save it for the real unsafe stuff, like babies deep in pouches with their chins on their chests and blankets over their heads. Save it for the situations where real safety issues are present. Quit giving people a hard time because it’s a bjorn or it looks funny to you or wasn’t what you were taught.

 

The nice thing is that the dominant attitude among most babywearing experts that I know (and I know a lot of babywearing experts) is now “Practice, not product”, which teaches that babywearing is a skill, not a specialty item. And in that vein:

http://canadianbabywearingschool.com/?p=17
“Practice, not product”

http://canadianbabywearingschool.com/?p=749
“Why is Arie wearing a Bjorn?” How to make a bjorn more comfortable.

http://beltwaybabywearers.blogspot.com/2014/02/lets-get-real.html
Awesome, awesome post on babywearing as a practice and a skill, and getting past the “quest for perfection” that can be so defeating.

 

And an amusing postscript… Bjorn has made a website saying basically what I’ve been saying (we don’t have research to say front facing out is bad). But they recently announced a carrier that they are developing in conjunction with the IHDI, with better hip position. It is hard to imagine how better hip position would NOT create a more comfortable carrier. So yay, change.

And lest anyone jump in with “if you had hip issues you might take this more seriously…”

I have hip issues. I have hip issues galore. In me, they are not caused by being worn in a frontpack. They are caused by childbirth. And having Ehlers Danlos through three pregnancies. (I was born with uneven creases and developed severe hip pain during the birth of my second child, and have been dealing with hips that don’t like to stay properly aligned and a sacrum that goes wonky at the drop of a hat ever since. None of which has ANYTHING to do with how I was carried in infancy.)

Posted in Baby Carrier Review, Baby development, Babywearing.

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