A Physical Therapist’s View on: The Dangers of Improper Babywearing

I know there is a lot of debate in the babywearing community about correct babywearing. Carriers that only have a small strip of cloth between the crotch to support baby don’t allow a comfortable seat to sit in, and they also leave their little legs dangling freely, hence the common name “crotch danglers”. Some people feel that no matter what you are wearing baby in, you are keeping them close to you and promoting bonding and security. While this is true, I feel that if I am going to wear my baby, I not only want her to be comfortable, but safe as well. When I started researching the dangers of improper babywearing and hip dysplasia, I quickly realized there wasn’t any evidence clearly linking poor babywearing to hip problems. However, since my husband is a Physical Therapist and has dealt with hip dysplasia in children before, I thought I’d see what his take on this subject was (as well as encourage him to check hip dysplasia research to see what he could  find). I should add that technically our daughter Avery has a very mild for of hip dysplasia, so we have dealt with a few hip issues ourselves. After Carl did a bit of research, he came to a few conclusions of his own that I asked him to share with you today! 

Even Avery was startled by this poor example of babywearing.


After doing an exhaustive search through medical journals and sites, I have found that there are no recorded instances of baby carriers causing hip dysplasia.  But, there is a reason for that. Hip dysplasia is a developmental condition that starts from birth that is often related to genetics or a breach birth.  The problem is that improper baby wearing can accelerate or make the problem worse.

Hip dysplasia is the abnormal formation of the hip joint.  It can range from very mild, such as just having loose ligaments around the hip, to severe, where the hip is dislocating (popping out) from the hip joint.  Even in its mildest form, hip dysplasia can lead to severe problems in later years of life, where the cartilage around the ball of the hip is damaged. This can end up leading to osteoarthritis and eventually, to a hip replacement in older adults.  Often in the early stages of mild hip dysplasia babies and children may not even experience pain or show any symptoms whatsoever.  Pediatricians do often check for hip problems in babies, and hip dysplasia is the most common hip developmental deformity in children.  It is estimated by the Center for Disease Control (CDC) that 1-2 of every 1000 babies have hip dysplasia.  However, many more go undiagnosed, as it may be too mild to even detect.  These cases may not even present problems until later in life such as early adulthood.

Look at my horrible early babywearing skills!

If a baby is diagnosed with hip dysplasia, they may be placed in a Pavlik harness or casted to promote a V-shape of the hip to allow for normal growth and development.  In a worst-case scenario set of circumstances, surgery may be warranted.   The best treatment for hip dysplasia is early detection and prevention.

So how does this affect baby wearing?  If a baby is diagnosed with even a mild case of hip dysplasia, the International Hip Dysplasia Institute recommends proper baby wearing that supports the baby’s hips in a V form, not using crotch danglers that may lead to further complications and degeneration of the hip. As stated earlier, many cases of hip dysplasia are undiagnosed.  If our children are diagnosed with a problem, do we not do everything we can to help them overcome their problem and give them every chance to live life to the fullest?  What if your baby or child has a very mild form of hip dysplasia that is not yet known?  The possibility of developing problems later in life is great.  As I said earlier, prevention is key. After talking with colleagues that specialize in pediatric physical therapy, and reading posts by several chiropractors and doctors, proper baby wearing will promote proper growth and development of the hip joint.   Proper babywearing places the baby or child’s hips in that V-Form I mentioned, with their knees higher than their bottom.  It supports the hips and keeps the ball of the hip tight into the socket.    So I ask you, do we wait to hear of our children’s pain and problems later in life or do we take steps now to give our children the steps to maximize their potential.  I know where I stand.

So there you have it. If you have any questions for Carl or myself, please leave us a comment! And of course, if you are interested in a safe, comfortable baby carrier for you and your baby, visit the TMD shop for lots of great options.

 

 

17 Comments

  1. Kelly V -  October 22, 2012 - 8:55 am

    Thank you for writing this!! I have had several friends who I tried to “sway away from” crotch danglers and they never found any evidence. I’ll be sending them here now!

    • Kelli -  October 22, 2012 - 4:38 pm

      Thank you! I’m glad you liked it, and I hope your friends read the post!

    • Sandra -  October 9, 2013 - 7:31 pm

      I think the best and safest carrier is the KiwiPeewee carrier. It is a new carrier on the market where the baby is seated on a seat, supported under the bum in the natural sitting position. It solves the “crotch dangler” problem and is super comfortable. And our baby can face inward OR outward. The problem with the Ergo is that the baby can’t face outward, whereas the KiwiPeewee enables both inward and outward. Great carrier. http://www.kiwipeewee.com

  2. Heather P. -  October 22, 2012 - 9:42 am

    Thank you for writing this! Good to have “something on paper” about it.

  3. Heidi -  October 22, 2012 - 10:27 am

    I have photos very similar to this from when I had Karoline. Thankfully Karoline didn’t really like to be worn, especially facing away from me so it was a rare occurrence.

    • Kelli -  October 22, 2012 - 4:38 pm

      Yeah, I wish I had known! Which is exactly why I love to share this with people now. I had no idea. Know better, do better, right? 🙂

  4. Evie -  October 22, 2012 - 11:31 am

    This is great! Any way you can add pics of recommended babywearing? With a seat that extends knee to knee with knees above the bum?

    • Kelli -  October 22, 2012 - 4:40 pm

      Any of our babywearing pictures here on the blog will be of carriers demonstrating correct babywearing. And Xza’s post on Splurge vs. Budget babywearing has a lot of great ideas for good carriers! My favorite are my woven wraps, my DidyTai, and my Angelpack. 🙂

    • Kelli -  October 22, 2012 - 4:40 pm

      I should add that any of our babywearing pictures on the blog with the exception of THIS post, which I show improper babywearing examples. 🙂

  5. Stephenie -  October 22, 2012 - 1:32 pm

    As an person that was born breech, has close family with hip problems, I still was never diagnosed with hip dysplasia. Now as an adult, I have CONSTANT pain in my right hip (diagnosed OA) and spine. My mother says she wore me in a sling, but didn’t know of the “better options” of wearing, oh so many years ago. I advocate for proper babywearing positions as often as I can. However, I STILL would rather see babies being worn, than not at all.
    This is a great piece, and I will definitely pass it on! I KNOW that it makes a difference, whether there are “documented” pieces or not.

    • Kelli -  October 22, 2012 - 4:41 pm

      Thank you so much for sharing that Stephenie!

  6. Allie -  October 22, 2012 - 9:22 pm

    Thank you for writing this and trying to get the word out about proper baby wearing. I do have a question however a friend brought to my attention. I have a 6 mo who I “wear” a lot. I froggied his legs (the v-form up against his chest) in a ring sling until he was about 3 mo and always pushed his legs out. So now, I wrap his legs around my torso (allowing his legs to hang out of the carrier) but always make sure his knees are still above his bum. A friend told me last week that his legs were spread too far and could potentially cause problems with hip dysplasia. I had always heard and learned as long as his knees were above his hips as you wrote, but just wondered if you had come across the legs being too far apart as a cause for concern through your research? And info would be appreciated! Thank you again, I’ll be sure to share this!

  7. Olivia -  October 22, 2012 - 10:17 pm

    Thank you for sharing this important information! I am wondering, we use the moby wrap and love it, but how would I go about keeping his knees above his bottom?

  8. Amanda -  November 24, 2012 - 11:59 pm

    Hi, I’m always reading about the effects on baby, but never about effects on parents. Since your hubby’s a physical therapist, I thought I’d ask. I wore my first two babies in a Maya Wrap sling ALL the time. My third I wore in a Moby, Mei Tei, and sling. Unfortunately, I started having chronic pain in my neck on the side where I usually wore the sling. I would love to see an article written about safe slinging – the importance of placement, and changing sides to keep the body even. Now, with my fourth, I can hardly wear at all, because even the most supportive two-shouldered wrap carries cause me pain.

    Thank you!

  9. Mariah -  February 7, 2013 - 1:14 pm

    Hi Kelli!
    It was really nice to read this but I would like a little more clarification on the “V” you describe for hip placement. I checked out the TMD Shop website and in all the pictures of carried babies I noticed that their legs are widespread around a mom’s back, side or front. Do those pictures represent the position you describe well? With my son I used a Moby wrap, which we both loved, but once he was around 6 months I was placing the fabric between and under his legs to wrap around my waist. Any further info would be great so I can be prepared the next time around.

    Thanks (:

  10. North London Sling Library -  February 9, 2013 - 11:09 am

    Fabulous article thank you! I have shared amongst our fans!

    As a point of interest, for anyone that struggles to obtain a correct position for their child or who needs extra help in using their ergonomic carrier to its full extent, I would absolutely recommend visiting a Sling Library or Sling Meet. Very often free advice is provided by long serving babywearers or babywearing consultants to parents who wish to wear their children. Libraries and meets are popping up all over the US and Europe so there is bound to be one near you. Another, more personalised, option is to enlist the services of a babywearing consultant who will visit your home with a selection of demo carriers and full explain how to use the carriers in detail. This is usually a charged service but to be honest its worth every penny!

  11. Jean -  August 6, 2013 - 7:07 am

    Amazing! Its really amazing post, I have got much clear idea about from this article.

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