Will the BabyBjorn endanger your infant’s health?

You don’t have to spend very long on the Internet as a parent to be made to feel that you are essentially abusing your child every 3 seconds. Not feeding them organic. Using formula. Daring to carry them, even just into the house, in a car seat. Using a pacifier. Co-sleeping. Not co-sleeping. The latest thing I came across was the dangers we were imparting on our infant (second, mind you, our first is a healthy 4 year old who went through the same things) by using a BabyBjörn infant carrier. They say it will give your kid hip dysplasia. But will it?

Recently my wife has become involved in “baby wearing”, which has become quite a movement. Like many groups of that nature, various rumors and potential woo have started to circulate. A particular idea that my wife wanted me to look into was whether the BabyBjörn — and presumably other carriers like it — can lead to hip dysplasia. If you’re confused about why BabyBjörn would not be proper equipment for “baby wearing”, it should be clarified that in general that movement only uses the fabric “slings”, “wraps” and “soft-structured carriers” (SSCs) and seem to shy away from the front-wearing backpack-like items, frequently calling them “crotch danglers”.

Some History

As expected, most people discussing infant carriers or using the term “crotch danglers” will fail to cite any sort of evidence about their claims. As best I can tell, the term originated in a 1996 article by Chiropractor Rochelle L. Casse, D.C. for The Continuum Concept entitled “Infant Carriers and Spinal Stress“. In my searches trying to track down information, I saw her name referenced a couple of times before finally locating the actual article. Her belief is that the infant carriers, jumpers, walkers, etc of the time (around 15 years ago) would lead to ismthic spondylolisthesis, which is basically slippage of the vertebrae out of place. In the article, Casse makes a prediction that, if true, should be quite easy to verify and would presumably confirm the hypothesis about non-sling infant carriers:

If the trend continues in the U.S. to carry infants in carriers (or place them in walkers, jumpers, etc.) that place their spines in a weight bearing position before the spine is developmentally ready to do so, I believe we will see an increase in the incidence of spondylolisthesis.

She cites 5% as the rate at the time of writing, though I don’t know if the figure was updated when she edited for the website. According to Wikipedia the current prevalence is 5-7%, so there certainly does not appear to have been a drastic rise from the data I can locate.

Note that at no time does even she mention hip dysplasia. The references I could find on spondylolisthesis do not cite infant carriers as a potential cause. In the article, Casse mentions that most people believe it is genetic but that she sees it as environmental, especially in reference to Eskimos who apparently have a high rate. However, she does not cite any evidence except her own views.

Hip Dysplasia… or poor spinal development?

So the first potential myth to look into is whether BabyBjörn and it like can lead to hip dysplasia. I had of course never heard of this, happily carrying our first daughter (now four) on many a trip to the grocery store and through malls. But is there any truth to this idea?

My wife sent me a link to one of the community sites making the claim. In there, multiple posters say to check a particular blog article, as well as including links in the forum posts to other blog articles which, supposedly, explain why “crotch danglers” are so bad. Clicking on the links (even the one that supposedly has so much “good information”) ends up providing no information about actual dangers. They appeal to emotion: “Would you want to be carried around by your crotch?” or “Well, there’s no back support for you”. Instead they just recommend all the carriers and slings that you should be using. The one link I found to what seemed to be much less alarmist and more balanced was actually the manufacturer of a competing product to BabyBjörn, Boba (makes what is referred to as an SSC, soft structured carrier).

That article actually discusses products (unnamed, but pictured) in terms of poor spinal development when front-facing. The product they picture which looks like the “Björn” they appear to have no beef with when the baby is placed facing the parent:

The wider base of the above carrier would provide some spinal support (maintaining the natural convex “c-shape”) if the baby was turned facing the father and his bottom was seated in it”

otherwise they say it causes the baby’s back to curve “unnaturally” (concave).

(Improper) swaddling the real danger

That article does not discuss hip dysplasia until they move on to swaddling (which we also do with our infant). The author even references studies! It’s not the swaddling per se, but swaddling when the legs are held tightly together rather than letting them spread, especially when there is congential dysplasia. For me personally, my daughter ends up with loose legs because it’s nearly impossible to get a tight swaddle. So, assuming the author is right, my own inadequacy in this turns out to be safer. The systematic review (yay!) by Van Sleuwen published in the American Association of Pediactrics (AAP) journal seems to be positive in support of swaddling except noting the possibility of hip dysplasia if done too tightly, and also a danger of SIDs once the infant is trying to turn over (I was already aware that once your infant can turn over swaddling should be discontinued). Support-wise (from the review),

Eleven epidemiologic studies have shown that the incidence of DDH (developmental dysplasia of the hips) is highly correlated with the traditional use of swaddling for newborn infants. (Van Sleuwen)

And,

This detrimental effect of swaddling is related to the misapplied use of the practice. Swaddling in a manner that allows the hips and knees to move freely might not have this risk-increasing adverse effect, but more studies are needed to test this hypothesis. The studies that showed beneficial effects of swaddling have been conducted with the infants’ lower extremities wrapped loosely, but the contribution of wrapping their legs on sleep, pain relief, and excessive crying also needs to be addressed. (Van Sleuwen)

PubMed currently has 11 results (reviews and individual studies) for “hip dysplasia swaddling”, but none that I could find related to carriers.

Responses to claims of hip dysplasia from BabyBjörn

So if you are confused… we started on BabyBjörn (and similar carriers) but have made it all the way to swaddling. Such is the path of rumors. But back to carriers (emphasis mine):

Although different in appearance, any modern baby carrier that does not support an infant’s legs (in a flexed abducted position oriented toward the wearer), any front facing carrier with leg holes is no more developmentally sound than a papoose (Boba)

What does BabyBjörn have to say on the matter? Naturally, the official response from BabyBjörn is a resounding no:

Your child cannot develop hip dysplasia or hip luxation by being carried in a baby carrier. Hip dysplasia, or hip luxation, is a congenital condition diagnosed through a medical examination. The notion that baby carriers can cause hip dysplasia is a misunderstanding and has no scientific foundation. This is confirmed by leading child orthopedists.

But it is perhaps reasonable to look further than the manufacturer of a product that is the target of the claim. Their answer references “leading child orthopedists”. It looks like they are specifically referring to Dr. Amanda Weiss Kelly and Dr. Allison Gilmore, which they feature in an article and video saying that the BabyBjörn “holds babies’ hips in the optimal position — the abducted position”. But we’re still within the realm of the actual BabyBjörn site.

Perhaps we can see what other experts have to say.

While hip dysplasia might be present at birth (congenital, CHD) it is usually detected later on during development of the child (developmental, DDH).

The International Hip Dysplasia Institute has a page on the causes of Hip Dysplasia.

  • Babies in the breech position are much more likely to develop dysplasia
  • Girls are 4-5 times more likely to to have hip dysplasia than boys
  • Cultures using cradleboards and papooses have high rates of hip dysplasia (see discussion above on very tight swaddling)

They also have a page discussing baby carriers specifically:
To start with, “The Medical Advisory Board of the IHDI does not endorse nor advise against any particular baby carrier or other equipment”. They do not say, “Run, do not walk, away from BabyBjörn!”. They then have some pictures demonstrating proper positioning, similar to what was shown on the site above from Boba and others. Essentially the baby should be worn facing the mother with the thighs well supported.

In the case of slings, similar rules apply: don’t place the baby in so that their legs are forced together (picture holding them horizontally across your body where their legs end up together).

All of their examples end up being with the baby facing the parent, which despite the community forums, seems to be actually well-evidenced to be safe (or at least there does not seem to be anybody credible citing evidence against it).

So is front-facing the problem?

BabyBjörn has a section of their site devoted to answering questions about front-facing, which I urge the reader to take a look at. In it they have articles from pediatricians, professors and other doctors discussing the BabyBjörn. They were most likely paid for their recommendation, so keep that in mind. But they are bringing to bear much more than those making the alternative claim.

I decided to do something insane and actually read the directions for the BabyBjörn that I own. I of course haven’t got a clue where the paper copy is, so I had to use the online version. The directions specifically note that the child should be well-supported by the bottom and the product must be adjusted based on their height. Odds are, most people never do that. If you make the correct adjustment you can see from the picture that the baby’s legs end up spread out, and certainly not simply “dangling by the crotch”. Additionally, the “Björn” we have is rated up to about 26 pounds. If you try to put a 40 pound 3 year old in there, they are certainly going to be straining the fabric a bit. I actually took pictures of me holding my infant in our carrier, with the adjustment placed in various positions. As far as I can tell, her legs are abducted and the thighs have partial support. But her feet are not supported, which is one of the recommendations. But I definitely would not classify her as “dangling” from the crotch. Also one interesting thing I’ve found myself instinctually doing is putting my hands on the bottom of her feet to hold them up while walking.

So I am on the fence a bit about front-carrying. My daughter seems to enjoy it and it certainly does not place her legs straight down, her hips are in fact supported, just not as close to the knees as perhaps is recommended. Until there is actually a study, or preferably multiple, linking front-facing carriers to actual, rather than what I would call hypothetical but-doesn’t-that-look-really-uncomfortable “common sense” evidence, I will continue to carry my baby occasionally front-facing, but certainly with more awareness.

Conclusion

Despite this starting as an intent to look into BabyBjörn (and carriers like it), there appears to be much more risk from incorrect swaddling. The closest thing I can find to an actual counter-indication is for front-facing, but as best I can tell the evidence for this is circumstantial/anecdotal, especially if the carrier is placed at the proper adjustment following the manufacturers instructions. Babies will tend to be swaddled for much longer stretches of time (8-10 hours a night) than they will be placed in a carrier. I will certainly be more careful about my swaddling techniques (perhaps continuing how I do it any how, but more conscious of it) and will make sure to properly read the safety guidelines for any product meant for young children.

If anybody is able to locate evidence (probably some epidemiological study) of an actual correlation between a front-facing carry and spinal or hip issues, I would definitely be interested in it. What I really came across in researching this was simply a lack of evidence, which does not disprove that front-facing infant carriers, such as the BabyBjörn,  can lead to spinal and hip issues. But neither does a lack of evidence support the idea of just “waiting and seeing” when anecdotally, the problems do not manifest (and neither my children nor apparently millions of others). 

UPDATE 7/1/2013: The manufacturer of BabyBjorn now has a site that is essentially their response to the claims against the product. While obviously not “independent”, it’s probably worth a look for those who have concerns.

REFERENCES
Boba. “strollers, baby carriers and infant stress”. Published 2010. Visited January 21, 2013. <http://www.bobafamily.com/research/strollers-baby-carriers-and-infant-stress/#2>
Van Sleuwen, Bregje E., Adèle C. Engelberts, Magda M. Boere-Boonekamp, Wietse Kuis, Tom WJ Schulpen, and Monique P. L’Hoir. “Swaddling: a systematic review.” Pediatrics 120, no. 4 (2007): e1097-e1106.
BabyBjörn. “Q&A: Baby Carriers”. <http://www.babybjorn.com/customer-service/faq/baby-carriers/>
International Hip Dysplasia Institute. “Causes of Infant Hip Dysplasia”. <http://www.hipdysplasia.org/developmental-dysplasia-of-the-hip/causes-of-ddh/>
International Hip Dysplasia Institute. “Hip Health in Baby Carriers”. <http://www.hipdysplasia.org/developmental-dysplasia-of-the-hip/prevention/baby-carriers-seats-and-other-equipment/>

About Josh DeWald

I am a software engineer, husband and parent of two. I have been involved in the Skeptical movement for a few years now, especially since having children and so needing to fight pseudoscience related to parenting (vaccines, homeopathy, etc). I've been fortunate to attend TAM twice with my wife (who is also of a Skeptical bent). I also have a blog known as "What Does the Science Say?" (whatdoesthesciencesay.wordpress.com), where I have an odd habit of writing a lot about aspartame.
This entry was posted in Health, New Age, Urban Legends and tagged , , , , . Bookmark the permalink.

47 Responses to Will the BabyBjorn endanger your infant’s health?

  1. Grandma says:

    Two of my grandchildren had hip dysplasia diagnosed at birth. After the requisite time in the fancy theraputic harness (I forget the correct name of the harness), the parents were able to use a Baby Bjorn. An item which is, I think, one of the best devices ever invented. Both children have remained just fine. (This is just an anecdote, I know, but reflects practices supervised by a specialist.)

    • Sandra says:

      Problem solved!!! There is a new carrier on the market by KiwiPeewee that seems to solve all of the problems. It is like a Bjorn but it has a seat underneath that the baby sits on so that it is supported under the bum. It’s a great solution to the problem. http://www.kiwipeewee.com

  2. Stephen Propatier says:

    Josh
    As an orthopedist I will tell you that dysplasia and spodylolisthesis have nothing to do with abducting your hips. That theory is part of the wider pseudoscience surrounding orthopedic issues, and a lack of understanding about the pathophysiology of the problem. The birth issues and the mechanics of birth do have an impact. However you should not be subjecting any post partum baby to that type of stress.In addition there are higher rates of displasia in cultures that papoose their children. Which is the opposite of the sling. The bottom line is we have a pretty good idea of the cause, and if you subject your child to that type of stress outside of the womb he/she will be screaming. The older the child becomes the more ossified the hip becomes and the less likely.
    Great post!

  3. Here’s another anecdote, for what it’s worth: I was working from home when my kids were infants, and both of them spent much of the day strapped to my chest. I carried them facing inward when they were ready to nap, but when they were alert I often turned them out.

    They’re 14 and 12 now, and neither has had the slightest problem with their hips or spine.

  4. erinalberty says:

    I’m skeptical that the Bjorn would an issue for a baby who is comfortable in it and has no known orthopedic problems. But I just wanted to say that the photos on the hipdysplasia.org page don’t compare front facing to back facing. They compare thigh support to no thigh support. I can see how the “not recommended” picture there might look like a Baby Bjorn — but with a bigger child. My baby’s legs are still so short that the Bjorn supports her as shown in the “recommended” picture.

    (Sorry I’m late to comment.)

  5. Michelle says:

    Yeah! Thank you for the useful and complete research! I am sick of all the rumors on the subject. Today a woman came up to me in a mall and said the Baby Bjorn is bad for the hips, but again, this is more rumor than evidence!

    • CG0507 says:

      You’re allowing your child to hang by their crotch, would you want to spend an hour like that or would you like to spend and hour with your legs bent in a correct seated position? I don’t understand why ANYONE would want to use a bjorn or any other non ergonomic carrier plus they are crazy expensive for something to cause yourself back pain.

      • Eric says:

        But you would like to spend an hour strapped against another person with your legs spread apart? Or in a sling? We’re talking about babies here, not adults. They have very different body proportions and they weigh a lot less. I could just as easily ask you, “Would you want to spend an hour strapped on your back in a rear-facing car seat or spend an hour in a correct seated position?” But I don’t think you’re going to rail against infant car seats.

      • RobH says:

        You’re just parroting the emotive argument again, used to sell different baby carriers – the entire point of this article is that such hypothetical but-doesn’t-that-look-really-uncomfortable “common sense” arguments are completely worthless without any real research to back them up.

  6. Babywearer says:

    Having used FFC’s, SSC’s, wraps and slings, I know which I prefer and it certainly is not the FFC. I do advocate the use of alternatives to FFC’s, everyone I know, myself included, say they are uncomfortable and after a while hurt their shoulders and backs. one manufacturer actually recommends not using their FFC for more than 30 minutes at a time…

    That being said, I don’t get into the hype of hip dysplasia. For me its a comfort thing. FFC’s are uncomfortable to use, and I would never hold my baby in my arms between the legs, rather under the bottom like SSC’s, wraps and slings mimic.

  7. Josh, thank you very much for your post. We have a carrier from Britax (Romer) in which you can carry the baby facing out and also facing inside. Until our son Damian was able to hold his head, we used to carry him facing us. Now we carry him facing out. My wife came across many websites (like Boba) claiming that carrying a baby facing out is not a good idea and it hurts our baby. She started to doubt about our carrier, but I couldn’t accept the idea that the company who invented Isofix for child safety would sell a carrier that was not suitable for carrying babies… So similarly to you, I started to search on the net for any medical / scientific study that could explain to me why it shouldn’t be a good idea to carry my baby facing out. I wasn’t able to find any scientifically backed up claims. Most of the articles against front-facing carrying I found were on the websites that actually produce or sell alternate carrying “devices” (slings etc.). Funny things is that these against-FFC pages or communities always mix arguments regarding dysplasia with totally unrelated arguments, e.g. information/stimulus overload of your baby, hard-to check baby’s temperature etc.

    So until there’s some real evidence that carrying our baby facing front is really not a good idea, I will treat those pseudo arguments as an urban myth (it reminds me the amber teething necklaces misbelief).

    Again, thanks for your article. Eventually, I do not feel being alone anymore :)

    • Josh DeWald says:

      As a fellow parent, I absolutely appreciate everything you said. It’s hard to know “who’s right” when someone is telling you you’re harming your child potentially.

  8. Ric Shewell says:

    Thank you for this post! Why does the internet want me to be afraid of everything!!!

  9. Thanks for this. I just wrote something similar on my own blog, and found this while I was researching it. I’m moving towards more ‘traditional’ wraps because the BabyBjorn has been hurting my back, but I too doubt the issues that it apparently has for babies.

  10. Wearyourbaby says:

    I completely agree with Babywearer. I would be surprised if users of FFC would still choose them after trying SSCs or wraps. Regardless of whether it is harmful for the infant or not, I know lots of moms who complain they are uncomfortable, and I doubt they are any more comfortable for the baby. Also, there is the issue of overstimulation – a FFC baby cannot nuzzle into his parent to block out overstimulation. Maybe FFCs aren’t specifically harmful, but I would argue they are inferior.

    • Josh DeWald says:

      Another anecdote of course, but my daughter regularly falls asleep Front-Facing. And when she’s not asleep, she’s giggling away. Neither of these would seem to indicate discomfort or overstimulation.

      Assuming there is a comfort difference in FFC vs SSCs, perhaps it’s related to the different center of gravity for men and women. Again anecdotally, but I’m a male and I do not have discomfort with the Bjorn when using it. So regardless of what other people are experiencing, I personally do not have an issue and I see no evidence that either of my children have had issues. My wife likes using a “ringsling”.

      • Thanks for the post- also trying to arm myself with info for when I’m accosted using my Bjorn. I also find the Bjorn to be very comfortable and I’m a female.
        I have manly shoulders though so maybe that’s why… Anyways I wear it in the shower and to bed sometimes. It makes it easier to bring my baby with me when I roll over in bed.

        Also, as avid rock climbers my husband and I spend a lot of time dangling by our crotches. I realize this is a baby ergonomics issue but more people need to crotch dangle. It’s quite enjoyable! Especially when your harness saves you from death! MORE DANGLING PEOPLE!

        • judith says:

          uhm, as a fellow rockclimber I do hope you use your legholders too on your harness, thus actualy creating a M shaped seat (knees higher than bum) ;-) !

          and to add to why face forward puts more muscle stress on the child: it doesnt support the babies spine into a relaxed C shape, unless your belly is inwards ;-). By most people (…) it is however far from going inward, even with me its going outward a bit and I’m a bit underweight :D. so at best the baby’s spine would be straight. And thats not the natural position it can be carried for long stretches of time in.

          also agree with the reactions about the comfort factor: the higher and more wrapped around your own centre of gravity you carry your child, the more comfortable it is.

          but hey, it seems the proof is in the tasting: feel free to test my wrap and ringtai and ringsling :)

    • sarah t says:

      I have both the Ergo (which I love, I bought a second one) and the Baby Bjorn Sport. I also have a Moby Wrap and a Maya Wrap woven ring sling and would LOVE a woven wrap if I could afford one now that I’ve experienced the Moby. I actually find the Bjorn to be incredibly comfortable. In fact, I think it was more comfortable then my Ergo for long periods. I can’t nurse in it and get baby in and out quick which made the Ergo better for daily use. My mother in law used the Bjorn and also thought it was fantastic. But when I tried to sell it I was told “Only safe carriers allowed” in one FSOT group and have seen so much I decided to research it. Thanks for your blog! I did find my baby was in a similar position in the Ergo and the Bjorn, I appreciate you pointing out that perhaps many don’t adjust it properly.My 9 month old prefers to face out and turns himself around in his Ergo. My first child would scream bloody murder if she couldn’t see out, as did a highly active baby I used to babysit for. You can manage (if you can finagle it) for the baby to be high on your back and look over your shoulder. Still researching it, I have a hard time believing that the Bjorn is dangerous.

  11. Thank you so much for this article. One of the groups I follow on Facebook posted last night about how awful the Bjorn is and made me feel like the WORST mother for using one. I’ve tried doing research and, like you, haven’t found anything to prove a direct correlation between hip and spine problems and this particular product. Especially since Bjorns have been around for a few decades, and have been one of the most popular products of its kind, you’d think there would be more research to prove that they are unsafe for baby’s development. But simply put, there isn’t. I have a three month old daughter and we purchased the Bjorn Miracle. The shoulder straps are extremely comfortable and it has both lower back and waist support. I have never felt any discomfort using it, and actually couldn’t stand the Moby wrap I was given and never even tried the ring sling as it felt very unsafe to me. I just can’t seem to get the Moby to be tight enough to properly support my daughter’s head, she is constantly wanting to look around and away from me if she is awake and alert when I’m wearing her. In the Bjorn, she usually falls asleep against my chest within a few minutes. I found a website that shows you how to help support your baby’s hips and get their legs to rest in the frog position by using a scarf or other material, if you are concerned about their legs dangling. But thanks again for this, I really needed to read it and realize that I’m not a bad mom at all, I’m making the choice that feels right for us.

    • Josh DeWald says:

      Thanks for the comment! A friend of mine is an avid “baby wearer” (she actually finds the Bjorn uncomfortable and does not use it) alerted me to a site recently (http://healthybabycarriers.com/) which is essentially the manufacturer’s response to the claims. That’s probably an even better source for info, citing some of the same research and doctors. Worth a visit. Obviously not “independent” though so it’s not going to convince anybody who is actively anti-Bjorn.

    • Ing says:

      I feel exactly the same. I have used the BB miracle with so much pleasure for my son, and now reading about this hip problem with carriers like baby bjorn. I have now been considering to use the ergo with the infant insert (my son hated that, and i only started using when i could not bear his weight anymore in the baby bjorn at around 8 months) but am sad cause wow my son really had the greatest time facing out in the baby carrier!!!

      Now i am very interested in that website showing how the baby can be positioned better while still using the baby bjorn, would you mind sharing that with us?

      Btw: great post, great to read quite comforting words instead of all those super negative publicity for such a great product!

  12. Irene says:

    I am currently looking for a baby carrier and am freaked out about possibly causing my baby some harm! Still on the fence about whether there is a link between spinal problems and the babybjorn type carriers. Guess we won’t know until a bunch of kids end up in wheelchairs.
    Just wanted to add my 2 cents about pseudo-science vs science: I think that parents should also use logic and listen to their intuition at times, instead of only relying on doctors and science. Science takes time and research is often tainted because it is funded by pharmaceutical companies. As a parent of a child with developmental issues, saying that something is not “proven” isn’t a good enough answer for me anymore. When it comes to your child’s health, I say follow your gut feeling.

    • Stephen Propatier says:

      Irene you are well within your rights to decide to just carry your child. You feel it is dangerous by all means don;t use it. That said the rest of your “2 cents”, far more irresponsible than having your child in any Baby Bjorn.
      Consider this “Parental Instinct” cause parents to drive in the front seat with a child in their arms, smoked while pregnant, and used major anesthesia for child birth. Fortunately science and research showed how dangerous these were to new borns and infants. I implore you consider the blanket statements and what they really mean.
      Do pharmaceutical companies fund the kepler telescope, NASA, and Iphone’s? What does science really mean? Really look into it don’t assume and buy the anti-corporate double speak.
      What is it about a rational systematic approach to learning things that offends you?

  13. Moral Dolphin says:

    I take it that a person who lives in a house, wears clothes, drives a car, uses a computer, drinks safe water, washes and cleans and has theunderstanding of a luddite should behave in a manner beneath her..

    Science shaped humans, not the other way around.. We evolved from creatures who saw relationships and used them to predict outcomes.

    For those who dont like science, back on the savannah, in the nude and hope that a rabbit dies near enough to eat.

    Humans doing cience even invented religion, art, mathematics and language..subtle and wonderful beings we humans. Forget the ingrates.

    I wonder how indigenes in other countries feel about them being looked down on being told they know shit about nature..(ie no science) by dolts in the west..

  14. I used a little baby carrier that started out being a back facing one for little babies, then converted into a front facing one you could wear on your back or front as they got older. It was pretty cool, I thought. Worked great. I think you ought to look at how girls and women just naturally carry their kids. Soon as they are able to hold their little heads up, girls rest the baby on their own hip, a comfortable and natural position for both. I carried my little sister and nephew that way for years. We walked everywhere back then. The baby’s back isn’t particularly supported, and their legs dangle just like the author’s daughter’s do in the picture he posted. The child faces sort of half front, half back. Huh. All the poor farmers’ daughters in this country ought to have hip dysplasia and spinal curvature. (Usually it’s the older ones that develop those problems, and not from being carried around.)

    The idea that their spines need to be supported in a curved position sounds to me like horse radish. Look at infant seats, car seats, high chairs, baby swings, beds, jumpers, walkers, and on and on. They don’t cause back problems in infants. No one is proposing banning baby beds/cribs. In fact, medical advice is to rest the baby flat on their back… and how many hours do they sleep v being carried by their parents? The baby does not need to be artificially rolled up like a little roly-poly bug.

    I think the key is, don’t carry them around 24/7. Put the kid down. Let them wiggle and squirm and lift their heads and roll over and learn to crawl. It’s the natural way babies develop. You don’t have to be your kids’ Siamese twin and they really don’t need to see the world from your perspective all the live long day. They’ll get grown up size soon enough. Just let them be babies and toddlers. And when you need to carry them, do what is comfortable for the both of you until some real definitive science comes along.

  15. Courtney says:

    Thanks for your post! It was great and really made a lot of sense to me. I couldn’t help but laugh out loud when I read your opening paragraph because it is so true……as a parent (and I’m a newish one with a 2.5yr old and 6 mth old) it doesn’t matter what you do, you feel constantly judged by others and having a Baby Bjorn has certainly meant I have felt that way. I have recently joined a baby wearing facebook group and I am surprised at the subtle ‘snobbery’ that appears to come from the members which seem to divide the ‘baby wearing’ community between those that have/use a bjorn and those that do not. I am amazed at how the choice of one particular product can alienate those who use it from an entire community of ‘baby wearers’ and how the judgement can make it feel like you are not a true ‘baby wearer’ if you use a bjorn. I really appreciated your article and have enjoyed reading through the comments and feedback in response. It is relieving to know that we are not alone in the journey! Thanks.

  16. Thank you for a great article. I am also very skeptical when it comes to claims about carriers and health. It is such a charged issue. I am looking to investigate the various ways parents / caregivers offload the weight of infants (0-18mo) and any correlation, if any, with back pain. I have not found much research on Pubmed. I would be curious if you or the others following the topic had any leads.

  17. Anonymous says:

    Thanks for doing this research; there’s so much conflicting advice it’s hard to know what is the ‘right’ thing to do. We’ll use our bjorn forward and then front facing just for short periods of time and ill make sure it’s adjusted properly :)

  18. Anonymous says:

    Thank you for this post and for taking the time to take a step back and give the topic an analytical evaluation.

    I am one of those “crazy babywearers”. But, I’m certainly not one to shame or guilt someone out of using any carrier. My personal reason for not using the narrow-based carrier I bought when I was pregnant is that it was horribly uncomfortable for me. Once I started looking for more comfortable options, I learned about the other benefits of ergonomic carriers.

    Once my baby got bigger (about 3 months old or so), I found it impossible for me to actually be productive while wearing my baby on my front. She is long, I am short. I might as well have been a t-rex, my arms were that useless! Finding a carrier that allowed me to carry my baby on my back was life-changing. She gets the comfort and snuggles she needs and I get to cook dinner. It’s a win-win for us.

    My reply to people who ask about narrow-based carriers is that, “No, there is no proof that they causes any hip or spine issues, but non-ergonomic carriers (and other baby items), can exacerbate pre-existing conditions.” Since we know that DDH can develop at any time during the child’s development, why not use baby equipment that is going to be ergonomic right from the start?

  19. Anonymous says:

    I think that one problem is, many babies have undiagnosed hip problems. If they had been diagnosed (as I was) the parents would have been advised by a doctor to posture baby in a certain way (as my mother was), and would be advised about the best possible way to carry baby in order to minimise damage or hopefully help baby to grow out of the problem naturally (as I did, with double nappies and being carried often with my hips spread in a cuddle type carry). Wether or not the baby bjorn can CAUSE the problem, I do not know , but I do know that there are very likely babies out there with undiagnosed clicky hips who are being carried in a way that will not help/may aggravate their condition.

    • Anonymous says:

      WSS. I think the pro-vs con thing goes wrong the moment you forget that there is an optimal way and the rest is suboptimal, and the suboptimal is just that: something you do untill you find an optimal. The fact that some people don’t trust the info thats given, though given by science or other ‘probably right sources’ makes it a difiicult debate: if one doesnt want to change ones beliefs, you can throw knowledge at them untill they keel over, but they wont change their beliefs.

  20. Anonymous says:

    I’ll just leave this here, http://www.manduca.de

  21. Anonymous says:

    Finally someone who is actually doing some research! I actually came across this because I was trying to look into scientific journals for the impacts of jolly jumpers, bumbos, etc. I’m not a parent and have never used the products but my sister was advised against them and of course I was a little skeptical as a nurse wondering the harm in some of these products if used properly and according to manufacturers instructions. With regards to any carriers I think parents should be more worried about their own backs and ergonomics and having harm done to themselves than the potential for hip dysplasia. Parents are too hard on themselves and need to listen to credible resources. Talk to an expert (doctor, public health, etc) about current recommendations. I can’t seem to find much on the other subject areas I mentioned earlier so feel free to give a go!

  22. Ash says:

    I briefly used a Baby Bjorn Original with my son. He liked it at first, and so did I. Then, he hit twelve pounds. I had him in the Baby Bjorn for an outing but he was being weirdly extremely fussy. When we got to our destination, I changed his diaper, hoping that would help. When I took off his diaper, I had to do a double take. For a brief moment, I thought the hospital had been lying to me and I’d actually had a girl because his boy parts were so squashed. I unsquashed his poor parts and he immediately started smiling and was cheerful for the rest of the trip (which he spent in his stroller).
    THAT is why I don’t like the Baby Bjorn and believe it is unhealthy for a baby. It hurt my child, literally. Fortunately not in the long run. We have switched carriers to an Ergo and are thrilled with it. I have never had anything like that happen in any other carrier I have tried and I carry him in it for up to 12 hours a day (with breaks), and he is now 10 months old.

  23. This is a great article from someone that hasn’t been paid off by Bjorn. Interesting read. While I have never used Baby Bjorn, from what I’ve seen and heard by fellow babywearers is that they are incredibly uncomfortable when the child gets heavier as they pull/dig in to the shoulders and B) they just don’t look comfy for a baby. I guess the way I view it is think of all your weight bearing down on your genitalia. Ouch!

    I’ve always used woven wraps (I’ve been carrying for over 2 years now using woven wraps exclusively) and they are incredibly comfy for the wearer and for the baby and the seating position is a lot better. The weight of the child is distributed across the wrap when the legs are in the M position.

    Like everything, there is good and bad, but I guess Bjorn have something that other wrap/carrier manufactures don’t and that’s a large marketing budget.

    BD

  24. Laurie says:

    From the time my infant was about 2 months old, I carried him in a Bjorn when we went out for the day. He was tiny so I generally kept my hand underneath him anyway for added support, but he was always comfortable and happy. As he grew, I switched to an Ergo to see if he would like it better… he HATED it. Every time, he screamed from the second I put him in it. There is nothing comfortable looking about it. Most people think babies look uncomfortable “crotch dangling”?! but I think babies that are held tight and their heads lean back over the carriers look way more uncomfortable!

  25. Annie says:

    Great article, thank you very much. We use the Ergo Baby, which is great, but I also wanted a carrier that has the front facing option. But a pediatric nurse told us that it is bad for the baby’s hips and back, as it is forced into a straight shape and the weight is distributed on just a small area in the front. So I ditched the idea. Having now used the Ergo as well as a stretchy wrap, one of the most important things for me is that I’m being comfortable carrying him. And that is easier for me using the tummy-to-tummy position.

  26. Channon says:

    I’m not going to use my Bjorn simply because it is padded with polyurethane foam. I got an Ergo instead (the Ergo is 100% cotton, as was claimed in the product details of my Bjorn, but Ergo’s 100% cotton really is 100% cotton. Bjorn’s is something tortured, like, “where we use cotton, the cotton is 100% cotton.”) Toxic material problem solved with the Ergo, BUT the hip concerns remain!

  27. Thanks for taking a balanced approach to this subject. I too have read these scare-tactic articles and wondered what the truth is and if it can be found. As a mom, my initial reaction was that this is a knee-jerk reaction. I have tried many different carriers, including the BabyBjorn, but we eventually moved on from it because its weight rating was so low. In particular, my son absolutely hated being carried facing inward and loved being carried facing outward. As an English teacher, it troubles me that bloggers depend on so-called experts who in turn don’t have any sound evidence. Just because someone is an expert in a field doesn’t mean you should just take his/her word for it–evidence is necessary.

  28. Jill says:

    Thanks for this! We did a lot of research before buying our Bjorn and also found no real evidence supporting the hip dysplasia panic so prevalent in babywearing communities. Our son’s comfort and safety were and still are paramount. He absolutely loved facing forward and never at any point appeared to dislike being in the Bjorn. If he had shown any signs of discomfort in his so-called “crotch-danger” carrier, we would have stopped using it immediately. Admittedly, I do not carry my son for twelve hours at a time, nor do I have a desire to do so. If I did, I would likely own multiple types of carriers and wraps. We wear him for an hour or so, every couple of days. Long enough to get a few things done around the house or take the dog for a walk. If I had it to do over again, I would choose a carrier with a higher weight limit simply because all carriers are overpriced (IMO, of course.) and I like getting my money’s worth. Bjorn isn’t the only carrier manufacturer with a large marketing budget and to think they are the only ones playing the marketing game is simply naive (Hello, Sakura Bloom, Boba, and Ergo.). Again, thanks for your well-thought-out article! We have enough guilt as parents over a million other things. Bjorn-shaming shouldn’t even be on the radar.

  29. Meredith says:

    Great article Josh. The first good legitimate research article I have seen on the topic. It has gotten to be more difficult to tredge through the opinion based articles to find something with fact. I appreciate your work and feel the same as you concluded. As my oldest grew we constantly changed the settings and positioning of our Bjorn to better fit her and us. Both of our girls enjoyed the Bjorn (both front and rear facing). I also love our Ergo, but our youngest hates it now and we use it as a back carrier for the oldest. Thanks again for the good information.

  30. Charlotte says:

    As a baby wearing peer supporter & someone that runs a sling library, I can tell you that during our training it is made clear that “crotch dangling” is not the cause of hip dysplasia. The M position is more for the comfort of the child & you.
    As with forward facing carries, yes the spine won’t curve into a nice rounded c shape, however the baby is unlikely to be held like that for long periods of time. More, with babies, it’s very difficult for them to turn away & shut off from everything going on in the world that they’re exposed to.
    I’ve owned a baby bjorn & whilst it’s not the first carrier I’d recommend if someone came to my library; if someone had one, I certainly wouldn’t poo poo it. They are expensive & you don’t want to make someone feel awful for buying what they thought was a good thing. Instead encouragement to wear their baby & showing them ways to make it comfortable for them will probably mean that person will wear their baby for longer & go onto using other carriers.

    I personally find them uncomfortable to wear for long periods even with a small baby, but it’s more because I find it near on impossible to get the baby tight into my body so all their weight is taken by my shoulders. This is easily rectified with a towel in the seat to support the baby’s thighs & a pashmina wrapped tightly around us to bring the baby in closer. Using this I find I can carry even a toddler for long periods fairly comfortably.
    Baby wearing is just that, wearing your baby in some shape or form. Like many things when it comes to children there is often no clear cut right or wrong way to do things. You make the choice as a parent what is best for you & your child.
    Really interesting article. :-)

  31. Emmazers says:

    I would echo another person who mentioned that it’s very difficult to measure issues when they are not diagnosed soon after birth. I was born with hip displasia, spent weeks in a spica (which holds the legs in a frog-leg position, similar to SSC carriers), only for my parents to then carry me in a Bjorn! I still suffer today with my hips (especially during pregnancy) but didn’t realise that it was probably related to the crotch-dangling carrier until I had children of my own. Personally, due to my own experience, I just wouldn’t take the risk and frankly don’t understand why anyone would considering there are far superior alternatives. I think you’re downplaying the views of the International Hip Displasia Institute, who quite clearly advise against Bjorn-style carriers, though of course they cannot mention them by brand.

  32. First of all, there’s actually a medical article from 2012 about WHY NOT TO CARRY YOUR CHILD FRONT-FACE and WHY TOO NARROW CARRIERS may help develop hip dysplasia. Although it’s originally printed in German, not English…
    http://www.aerztezeitung.de/panorama/article/809070/babys-nicht-gesicht-nach-vorn-tragen.html#.T3Df2uVoKzs.facebook
    Secondly, the picture of Hip Displ. Institute clearly shows that BABY’S LEGS SHOULD BE SUPPORTED FROM KNEE-TO-KNEE. Bjorn does not support the legs as it’s shown on the picture.
    If you take the time and check the site of Hip Disp. Inst. for yourself, you can see that there’s an other picture of NOT RECOMMENDED sitting of a baby in a carrier. That’s exactly the way how babies sit in a BB. Finally: small infants (i.e. from newborn to 5-6 months or till they can sit on their own) should NOT BE PUT IN ANY CARRIER ONLY IN A SLING OR WRAP! Their backbone is too sensitive and may be hurt, if they are not put in a froggy-leg position and inverse C shape. Bjorn definitely does not provide that, nor do it some ergo types either. I suggest that you contact a person, who is trained in giving advice about baby carrying! (Not the multi manufacturers, who spend millions on advertising to promote their products… Surprisingly ergo carriers are not that much advertised – wonder why…)

  33. Sherry jones says:

    Has anyone experienced bruising or temporary blood pooling due to a baby jumper, like the stationary ones on the ground? I believe my child had some bruising as a result and I’m interested to know if this is a common occurrence?

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