Baby sling carriers raise safety concerns

Baby slings may be fashionable among Hollywood stars and other new parents but at a recent meeting I learned about some safety concerns that made me shudder. Over the past 10 years, there have been at least 22 reports of serious injury associated with the use of sling-type carriers. The injuries include skull fractures, head injuries, contusions and abrasions. Most occurred when the child fell out of the sling.

In addition to the injury reports, which were gathered by the Consumer Product Safety Commission, a number of recalls of sling carriers in recent years (including the Infantino pictured) has prompted ASTM-International, a voluntary standards-setting organization, to hold its first organizational meeting to start a standards-development process for sling carriers to address safety problems. Concerns raised by manufacturers, who requested the review, included not only the fractures and bruises but the risk of smothering.  The CPSC information documented a risk of death caused from “positional asphyxia” caused by placing the infant in the sling in a head-forward position that can cause the airway to close.

Some of the incidents with sling carriers were likely due to improper assembly, improper wearing, or failure of rings or other hardware. Most of the sling carriers demonstrated at the ASTM meeting seemed complicated to put on and prone to user error. Clear instructions and perhaps video demonstrations might help prevent mistakes. But, as we all know, consumers may not read the instructions, and misinterpretation or misunderstanding can lead to errors that can endanger precious cargo.

It’s uncertain how an ASTM standard can help make these products safer or error proof. We caution parents who do favor the sling carriers to frequently check the hardware and adjustments—and to do so without the baby on board. For now, we think there are better ways of transporting infants including strollers, hand-held infant carrier/car seats and even other types of soft infant carriers. For additional information on our Ratings for these and other products visit the Babies & Kids section of the Web site or read the Babies & Kids blog. -- Don Mays

Sling carriers recalled by the CPSC

• Ellaroo Ring Sling Baby Carriers (2008)
• Infantino SlingRider Infant Carriers (2007, pictured above)
• ZoloWear Infant Carriers/Slings (2005)

Comments

[Phillip]

Good day. I am very disappointed in CR for this article. Yes, I am a print and online subscriber. Yes, I have relied on CR for information in the past. And yes, this article makes me really question the value of your information that I've accepted in the past.

[Lisa C]

I thought that strollers and carseats had recalls, too. Personally, I feel my baby is safest when he is attached to my body. It's true that some slings are not safe, but many are safe when used correctly. To generalize them and telling people to avoid them is like telling them to avoid cribs and carseats, too. Just because something is tested for safety, doesn't mean it is safe. Cribs and carseats get recalled, too! And they are supposed to be the safest.

Anyway, instead of telling people to avoid carrying their baby next to their body in a sling, maybe you could advise people to learn what the safest slings are and how to use them correctly. (You think that people will ignore the directions? Um, how many people ignore the directions on "safe" infant products, like placing carseats on top of a bed?) I also really hate using our stroller. I'm always afraid it is going to collapse. Or that he might fall out of it.

[Catherine T. Sizer]

I don't think I'll be renewing my online subscription either. I used a sling with my son and my daughter, a Nojo with my son and a homemade sling with my daughter. I honestly feel that I could carry a grown adult (if I were strong enough to do so) in my homemade sling and it would hold. I have put my toddler in it for short periods of time with no problem. I used safety tested rings and used a very strong waffle comb stitch on the fabric which I left at full thickness. I resent CR telling me I'm putting my child at risk. I guess I am just a snotty, "smarter than thou" parent but I feel I can use my slings just fine thank you. For others that are not so smart let them use a stroller and fail to buckle the kid in and when it falls out because of their ignorance then we can take strollers off the market! Car seats are another great example, the majority of deaths of kids are caused by auto accidents despite car seats. BECAUSE there is a very high rate of misuse but you do not see car seat manufacturers making THEM easier to use despite the fact that a misused car seat is possibly more dangerous than no car seat at all. At least the vehicle manufacturers have done a little something with the invent of LATCH. But misuse is still terribly high. So should we tell people to not use car seats? Or course not! And we also should not tell people not to use slings. They are useful and safe if used properly and made properly.

[Meg]

This just in: Consumer Reports warns that carrying babies in arms is not safe. "Parents want to hold their babies. And babies love to be held! Unfortunately, human arms come in many different sizes and strengths. There is no corporate funded testing facility for arms. Many new parents feel unsure of how to hold their babies-and we know they won't listen when Grandma tries to tell them how to do it. Injuries have occurred when parents doing a "spit-up handoff" miscalculate distance and slipperiness and one of them drops the baton (so to speak.) And baby-induced sleep deprivation causes clumsiness-a parent carrying a baby might actually trip or even fall! Over the past 10 years, there have been at least 22 reports of injury associated with the practice of holding babies in arms. Along with more serious injuries we include in this number contusions and abrasions (fancy names for boo-boos.) Hold you baby when you absolutely must, but for thier own good they really should be left screaming for love in a nice safe crib or slumped over in a $20.00 umbrella stroller.
Next story: Has your uterus been recalled? Is this untested device really the best place to grow a baby?

[Beth L.]

I am very disappointed in CR for this article. Yes, I am a print and online subscriber. Yes, I have relied on CR for information in the past. And yes, this article makes me really question the value of your information that I've accepted in the past.

There are many many other comments that I could agree with. They're well worded, smart, and on point. But I had to write something. I had to add my feedback to the chorus. This article was biased, incomplete, and this topic deserves accurate, adequate, and comprehensive research, complete with references. Please, PLEASE try this again.

[Gretchen Pittendrigh]

I also just wanted to share that co-sleeping is the safest way to sleep with a newborn, and has a lower risk of SIDS when done safely the mother is able to regulate baby's body heat without concern about over-bundling, and mama's breathing reminds baby to breathe, etc. Many cultures have done it for centuries, and as a fact, cribs were only recently introduced in Europe in the last century. The same instinct that keeps a person from rolling off the bed, also keeps a sober and healthy mama from rolling on her child. I've seen a lot of cribs recalled, I don't see CR telling us not to put babies in cribs!

[Gretchen Pittendrigh]

I seriously hope CR plans to take a closer look at poorly written, un-researched and overly opinionated articles like this one get into print again. I certainly won't be looking for advice here, next you'll be telling us formula is better than any nursing, because some mama's don't make enough milk!
Is someone feeling some father neglect?

[Tina]

I cannot believe you actually made a blank statement about slings being unsafe. this is the most uneducated report i have ever seen. at least do some reserach, mention a few that were recalled, and others that have been tested according to new CPSIA and possibly also European carrier standards. and last, see for yourself how great a sling is for a baby and parent, and check out some new ones that are designed with extra support over baby using a second loop, like the Baby K'tan, and ones that tie around parent to support baby, like the Moby Wrap. Just because you are not familiar with these great carriers do not close the door on them to your readers.

[Observer]

I was reading the comments left previously, and it occurred to me that if most of the injuries were caused by the parent tripping and falling with the infant, the problem is most likely the change in center of gravity caused by the additional weight of the baby, not the sling itself. Yes, these same women were just carrying that baby for nine months, but now the baby is at least a foot higher, outside the body, gaining weight every day, and moving around.

Several of the commenters work with organizations that help new mothers care for infants. May I suggest that they start having the mothers practice using the slings with weighted dummies for awhile BEFORE putting live babies in them? Or at least make them aware of the difference and caution them to brace themselves while maneuvering (holding hand rails, hand against the wall, etc.) until they're used to the change in body dynamics.

Disclaimer: I have never had a child and never cared for a newborn for more than an hour. But I have had numerous orthopedic injuries and surgeries, and having one arm strapped across your chest after shoulder surgery can really mess with your balance. Ditto a cast on an extremity.

[No longer a fan of CR]

This writer knows nothing and did not research this at all. Research points to just the opposite: German researchers studied two-dozen preterm and a dozen full term infants. Doctors monitored babies' oxygen saturation, pulse, nasal airflow, breathing, and overall movements, comparing cardiorespiratory function while the newborns were lying in a pram versus being transported both upright and lying down in a baby sling carrier.

The study's results showed that a child transported in a baby sling carrier was not at risk of any changes across all measures studied. Doctors concluded that the use of a baby sling carrier "is not associated with an increased risk of clinically relevant cardiorespiratory changes in term and preterm infants."

Research Conducted at: Children's Hospital, University of Cologne, Koln, Germany. waltraud.stening@uni-koeln.de

OBJECTIVE:
Parents in industrialized societies make increasing use of infant slings to carry their infants. This study was conducted to determine whether infants who are carried in slings are at risk of experiencing clinically relevant changes in cardiorespiratory measurements.

METHODS: In a 3-period crossover trial, 24 preterm and 12 term newborns were continually monitored while being carried horizontally or vertically in a sling or lying in a pram. Oxygen saturation, heart rate, nasal airflow, abdominal breathing, and movements were recorded.

RESULTS: Infants who were carried in slings were not at risk of clinically relevant changes of oxygen saturation or heart rate. The 90% confidence interval of oxygen saturation in both infant sling positions remained within a +/-2% interval around the average oxygen saturation in the pram. However, a significant decrease of oxygen saturation was observed while infants were carried in a sling with a mean oxygen saturation of 96.3% (standard deviation [SD]: 1.8) in the vertical and 96.1% (SD: 2.0) in the horizontal sling position compared with the mean oxygen saturation in the pram (97.1%; SD: 1.5). The degree and the incidence of desaturations and bradycardia did not change while the infants were carried. Both types of episodes were seen only in preterm infants.

CONCLUSION: The use of carrying slings is not associated with an increased risk of clinically relevant cardiorespiratory changes in term and preterm infants.

[Brandon Waterman]

I am proud to say i will be a first time father come may 2009. I have been at my computer all dayresearching methods to transport my first child when born. After readingthe above article, i must say that after seeing the facts about strollers and other hardcast carriers, i feel more comfortable carrying my child in a traditional sling and or maya carrier like has been done for centuries versus transporting my child in a contraption built by the lowest builder. I have read report after report on these stroller and hardshelled carriers failing, versus 22 over a 10 year period, it doesnt take a rocket scientist to figure out what is the safest method of transport. Do some factual research before writing an ignorant article, it really does make you look bad.

[Brooke McIntire]

This report is nauseatingly wrong in so many ways. This is strictly the opinion of one very ignorant and uneducated man. Sir, you have NO IDEA what you are talking about. You're "Facts" are simply your opinion, on a matter that you have obviously not taken the time to do appropriate research. Once again, my opinion of CR's is very low due to inaccurate and bogus reports.

As a co-leader of a local babywearing group, I have to battle this kind of information EVERY DAY, and it makes it so difficult for me to help mothers (and fathers) wear their babies safely. This is not a celebrity induced fad, as most celebrities wear their babies inappropriately. This is a way of child-rearing that has taken place for centuries.

I highly recommend you learn to research things before you post something so stupid as fact. I am so very very disgusted with this entire situation. I just pretty much echo what everyone else has said.

Brooke McIntire
Co-leader
River City Slingers
Decatur, AL

[Bailey Umm Ibrahim]

I think that in our society; because babies are not traditionally worn parents and caregivers don't know how to do it, couple that with the fact that there *are* some shotty slings and less than stellar baby carriers out there that are not just a waste of money but also a hazard. But, the vast majority of carriers are safe *when used properly*. Additionally in the majority of the world mothers still carry their babies around in some sort of carrier. It is the norm worldwide, it has also been the norm since who knows how far back. Car seats and strollers are a recent invention and so personally, and in my own experience I do think that if one uses a carrier properly and with common sense it's definitely safer than anything else out there.

[Nico]

I'm amazed Consumer Reports let this blog be posted & then LEFT IT UP! Where are the supporting facts? As far as I can see the facts support the opposite of what is being stated here. Are the editors alseep?? As a pregnant woman I've never used a sling & never owned any of the rest but even I can see this article has no value.

[Wendy]

I think the previous comments have said it all, this article is biased and ridiculous. I will now be taking any other recommendations CR has made with a grain of salt. If you are so out of line on this, how can I rely on CR for any information?

Since most of the documented injuries were from the parent tripping, I want to point out that I once had a bad fall while wearing my baby in a maya wrap. The maya wrap saved my baby because she stayed close to my body and secure in the wrap when I fell on my hands and knees and bloodied them up. If I had been holding her in my hands/arms she would have fallen on the hard cement. Thank goodness I had on a baby carrier.

[Eric]

I’m surprised that CR would encourage the use of other transportation methods, when the Consumer Product Safety Commission, an agency obviously respected by CR as a reliable source, reported for 2005, one year mind you not ten, 10,800 stroller injuries and 14,000 hand-held infant carrier/car seats injuries. If I had to choose a method of transportation for my child I would go with the product that had less than 3 injuries per year over the product that had more than 10 thousand injuries per year.

[Marketing Mommy]

Is this post an April Fool's joke or an attempt to get a job at The Onion? I'm flabbergasted that Consumer Reports would recommend a car seat or stroller over a sling. If I hadn't canceled my subscription a couple of months ago, I definitely would today.

[Julie]

The whole tone of this article is biased. Twenty-two injuries in ten years is very low. How many injuries have there been from stroller use? Many, many more, I would venture to guess. An improperly used stroller would be just as dangerous or possibly more so. It is unfortunate that this article (1) does not distinguish between types of carriers, (2) does not compare carriers to other methods of transporting babies, and (3) does not acknowledge that the "user error" likely results from our societies lack of familiarity with baby carriers.

Dismissing babywearing in favor of infant carseat style carriers and strollers when no data supporting lower injury rates for those methods is shocking.

One expects Consumer Reports to be unbiased and well-researched. This article was neither, and thus, I no longer trust Consumer Reports. I will not renew my subscription.

[J.B.]

Wow... it is amazing to me that a person uneducated on this subject wrote this article. Have you checked how many infant carseats have toppled over a shopping cart resulting in injury? Or maybe how many infants have fallen out of their strollers? Or babies in jogging strollers that have had the front wheel come off? I have had my infant in a sling/wrap/soft structured carrier since the day he was born. It is much safer then any stroller I have ever seen.

[J.J.]

So, 22 injuries over a ten year period is worse than the hundreds of stroller/carseat related injuries reported each year? Perhaps you should have included statistics to compare carrier injuries to injuries that occur in strollers, carseats, or shopping carts.

I am disappointed at how one-sided and presumptious this report is. Next time you should actually do some research instead of make a bunch of uneducated assumptions.

[Holly McCroskey]

Carrie, positional asphyxia refers to what happens when a newborn's head is pressed down into a chin-against-chest position. The newborn does not have the neck strength to keep his head up, so this can happen when the baby is in a carseat that's not at the correct recline angle, and it can happen in a sling or other carrier when the baby is not positioned correctly. The "kink" in the baby's airway can cause breathing difficulties and even suffocation.

This is an easy problem to avoid in most baby carriers, including most ring slings, with some awareness and perhaps a little practice. But bag slings, like the Infantino pictured, have several design features that can make it very hard for a newborn to breathe. (Infantino has recently added mesh panels to the sides of their bag sling in an effort to solve this problem, but of course many older models are still in use. And it's not a complete solution either.)

In any case, of course, the risk goes down a lot as soon as the baby gains more head control and strength, usually between 2 and 4 months.

I posted a long, detailed comment with links to statistics on stroller- and carrier seat-related injuries, as well as links to non-commercial/non-profit websites with a wealth of information on babywearing (including the one on which the original research regarding positional asphyxia in bag slings was posted), but it was "flagged as possible comment spam" perhaps because of the links. I do hope that Consumer Reports will publish it.

[Jane Lebak]

The article states:
"But, as we all know, consumers may not read the instructions, and misinterpretation or misunderstanding can lead to errors that can endanger precious cargo."

This is definitely true about car seats, which are installed improperly nine out of ten times even by parents who have read the owner's manual. But a baby sling is a fairly straightforward and uncomplicated piece of "equipment" and yes, my Mayawrap did come with an instruction video.

When a sling is used improperly, the wearer frequently knows it because the baby's position isn't secure. This is opposed to strollers and car seats which appear to function properly right up until the moment of crisis.

This is a very poorly written and poorly researched article. I generally expect better of Consumer Reports.

[candy]

This is a ridiculous report that reminds me why I hate Consumer Reports. They never do enough research on the products to come to any valuable conclusion.

Slings are safe. Life is dangerous.

Candy

[Shannon]

I am extremely disappointed in this article. 22 injuries in 10 years? Is that even worth reporting? Of course, any injury to a child is a tragedy, but they happen with ALL types of carriers, and 2 children a year is a very low number.

I'd be much more interested in seeing an article about how many babies have been injured by strollers and/or carseat carriers in the same 10-year span. I know for certain that there have been carseat recalls because of faulty handles that can give out and spill the baby out of the carrier. Babies have also died from positional asphyxiation in carseats, and some have been strangled by the straps when they were sleeping in the seat without being strapped in tightly enough. Babies have also fallen out of shopping carts, which have tipped over because the infant carseat on the top made them top heavy. Shopping with the baby in a sling or other worn carrier would solve that problem entirely.

There have been stroller recalls because of folding and tipping issues. How many babies have been injured in these sorts of accidents? How many babies have slipped out of a stroller because they weren't strapped in? How many toddlers have climbed out and tipped it over? User error is a concern with ALL baby products, and I'd guess there are a lot more than 22 injuries in 10 years with most other items.

Slings, wraps, mei tais, and other soft baby carriers are generally very safe. Yes, there is a learning curve to use them, but most come with written instructions, and many come with video demonstrations, as well. I wore both my daughters in slings and had absolutely no reservations about their safety because 1) I read the directions, 2) I practiced putting a baby doll in the sling before I put the wiggly baby in it, and 3) they were close to me, so I was much more aware of their well being than I would have been if they'd been facing away from me, mostly out of my sight in a stroller. Both despised the carseat and stroller but were quite content in the sling, close to Mama, where they could observe the world and then fall asleep when they were tired. Wearing them in the sling also kept them away from curious groping stranger hands and germs during flu season, and it provided a discreet way to nurse them when we were out and about.

I would suggest you do a lot more research before recommending against baby slings. They're probably a much SAFER way to carry a baby when you consider the injury statistics for strollers and infant carseats.

[Katrina]

I find your shortsighted dismissal of sling-type baby carriers to be extremely disappointing considering your place in the consumer landscape as a supposedly unbiased organization committed to providing expert product ratings and reviews.

I would have assumed that in an effort to provide expert reviews your organization would have done more research in an attempt to actually gain expertise relating to infant carriers. By availing yourselves of any of the many excellent sources of information on sling-type carriers you could have provided a more informed and intelligent recommendation than avoiding them.