Human babies are born more dependent on their caregivers than most other mammals. They need close contact with an adult for feeding, comfort, warmth and protection. Parents and caregivers around the world have carried their babies for thousands of years using slings and carriers.
Today, many babies spend some of their daytime sleep in a sling or carrier. In a recent UK survey that my colleagues and I conducted, 96% of the 1,470 parents and carers of babies under one who responded said they had used one, often to soothe their baby or remain mobile while keeping them close.
Slings and carriers can be useful, but babies need to be positioned carefully, particularly when they are very young or are being fed. In a systematic review, my colleagues and I found reports of infrequent accidental deaths and injuries associated with poorly fitted or incorrectly positioned carriers.
Following the death of a seven-week-old baby who was being breastfed hands-free in a carrier while his mother moved around her home, a coroner warned that parents were not being given enough information about how to position young babies safely and called for consideration of industry standards. The Lullaby Trust, a baby-safety charity, has also published advice urging parents not to feed babies hands-free in slings or carriers.
At the Durham Infancy and Sleep Centre, my colleagues and I study infant sleep and sleep safety. We take an anthropological approach, considering both babies’ physical needs and the cultural expectations placed on parents. This helps us develop evidence-based guidance for families, health professionals and policymakers.
To understand both the benefits and risks of babywearing, we first carried out a systematic review. A systematic review is a method of bringing together and evaluating the available research on a particular topic. We found evidence that using slings and carriers can benefit babies and caregivers. Reported benefits included supporting breastfeeding, promoting infant development, strengthening parent-infant bonding and improving parental mental health and wellbeing.
The review also examined the risks associated with sling and carrier use. Overall, deaths associated with slings and carriers were infrequent. When deaths did occur, the most common cause was asphyxia, which means a baby is unable to get enough oxygen.
Young babies, especially those under four months of age, are particularly vulnerable because their neck muscles are still developing and may not be strong enough to support their relatively large heads. If a baby’s head and neck are not properly supported, or if they are positioned unsafely, their chin can fall onto their chest and restrict their airway, making it harder to breathe. This is known as positional asphyxia.
The review also found that injuries were most commonly linked to falls, either because a baby fell from a sling or carrier or because the caregiver carrying them fell. Both deaths and injuries were often associated with slings or carriers that were poorly fitted or used incorrectly. This suggests that clearer guidance on safe use could help to prevent some of these incidents.
To understand what parents know about sling safety, we also conducted a survey of UK caregivers. We found that parents use slings and carriers for a wide range of reasons, including making it easier to get around, strengthening bonds with their baby and helping to soothe or settle them. Most parents began using a sling during the early months of infancy and many had already decided to do so while pregnant.
Despite this, many parents reported receiving little or no information about safe sling use from manufacturers or retailers when purchasing a sling or carrier. We also found that many were unaware of the specialist support available across the UK. This includes sling libraries, community services where parents can borrow different types of slings and carriers, receive personalised fitting advice and learn how to use them safely.
A quarter of the parents surveyed were not aware of existing UK guidance on sling safety. Another quarter felt that the guidance they had seen did not provide enough information. These findings highlight both the important role that slings and carriers play in infant care and the need for clearer, more accessible safety information for families.
Our research shows that slings and carriers can offer benefits for babies and caregivers. It also found that deaths and injuries associated with sling use are infrequent and are often linked to poor fit or unsafe positioning. Although these incidents are uncommon, their consequences can be devastating. Parents need clear, practical information about safe use.
With slings and carriers widely used in the UK, there is a strong case for a national, evidence-based campaign on sling safety. Parents should receive clear guidance at the point of purchase, including information about how to position babies safely, how to recognise and prevent positional asphyxia and why it is important to keep babies under close observation while they are in a sling or carrier.
Guidance should also direct families to specialist sources of support so that they can use slings and carriers safely and confidently while enjoying the benefits they offer.
