The Facts about Forward Facing

Carrying babies forward facing (looking outwards toward the world) is something I get asked more questions about than anything else.  So many different questions on this topic.  The reason is simple – there is a lot of conflicting opinions on this and even more conflicting information.  A disturbing amount of this information comes from articles originally written by carrier manufacturers who either did or didn’t make forward facing carriers and was motivated by marketing. Very very little of it has any evidence to back it up.  So its no surprise that often parents are left pretty confused about whats best for them and their child.

So here are some of the questions I am asked and the facts to be aware of when deciding whats best for you and your little one;

Is forward facing dangerous? Nope.  There is absolutely no evidence to suggest forward facing your baby is in anyway dangerous, so long as they are developmentally ready and awake.  These carriers have all undergone safety testing – they simply would not have passed if there was evidence that forward facing could harm your baby.

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Rachel aged 7 months in the Ergo 360

The better question is – Is forward facing comfortable? While not remotely dangerous, its hard to get as comfortable position forward facing verses facing inwards.  Both for your child and for you.  For your child this is simply because the forward facing position in most carriers offers less support.  Less support for their legs, less support for their neck and upper bodies and as their backs are against you they are often slightly flattened out verses how they’d be either in arms or facing toward you.  None of this is dangerous, nor even uncomfortable in the short-term but but if worn for longer periods they might start to become less comfortable over time.  Think of it a bit like being in a rock climbing harness, completely fine for short periods you wouldn’t want to be in it all day every day.

For you the parent, forward facing is less comfortable as it puts the child’s centre of gravity further away from you.  We load bear best by holding weight high and tight to our own centre of gravity – when baby is inward facing the weight is held very close to our centre gravity.  In contrast, when facing forwards baby’s weight is held slight away and thus feels heavier and puts more strain on the parents body.  Again not a problem for shorter periods, and worth listening to your own body and reading babies cues when forward facing to ensure comfort levels on either side aren’t exceeded.

Is forward facing better for my child’s development?  Nope.  Again there is absolutely no evidence to support this at all.  I completely understand why people might think this would be the case, forward facing allows the child to look out and therefore perhaps ‘gain a better view’.  However, there is no evidence that this is helpful to a baby.  In fact there are several lines of research suggesting parent’s facial expressions are key in infant learning. This is called ‘social referencing’;  in new situations or experiences babies look to their parents or primary caregivers and watch their reactions first.  I.e. when someone picks up my daughter she immediately looks at me, if I smile she smiles and is happy to be held.  While if she can’t see me or I don’t smile she immediately cries.  She is using me as a touchstone to reassure her in this new situation.  Similarly as she begins to eat solid food, if I am eating it, she wants to eat it…. if I am not eating it, she has no interest!  Looking to our parents and watching their facial cues is an evolutionary driven imperative, it allows the infant to judge if a situation is safe or dangerous.  I.e. if my daughter reaches for something and I look alarmed … she knows its dangerous.  It also helps babies determine what is important/interesting, i.e. say she is looking at a new toy she also looks at me – am I looking at the toy? Do I find the toy interesting too?  Thus when holding or wearing our babies its important for their learning that they can see our faces.  When facing out they can’t, they don’t need to see our faces all the time so its fine but this idea that perhaps facing out is better for learning is certainly false.

Its also worth noting that in a well fitting inward facing carrier where baby is able to turn their head easily, they should still be able to get a really good view of the world.  And its worth considering how good a view they need – how well can they actually see?  Its interesting to note that while their eye sight is developing rapidly, children don’t generally reach full adult 20:20 vision until somewhere between 3-5 years of age!  In fact babies lack the ability to see in 3D until depth perception starts to develop somewhere around 5 months.

IMG_2451When can I start forward facing my baby?  When a) they have excellent head control and upper back strength and b) they are big enough to comfortably fit the carrier you have for them.

I prefer to explain this in terms of developmental markers rather than age because different babies will reach this sooner or later than others, and its more important that babies have reached this developmental stage than arbitrarily be over a certain age.  The reason they need excellent head control and upper back strength is simply because when forward facing the carrier is unable to provide any head support.  And because they are facing outwards their head and uppermost torso isn’t even supported by your body either.  So they need to be able to hold these up for themselves.  And its it needs to be rock solid – I remember my daughter went through a distinct ‘nodding dog’ stage where she could mostly hold her own head but she looked a little bit like one of those nodding dogs.  No nodding dogs!!…  we need rock solid.

Comfortably fitting the carrier you have for them is different between different brand carriers.  Some are bigger than others, and so the baby needs to be older/physically bigger before they can be used in the forward facing mode compared to other smaller brands.  Rachel and I are working on a full comparison of the forward facing carriers in the library, which will include more information on this…  But what you are looking for when trying carriers on is that baby is not over extended – that their backs are not really flattened out and over extended in order to look over the panel and equally their in a good sitting position with legs not over spread or conversely under supported.  When trying carriers on trust your gut – does baby look comfortable or overly straightened?

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Tom at 10 months old in the Lillebaby Complete, making friends at the Chinese New Year Celebrations in Trafalgar Square

How long can I forward face my child for?  Several manufactures suggest a time limit for forward facing.  This is something I find fascinating, because babies are all different and they are different on different days!  Some days my children would have been happy forward facing for an hour, other days they’d have got fed up of it after 5-10 minutes.  So far better to read their cues than work off an arbitrary time limit.  And it really is arbitrary because as far as I can tell, unlike the limits set for car seats which were set based on research and understanding of optimal infant positioning, these are suggested not based on any researched or evidence but in response to articles written by companies who didn’t make forward facing carriers and were suggesting that it was ‘dangerous’.  So the companies who did make forward facing responded by suggesting it was ‘safe’ so long as under an arbitrary time limit.

Confused?  I know I was!  So what cues are we looking for in deciding how long to forward face your child on any given day?  Babies enjoy forward facing best when they are wide awake and at their most playful and alert.  So we are looking to time around this phase, and as mentioned how long this phase will last will be different on different days!  We are then looking to turn baby inward before they get tired, as they are becoming less playful, less alert,… long before they are actually tired we want to bring them inward.  When forward facing, babies don’t have the ability to snuggle in if everything becomes too much, so we run the risk of over stimulation and ultimately over tiredness.  The best way to avoid over stimulation is to turn baby in long before they get tired.  This gives them the option to snuggle in and helps them process, and ultimately should help them get that all important nap when they need it!  We all know the pain of a missed nap!

Does it matter if my baby falls asleep while forward facing?  Yes. Unfortunately, there is no head support for baby while forward facing which means if they fall asleep and their head starts to loll there is nothing to help support their head.  If this does happen please check their airway – check that as their head lolls it doesn’t loll over the top of the carrier.

In an ideal world you’d turn your baby inward long before they started to fall asleep, but accidental naps do happen!!  So best practise would be as soon as you notice that baby is falling asleep you’d turn them inward.  While I understand it is obnoxious to move a sleeping baby, the forward facing mode is really only designed for babies who can hold their heads up and are awake enough to be able to hold their heads up.

But my baby isn’t happy in their Caboo/stretchy wrap, they are nosy and want to be able to see and only forward facing will let them do this.  I completely get this, the vast majority of parents coming to me considering forward facing are those whose babies are starting to grow out of the Caboo or Stretchy wrap.  As I have discussed at length before both the Caboo and stretchy wraps are amazing for newborns, but parents often feel ready to move onto something else when babies leave the 4th trimester and go through that huge developmental leap where there are sleeping less and more interested in the surrounding world.  These slings are pretty confining, they are like swaddling, so it not a big surprise that babies might grow out of them developmentally around the same time they grow out of swaddling.  However, please don’t mistake this restlessness in a stretchy wrap or Caboo – where the sides of the sling come up high close to baby’s face – to mean your baby particularly wants or need to forward face.  Instead swapping baby to a carrier where the fabric doesn’t pass beyond the top of the shoulder blades – giving baby the freedom to turn their head this way and that unfettered – is usually more than enough to cure this new-found restlessness in slings.

21013881_1288986917896999_3133343590819235261_oIts also worth noting that forward facing is not the only alternative for a nosy baby.  Most slings and carriers also offer positions on the carers hip or back.  In general, for a buckle carrier, the hip position can be used once baby has good head control.  From here baby can see outward and get just as good a view of the world as they would forward facing, but they can also see the parents face for social referencing.  They can easily tuck in towards the parent when they start to become tired and naturally fall asleep, and they are fully supported in a very ergonomic position.  Its also possible to wear a younger baby on the hip in a ring sling or woven wrap or even a stretchy wrap, provided that the sling is worn in a way that supports the baby’s neck.  Often a muslin rolled into the wrap or sling is perfect for this – providing support behind the babies neck but still allowing them to move and be as nosy as they like!

img_8713The other alternative is to wear baby on your back.  Once they are tall enough to see over your shoulder they can get the same view as forward facing on your front, but it is more comfortable for you the parent as we load bear much better placing weight on our back verses carrying weight on our fronts.  Like the hip carry, it also gives the child the option to tuck in and fall asleep when needed.  For a buckle carry, this position can be used once the baby is able to sit independently or is very very close to being able to sit independently.  So in theory often from 6 or 7 months old, however, most 6 or 7 months old can’t see over their parents shoulders yet and thus are usually less impressed with this position.  Instead back carrying in a buckle carrier comes into its own from around 1 year old.  However, it is possible to carry younger babies on the back – my choice for this is a woven wrap because it is possible to wear babies up much higher so they can see over your shoulder right from the beginning and because they can be tightened to give better support enabling a baby who is not yet able to sit independently be worn on the back without fear of slumping etc.

It is also worth considering how long the forward facing phase lasts for.  As discussed above, babies can be worn forward facing once they have excellent neck and upper torso strength.  This is typically around 4 months (although this can vary a lot, anywhere from 3 months to 6 depending on the individual child).  Interestingly, around 8-10 months most babies seem to grow out of forward facing.  They are less interested and/or equally happy or even more happy in a inward facing carry.  Also around this time they get a lot heavier and the extra strain of forward facing starts to become too heavy for the parent.  Consequently, this is also often when parents start thinking about switching over to back carrying instead.  So the forward facing carrying phase is actually pretty short, typically only 4 to 5 months.  When you consider the majority of forward facing carriers are designed to be used from birth all the way to 2 or even 3 years old – the forward facing phase is only actually quite a small percentage of the total life of a carrier.

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Rachel aged 8 months in the Ergo Omni 360

Finally its worth considering cost and your budget.  Generally speaking you’ll pay a premium for forward facing. So its worth weighing all the information above up and decide how much you might use the forward facing position and how much it is worth to you.  How much are we talking?  Depends on which carriers but for example the new Ergo Omni 360 is £155 verses the Ergo Adapt (which does not offer forward facing but is a very similar carrier to the Omni in every other way) at £110.  So in this case the ability to face forward is costing £45.  Most forward facing carriers are around the £120-£150 mark.  While carriers lacking this function (but offering all the other positions, and a great many other features etc) are typically in the £75-100 region.  The exceptions to this are the Izmi priced at £75 and the Beco Gemini at £99… but these are a fair bit smaller than other forward facing carriers such as the Ergo 360s, the Lillebaby Complete, the Beco 8, the Mountain buggy Juno etc etc and thus while they do cost less they are unlikely to last your baby quite as long.  Deciding on whether its “worth it” or not is really a personal choice and depends a good deal on the personal preferences of both you and your child!  This can be where hiring a carrier for a couple of weeks and trying it out in your normal day to day life can really help.  I’ve had parents who’ve tried it out and decided that forward facing is a position they really love and use frequently and likewise I’ve had parents that to their surprise have found that they barely used the forward facing position.  For the latter group many went on to choose another carrier that didn’t offer the forward facing position and saved themselves a good deal of money. While those in the former group invariably were able to happily go and spend the extra money safe it the knowledge that it would be worth it for them.

-Madeleine

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