Babywearing Articles & Research

Our volunteers have worked hard to summarize the latest articles and research on babywearing and related topics. Know of one we haven’t included? Please contact us to let us know. Wherever articles are freely available, we have included a link. Copies of articles that are not available to the public are available to School of Babywearing trainees under our academic copyright license – this is indicated in the table below where relevant.

If you’re attending a School of Babywearing Consultancy course, you may well like to read the Cache or Carry , Attachment Versus Attachment Parenting articles and look into the section on Physical Development which highlights the links between babywearing and healthy hip development before your course.

Research topics:

Breastfeeding

Crying

Kangaroo Care, Premature Babies & Skin to Skin

Parenting, Anthropology & Attachment

Physical Development

Postnatal Depression

Sleep

Breastfeeding

Use of baby carriers to increase breastfeeding duration among term infants: the effects of an educational intervention in Italy
A Pisacane, P Continisio, C Filosa, V Tagliamonte, G I Continisio 2012
This study investigated whether the use of baby carriers with term infants during the first month of life is associated with increased breastfeeding rates. It found that infants carried for at least one hour per day during the first month of life breastfed more frequently at two and five months than those who were not carried.

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 Article available to School of Babywearing students

Crying

Baby Years – Babyjahre – das andere Erziehungsbuch
RH Largo 1995
This excerpt discusses the connection between close physical contact between a parent and baby, and non-specific crying. It references a study reporting that repeated carrying for three hours per day leads to a considerable reduction of crying, where the carrying is spread over the whole day.

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Increased carrying reduces infant crying: A randomised controlled trial
UA Hunziker, RG Barr Pediatrics 77 1986
This study investigated the links between a reduction in “normal” crying when babies were carried more frequently during the day. It concluded that increased carrying was linked with a reduction in crying in first born, breastfed infants in the first three months of life.
NB – Further studies did not replicate this result & some caution should be exercised in citing this study

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Article available to School of Babywearing students

Kangaroo Care, Premature Babies & Skin to Skin

Babywearing premature babies
V Ward Practising Midwife 2010
This article summarizes the benefits of babywearing for premature babies and offers advice on choosing the right sling.

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Breast and Infant Temperatures with Twins during Kangaroo Care
SM Ludington-Hoe, T Lewis, K Morgan, X Cong L Anderson, S Reese JOGGN 2006 35
This study showed that breasts change temperature in accordance with infant temperature, to heat up or cool down an infant appropriately. They also showed that, during kangaroo care with twins, each breast can act independently to adjust to the need of the baby on each side.

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Chest skin temperature of mothers of term and preterm infants is higher than that of men and women
K Bauer, K Pasel, H Versmold Paediatric Research 1996 39(4)
This study monitored the temperatures of men and women, including mothers of term and pre-term infants and non-mothers. Women have higher temperatures than men, mothers have higher temperatures than women who are not mothers and lactating women’s temperature is higher still, with small increases in temperature for days post birth. Lactating mothers can have a temperature 3 degrees higher than non-lactating mothers and a larger area of the chest warms up to warm the baby.

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Article available to School of Babywearing students
Further information
Early Contact versus Separation: Effects on Mother–Infant Interaction One Year Later K Bystrova K, V Ivanova V, M Edhborg et al Birth 36, 2002
This Russian study compared possible long-term effects of mother-infant interaction with both skin-to-skin contact and with separation of mother and baby. The researchers found that either skin-to-skin contact, early suckling, or both during the first two hours after birth when compared with separation between the mothers and their infants positively affected the outcomes of infant self-regulation at one year, and the mother showed greater interaction and interest in the infant and greater reciprocity compared with the separated pairs. The researchers argue that this shows that close contact between mother and infant immediately after birth may induce long-term positive effect on mother-infant interaction.

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Article available to School of Babywearing students
Early dyadic patterns of mother-infant interactions and outcomes of prematurity at 18 months
M Forcada-Guex, B Pierrehumbert, A Borghini, A Moessinger, C Muller-Nix Pediatrics 118(1) 2006
This study investigated the effect of mother-infant interactions on the behaviour and development of pre-term infants. It found that certain patterns of interaction were related to positive outcomes in terms of the pre-term infant’s development. The results indicated that the most important clinical implication should be to support a healthy parent-infant relationship in the NICU and in the first months of the infant’s life.

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Article available to School of Babywearing students
Early skin-to-skin contact for mothers and their healthy newborn infants
ER Moore, G Anderson, N Bergman, T Dowswell
Cochrane Pregnancy and Childbirth Group, 2012.This study assessed the effects of early skin-to-skin contact on breastfeeding, physiological adaptation, and behaviour in healthy newborns. It found that babies exposed to skin-to-skin contact interacted more with their mothers and cried less than babies receiving usual hospital care. Mothers were more likely to breastfeed in the first one to four months and tended to breastfeed longer, if they had early skin-to-skin contact with their babies.

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Effect of early skin-to-skin contact after delivery on duration of breastfeeding: a prospective cohort study
K Mikiel-Kostyra, J Mazur, I Boltruszko, Acta Paediatrica 91 2002
This Polish study followed children from birth to three years of age and looked at the influence of skin-to-skin contact at birth on breastfeeding. It concluded that skin-to-skin contact between mother and infant lasting longer than 20 minutes increases the duration of breastfeeding.

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Article available to School of Babywearing students
Effect of Kangaroo Mother Care on physical growth, breastfeeding and its acceptability
G Gathwala, B Singh, J Singh, Tropical Doctor 40(4) 2010
This study investigated whether Kangaroo Mother Care (KMC) to low birthweight infants would improve breastfeeding, physical growth and its acceptability. Babies received KMC for at least six hours per day, including after moving from the neonatal intensive care unit and at home. Researchers found significantly increased weight gain, length gain and occipitofrontal circumference gain in the KMC infants when compared with the control group. The exclusive breastfeeding rates were increased in the KMC group, and KMC was well accepted by mothers and nurses.

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Effects of handling on the subsequent development of premature infants
N Solkoff et al, Developmental Psychology 1(6) 1969
This 1960s study looked at the immediate and subsequent effects of touch on the behavioural and physical development of low birth weight infants, and compared it with traditional nursery care. It found that the infants who were stroked in their cribs for 5 minutes every hour were more active, regained birth weights faster, and were physically healthier than the babies not exposed to touch.

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Heart Rate Variability Responses of a Preterm Infant to Kangaroo Care
GC McCain, SM Ludington-Hoe, JY Swinth and AJ Hadeed
Journal of Obstetetrics, Gynecology & Neonatal Nursing 34(6) 2005
This case study describes the behaviour of a 35-week old preterm infant. While in an open crib, he was fussy and restless, but calmed and fell asleep immediately on being placed skin-to-skin on his mother’s chest. Heart rate variability was increased when in the open crib but decreased during kangaroo care. These changes were indicative of decreasing stress.

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 Article available to all
ICEA Position Paper on Skin to Skin Contact
A summary of relevant research on skin to skin for Childbirth Educators

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Kangaroo care in pre-term or low birthweight babies in a postnatal ward
S Gregson, J Blacker British Journal of Midwifery 19(9) 2011
This study compared the use of kangaroo care (skin-to-skin contact with the mother) with standard care (next to mother in a cot) for premature or low birthweight babies of diabetic mothers on a transitional care ward. It found that in the group using kangaroo care, the length of hospital stay decreased and exclusive breastfeeding rates increased. It also found that parents rated kangaroo care highly, especially in the two weeks following birth.

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 Article available to School of Babywearing students
Kangaroo Care (Skin Contact) Reduces Crying Response to Pain in Preterm Neonates: Pilot Results
R Kostandy R, Pain Management Nursing, 9(2) 2008
This pilot study investigated whether maternal kangaroo care could reduce preterm infants’ crying response to the heel prick test. It found that where kangaroo care was employed for at least 30 minutes before the heel prick test, crying time was lessened during the test and recovery time, when compared with infants remaining in an incubator.

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Kangaroo mother care for low birthweight infants: a randomized controlled trial in different settings
A Cattaneo et al    Acta Paediatrica 87, 1998
This study looked into the effectiveness, feasibility, acceptability and cost of kangaroo care compared with conventional methods of care in Ethiopia, Indonesia and Mexico. Researchers found that overall with kangaroo care, hypothermia was significantly less common, exclusive breastfeeding at discharge was more common, mean daily weight gain was higher, and infants were discharged earlier.

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Kangaroo mother care to prevent neonatal deaths due to preterm birth complications
Lawn et al, International Journal of Epidemiology 39 2010
Researchers conducted a systematic review of 15 studies looking at the effects of kangaroo mother care on neonatal mortaility caused by complications of preterm birth. They concluded that kangaroo mother care significantly reduces neonatal mortality rates among preterm babies in hospital and is highly effective in reducing severe morbidity, particularly from infection.

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Kangaroo transport instead of incubator transport
D Sontheimer, C Fischer, K Buch, Pediatrics 113 2004
This study investigated kangaroo transport – transporting a preterm infant on the mother’s or other caregiver’s chest – and compared it with traditional incubator transport. The study found that heart rate, respiratory rate, oxygen saturation and rectal temperature remained stable during all kangaroo transports; common risks associated with incubator transport. Parents also felt comfortable with kangaroo transport.

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Article available to School of Babywearing students
Testing a Family Intervention Hypothesis: The Contribution of Mother–Infant Skin-to-Skin Contact (Kangaroo Care) to Family Interaction, Proximity, and Touch
Feldman R et al, Journal of Family Psychology 17(1) 2003
Researchers studied the effects of skin-to-skin contact between preterm infants and their mothers in a neonatal nursery. They found that where skin-to-skin contact occurred, mothers and fathers were more sensitive and less intrusive, infants showed less negative affect and family style was more cohesive. Interestingly, positive effects on the family unit were also observed: maternal and paternal affectionate touch of infant and spouse was more frequent and spouses remained in closer proximity.

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Article available to School of Babywearing students
The Effect of Skin-to-Skin Contact (Kangaroo Care) Shortly After Birth on the Neurobehavioral Responses of the Term Newborn: A Randomized, Controlled Trial
S Goldstein Ferber, I Makhoul    Pediatrics 113 2004
This study evaluated the effect of kangaroo care used shortly after delivery on the neurobehavioural responses of newborns born at term. Results showed that four hours postnatally the infants who had received kangaroo care slept better, were mostly in a quiet sleep state, exhibited more flexor movements and postures, and showed fewer extensor movements. These findings support the use of kangaroo care straight after birth for healthy, term infants.

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Article available to School of Babywearing students

Parenting, Anthropology & Attachment

Attachment versus Attachment Parenting
Tracey, 2013
A discussion of the key elements of attachment parenting and the differences between Attachment and Attachment Parenting.

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Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment
E Anisfeld E, V Casper, M Nozyce, N CunninghamChild Development 1990This study looked at the link between increased physical contact using baby carriers and more secure attachment between mothers and babies. It concluded that for low-income, inner-city mothers, there may be a causal relation between increased physical contact, achieved through early carrying in a soft baby carrier, and subsequent security of attachment between infant and mother.

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Hold Me Close: Encouraging Essential Mother/Baby Physical Contact in Birth: Care of Infant and Mother: Time Sensitive Issues Best Practices in the Behavioral Management of Health from Preconception to Adolescence Maria Blois 2007-8
This article discusses various methods of increasing physical contact between a mother and her baby: kangaroo care, in-arms holding, and using soft baby carriers. It compares the results of a number of studies into baby carrying and concludes that promoting skin-to-skin contact, in-arms holding and babywearing offers benefits to both the baby and the parent.

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Infant Carrying: The Role of Increased Locomotory Costs in Early Tool Development
CM Wall-Scheffler, K Geiger, KL Steudel-Numbers
American Journal of Physical Anthropology (2007)
This study compared the physical drain of carrying an infant in-arms with carrying in a sling. It found that the burden of carrying in-arms is 16% greater than using a tool (i.e. a sling) to support the baby’s mass, which is potentially an even larger burden than breastfeeding.

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Article available to School of Babywearing students
Natural Parenting – Back to Basics
Regine A Schön, Marrit Silvén Evolutionary Psychology, 2007
This review examined natural parenting, including extended breastfeeding, babywearing and cosleeping. The study included a critical investigation of Western parenting and concluded that natural parenting offers infants an ideal environment for optimal growth – both psychologically and physiologically.

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Physical Development

Back-carrying Infants to Prevent Developmental Hip Dysplasia and its Sequelae: Is a New Public Health Initiative Needed?
S Graham, J Manara, L Chokotho, W Harrison Journal of Pediatric Orthopedics 35 (1) 2015
This is a retrospective review of the incidence of hip dysplasia in Malawi, where the vast majority of infants are carried on their mothers’ backs between 2 & 4 months of age. It is suggested that the position in which they are carried is the prime reason for the low incidence of hip dysplasia and recommends a clinical trial into back carrying and the prevention of hip dysplasia in African populations.

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Article available to School of Babywearing students
Cache or Carry? Comparative biology and infant carrying
K Nicolai (2013)
A comparison of the behaviour patterns of different mammals and the ways that human babies are ideally adapted to being carried.

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Cardiorespiratory Stability of Premature and Term Infants Carried in Infant Slings
W Stening, P Nitsch, G Wassmer, B Roth Pediatrics, 110 (5) 2002
This study aimed to determine whether infants carried in slings are at risk of experiencing changes in cardiorespiratory movements. Infants were monitored while being carried horizontally or vertically in a sling or lying in a pram. The conclusion was that the use of slings is not associated with an increased risk of clinically relevant cardiorespiratory changes in term and preterm infants.

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Article available to School of Babywearing students
Increase in late diagnosed developmental dysplasia of the hip in South Australia: risk factors, proposed solutions
K Studer, N Williams, G Antoniou, C Gibson, H Scott, W Scheil, B Foster, P Cundy MJA 204 (6) 4 April 2016
This study looked at the incidence of hip dysplasia in Southern Australia, which was found to have increased. Increased awareness and education are recommended and there is a specific recommendation to provide information to parents about baby carrying.

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Infant Calming Responses during Maternal Carrying in Humans and Mice
G Esposito et al Current Biology 23 2013
This study found that infants under 6 months of age carried by a walking mother immediately stopped voluntary movement and crying and exhibited a rapid heart rate decrease, compared with holding by a sitting mother. Researchers observed very similar responses in mouse pups and concluded that the infant calming response to maternal carrying is actually a coordinated set of central, motor and cardiac regulations.

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Article available to School of Babywearing students

Related video

Motor skills gap hampers young children’s learning
C Gaunt Nursery World, 14 June 2011
This article discusses the results of a German study, which found that more than half of seven- and eight-year-olds in a group of 164 primary school children showed traces of residual primitive reflexes. These findings were in line with other small-scale studies carried out in Northumberland in 2006 and Northern Ireland in 2004. The article quotes the director of the Institute for Neuro-Physiological Psychology, who suggested that this could be due to some babies not getting enough tummy time, to help them develop reflexes and motor skills and concludes that babies need more time being carried rather than left in car seats & similar objects.

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The Containerization of Infants
B Breitbach 2010
This paper reviews the physical development needs of babies that are associated with being free to move, held in arms and not placed in ‘containers’ such as infant seats, car seats and pushchairs for prolonged periods of time.

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Unfounded fear of postural damage by carrying
Kirkilionis E. 1985, 1992.
This study investigated various carrying methods and durations, and found no link between carrying infants in an upright position and an increase in postural damage. It concluded that a fear of postural damage in children due to early carrying is unfounded, and similarly there is no need to fear spinal damage in carried children.

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Use extra caution with infant carrier slings
CPSC, 2010
Video from 2010 showing some of the dangers of bag style slings.

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Postnatal Depression

Depressed Mothers’ Touching Increases Infants’ Positive Affect and Attention in Still-Face Interactions
M Peláez-Noguerast al, Child Development, 1996
Researchers looked at the effects of depressed mothers’ touching on their infants’ behaviour while the mothers adopted a ‘still face’. Infants of depressed mothers showed more positive affect (smiles and vocalisations) and gazed more at their mothers’ hands where touch accompanied the still-face interaction than the infants of nondepressed mothers, who grimaced, cried, and gazed away from their mothers’ faces more often. These results suggest that mothers can compensate for negative effects of depression during interactions by providing touch stimulation for their infants.

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Sleep

Baby Business: a randomised controlled trial of a universal parenting program that aims to prevent early infant sleep and cry problems and associated parental depression
F Cook et al,. BMC Pediatrics 12 (1) 2012
This Australian study is ongoing and looks at whether providing anticipatory guidance about infant crying and sleep problems could improve adverse outcomes including postnatal depression symptoms, early weaning from breastfeeding, and later child behavioural problems. It is the first randomised controlled trial of a program which aims to prevent both infant sleeping and crying problems and associated postnatal depression symptoms. If effective, it could offer an important public health prevention approach to these common problems.

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Should Neonates Sleep Alone?
B Morgan, A Horn, N Bergman Biological Psychiatry 70, 2011
This study investigated the effects of maternal-neonate separation, a Western norm and standard medical practice. Researchers compared the heart rate variability of a group of infants sleeping in skin-to-skin contact with their mothers, and a separated group. Results showed an increase in heart rate variability power in infants sleeping separate from the mother, indicating that maternal-neonate separation may be a stressor the human neonate is not well-evolved to cope with and may not be benign.

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