H = Hands-free
If you feel the need to use your hands or arms to support your child, then your instincts are kicking in to prevent them falling out! To make the carry secure enough so that you can be hands-free, check that it is fastened correctly and safely, and that your child is snug against you. If in doubt, get 1:1 support to learn how to achieve a hands-free carry.
A = Airway
Always check your child can breathe! Nose and mouth should have plenty of airflow and you should be able to fit two fingers under their chin – they shouldn’t have a chin slumped down onto their own chest (it’s hard to breathe like that!) Sleepy small babies tend to snuggle on in: be vigilant and gently reposition if you need to. Never cover your babies’ whole head (even if you think they’d prefer to nap in the dark) – make sure there’s always plenty of airflow. If in doubt, get 1:1 support to learn how to achieve a safe carry.
N = Knee to Knee
Check that there is fabric supporting your child from the back of one knee, all the way under their bum to the back of their next knee. Your child should still be able to move their knees and lower legs freely. This is optimal positioning, in the absence of other considerations.
D = Deep seat
This means that your child is sitting with their knees higher than their bottom, with a nice gentle ‘j’ curve running from bottom of the bum up the back. This is known as a ‘pelvic tuck’ position. This is optimal positioning, in the absence of other considerations.
S = Supported back
We want your baby to be supported by the sling in the position in which they’re comfortable, and which supports their back and spine. Have a look at your baby in position but without the sling – just held in your arms. Have a look at the natural curve to their spine. We want to respect that natural spinal position in a sling – smoothing it up over your child’s back for a tight carry that doesn’t distort their back position. A sling that doesn’t support their back enough, can lead to a child slumping down, which can lead to an airway risk. Supporting your child’s head in the sling with your hand, gently lean forward and ensure their torso does not move away from you. Typically before head control is present, a sling needs to provide support up to the nape of the neck. After head control is present, the supported is needed to the top of the shoulders, and once a child can sit unaided, up to their armpit level as a minimum.
With thanks to the UK Sling Consortium – http://babyslingsafety.co.uk/
These are a more common set of guidelines, although they don’t work for all carries (e.g. if you’re carrying a child on your back they aren’t close enough to kiss, but could still be safe!) The TICKS guidelines are particularly designed to prevent airway and fall risks when carrying babies on your front. Close enough to kiss is really about making sure a child isn’t sleeping on a pillowy mammary zone!
More safety resources
From Carrying Matters
GP Rosie Knowles runs the Carrying Matters website, a seriously well-researched site with excellent guidance on all things sling. See her ‘How to use a sling safely‘ page for:
- Diagrams of ergonomic positioning as babies grow
- Video of how to do a ‘pelvic tuck’
- The ABC sling safety acryomn (does a very similar job to HANDS or TICKS but might be more memorable for you?)
- Advice on the risks of overheating and carrying safely in very hot or cold weather
- Risks to be aware of when your child is facing out
- Using your sling for exercise
- Getting to know your sling and child