Four ways of carrying your baby from birth which make life easier (not harder)

There are four different ways of keeping babies up close to our bodies, and things worth knowing about these methods which might be different to what you've heard. Needless to say, you won't always want to have your baby in a carrier or in your arms. Life is definitely about workability, not perfection, when you're looking after a baby! But using a baby carrier at times generally makes life a lot easier, not harder.

You can find out about baby carrier use and safety, including protecting your baby's hip development, here.

1. Skin-to-skin contact

There's a great deal of evidence to show the benefits of generous amounts of skin-to-skin contact with your baby from immediately after the birth, and hospitals now work hard to support this.

But if you and your little one do have to be separated in that sensitive time, it helps to remember that establishing breastfeeding and building a strong bond together happens not just in those few hours post-birth, but over the days and weeks and months ahead. You and your baby form a surprisingly resilient ecosystem, actually. Just do what you can to keep your little one close (and direct breastfeeding very frequently), once that becomes possible.

Also, don't feel you have to completely strip your baby and have direct contact between your bare chest and baby's skin after the first day. Direct skin-to-skin contact definitely has benefits in those first hours and days of life, and is something your baby's other parent or other loving adults can provide. But here are some thoughts to take into account as you experiment your way through.

• What matters going forward into your life together is physical closeness, even if there is a layer or two of soft fabric between you and your baby. Just minimise bulkiness, that's all (unless you're outside in a cold climate)! When breastfeeding, you might often keep your baby in light warm garments as a matter of practicality. We want to make everything as easy as possible for you and your baby.

• Even if you don't take your own upper garments or bra off, have the whole of your breast exposed so that baby can achieve a good face-breast bury when you breastfeed. There is more about the gestalt method of fit and hold here.

• Undressing your baby before offering the breast can dial your baby up, which might interfere with baby coming on to the breast easily. Of course, the whole idea with skin-to-skin contact is that it then dials baby down again. But use your own judgement, as you get to know your baby.

Prematurely born babies and Kangaroo Mother Care

In industrialised societies we've tended to think that keeping prematurely-born or low birth weight babies separate from the mother's body in highly regulated and technologically monitored environments is best for them. But the latest research very clearly shows that skin-to-skin care, known as Kangaroo Mother Care, dramatically improves the survival and well-being of low birth weight and preterm babies, unless the newborn is critically sick. The World Health Organisation recommends Kangaroo Mother Care as the essential standard of care for all preterm and low birthweight babies, in all countries, starting immediately after birth.

2. Carrying baby in your arms

Often babies (especially once they are older than two weeks) don't like being held upright with their tummy against a caregiver's upper chest and their head against the caregiver's shoulder. They can't easily see the world around them in this position. If your baby is fussing or dialling up in this position, it's not due to reflux or wind or air swallowing, the way you often hear. Perhaps you could experiment with something different.

Most babies love to be held across their parent's forearm, their spine tucked securely in against your body with firm pressure over their tummy, their head resting on your arm but facing out, your hand holding their upper thigh. This position dials babies down because they feel firmly held in against you but can still see the world around them. This position is also a form of tummy time, in which your baby practices constantly adjusting her posture against the highly variable experience of gravity acting on her little body (in tiny ways that you might not even notice) as you move around.

3. Babywearing on the front of your body

In the first two or three months of life, your baby looks in with his chest and tummy snug up against your body when you are wearing him in some kind of carrier. I discuss safe use of a baby carrier on the front of your body here.

But parents might find that from sometime after two or three months of age, their baby is much happier in a carrier when facing outwards. This is because he wants to see as much of the world as possible!

You might hear that you can’t turn the baby around in the carrier with his back against you, looking out, until he is a certain age in order to protect his spinal development. I worry that this advice results in families missing out on the benefits of baby carrying unnecessarily.

Actually, you can turn your baby to look out from the time she begins to signal that she is happier that way. What matters is that you protect her developing motor and musculoskeletal system, by ensuring that

• Her pelvis and spine are flexed forward into a C-shape, to protect her spine from a 'banana back' shape, also known as hyperextension

• Her little legs are spread apart and her hips tilted forward in an 'M'-shaped or 'frog-legged' position, which protects against Developmental Dysplasia of the Hips.

4. Babywearing on the back of your body

My babies spent many hours in a light aluminium-framed backpack carrier, well before the six months that is commonly advised as the lower age limit for using structured or camping backpacks these days. They loved it. I made sure that their pelvis and spine were C-shaped, and their hips frog-legged. This was before babies were strapped into back-packs and they flopped around a bit at first, but I was careful. I knew even then, from early cross-cultural studies, the benefits of constant postural change relative to gravity for developing little motor and nervous systems. In my life, backpack carrier use from early on meant a happy baby. It meant that my hands were free to do things, either inside the house, or as required by the toddler.

Straps in structured backpack carriers are a sensible safety feature. Some parents use cloth wraps or semi-structured carriers on their backs, but others find these too fiddley. For myself, it was important to make it easy - having a structured aluminium frame that sat securely on the ground as I put the baby in before lifting it up onto my back worked very well for me. I could put the baby on and off, on and off my back, according to our changing circumstances.

Structured backpack carrier use is a strategy some parents like to experiment with in the evenings with older babies, whose sensory needs can be intense and exhausting at that time of day. Backpack babies love seeing what the parent is up to, peering over the parent's shoulder, pulling on the parent's hair, chewing on the parent's T-shirts, revelling in the constant motion and changing view, at the same time as the parent – if slower than usual – might even manage to get something done!

Recommended resources

Kangaroo mother care: a transformative innovation in health care. World Health Organisation 2023

Why baby wearing makes life easier (not harder)

How to use baby carriers safely from birth

What is sensory motor nourishment and why does it help with baby sleep?

Filling your baby's sensory tank

What your baby needs for best possible motor development

About positional plagiocephaly and motor development

The NDC evolutionary perspective on positional plagiocephaly, motor development and sleep

The holistic NDC or Possums 8-step approach to supporting baby's motor development

Selected references

Berecz B, Cyrille M, Casselbrant U, Oleksak S, Norholt H. Carrying human infants - an evolutionary heritage. Infant Behavior and Development. 2020;60:101460.

Bergounious J, Madre C, Crucis-Armengaud A. Sudden deaths in adult-worn baby carriers: 19 cases. European Journal of Pediatrics. 2015;174:1665-1670.

Conde-Agudelo A, L D-RJ. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews. 2016;2017(8):CD002771.

Esposito G, Yoshida S, Ohnishi R, Tsuneoka Y, Rostagno MdC, Yokota S, et al. Infant calming responses during maternal carrying in humans and mice. Current Biology. 2013;23:739-745.

Havens KL, Goldrdod S, Mannen EM. The combined influence of infant carrying method and motherhood on gait mechanics. Journal of Applied Biomechanics. 2023:https://doi.org/10.1123/jab.2023-0127.

Hunziker UA, Barr RG. Increased carrying reduces infant crying: a randomized controlled trial. Pediatrics. 1986;77(5):641-648.

Lee H-M, Galloway JC. Early intensive postural and movement training advances head control in very young infants. Physical Therapy. 2012;92(7):935-947.

Little EE, Legare CH, Carver LJ. Culture, carrying, and communication: beliefs and behavior associated with babywearing. Infant Behavior and Development. 2019;57:101320.

Moore ER, Berman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews. 2016(Issue 11. Art. No.: CD003519):DOI: 10.1002/14651858.CD14003519.pub14651854.

Minckas N, Medvedev MM, Adejuyigbe EA. Preterm care during the COVID-19 pandemic: a comparative risk analysis of neonatal deaths averted by kangaroo mother care versus mortality due to SARS-CoV-2 infection. EClinicalMedicine. 2021;33:100733.

Riem M, ME, Lotz AM, Horstman LI. A soft baby carrier intervention enhances amygdala responses to infant crying in fathers: A randomized controlled trial. Psychoneuroendocrinology. 2021;132:105380.

Sidharthan S, Kehoe C, Dodwell E. Post-natal positioning through babywearing: what the orthopaedic surgeon needs to know. Journal of the Pediatric Orthopaedic Society of North America. 2020;2(3):https://doi.org/10.55275/JPOSNA-52020-55131

Sivanandan S, Sankar MJ. Kangaroo mother care for preterm or low birth weight infants: a systematic review and meta-analysis. BMJ Global Health. 2023;8:e0101728.

Wall-Scheffler CM, Geiger K, L S-NK. Infant carrying: the role of increased locomotory costs in early tool development. American Journal of Physical Anthropology. 2007;133:841-846.

Here is a photo of me, taken a long long time ago, with my baby son in a backpack.