A Baby Wants to Be Carried - book review

Let me start this book review by telling you about Dr Evelin Kirklionis. She is one of my heroes – a true giant of the babywearing world, who has done more for the cause of safe, ergonomic and comfortable babywearing than anyone else. Her doctoral thesis in 1989 (on the subject of the adaptation of human babies to be always in close contact to the parent, and to be carried upright) was a game-changer in Germany in the 1990s, where it had been believed it was unsafe to carry babies upright before they were able to sit unaided.

As a result of her twenty plus-years of valiant, committed efforts to keep safe babywearing in the public eye (working with midwives, physicians, physiotherapists, orthopaedic surgeons) the face of sling use in Germany was completely changed. This means that deaths in slings in that country are unheard of, which is sadly not the case in the UK or in the US.

This doctoral thesis was the base for the book “A Baby Wants to Be Carried”, written in 1999 and reprinted in 2013 in Germany. It has now been translated from the German into English in 2014. It is not a new edition and it is not clear if the 2013 German edition was a rewrite or a reprint. My huge respect for Dr Kirklionis meant that I was very pleased to be offered the chance to review this by Pinter and Martin when it first came out, and saved it for my summer holiday reading around the South Coast!

It is bold and attractive, with glossy photos of happy babies and children in slings, as well as clear diagrams and easy-to-read text separated into digestible chunks. It is free of logos and advertisements for particular companies, and would not be out of place as a coffee-table book, but is still small and light enough to fit into a handbag.

What’s the book about?

It begins with a general introduction where Evelin states that one of her main aims is to awaken parents’ understanding of the basic needs of their children. These basic needs are founded in evolutionary history; babywearing is much more than a convenient form of transport – it is a way of helping to form a successful emotional relationship between young and adult participants.

The book is split into two parts.

Part one is the theory of babywearing.

Why carry your child in the first place? Evelin makes an eloquent and passionate argument for keeping your child close, especially in the early days, based on her thesis that the genetic features of our behaviour corresponds to the hunter-gatherer societies we evolved from. She argues that a baby’s evolutionary biological need for the constant proximity of a familiar person who can care for him is still present. “The idea of the egotistical infant who needs to be taught as early as possible that she shouldn’t “play up” seems impossible to eradicate.”  You do not spoil children by meeting their needs when they express these needs; you give them confidence and security and safety. Evelin talks about “intuitive parenting” and discusses how infants’ senses and understanding develop – it is not till nine months old that babies understand object permanence (carer continues to exist even if baby can’t see carer).

She discusses the anthropology in some depth, stating that “we can find a genetic predisposition to being carried that goes back 55 million years” if we are willing to look at the behaviour of apes. Ape and human babies both demonstrate the spread-squat position when laid on the ground; pelvis tilted upwards with knees raised and hips spread; this is designed in apes to allow the hands and feet to cling to the mother’s chest hair. Human babies, like apes before them, are “active clinging young” – their first habitat is their mother’s body and is where their immature physiology can be regulated by close contact. She discusses how anatomy evolved to allow humans to walk upright, and how the pelvic changes involved in this gave mothers a distinct curved waist-hip area.  The spread squat tendency persisting in human babies means that once the baby is bigger and heavier, his hips and knees are already pre-adapted to “slide” from the newborn frontal position of simple carrying into a sideways hip carry in the spread squat shape. Baby’s knees are then able to “grip” mother’s side to aid clinging when on the move. I found this anthropological theory fascinating, and very persuasive.

She also discusses baby spine development, the research done into the optimum angle of hip spreading in infants, and devotes a whole chapter to the issue of hip dysplasia. Malformations of the hip joint are far lower in cultures that carry infants in the spread squat position… and blood flow in the developing joint is optimal in this M shape with the knees raised above bottom. Hip dysplasia is not caused by the way a baby is carried; but can be worsened by the choice of hip position.

There is a great section about some of the positive effects of carrying; the enormous benefit of frequent tactile contact on almost every area of development, the learning of attentiveness, co-ordination and communication and the assistance with attachment. There are myriad benefits to the parent as well; bonding, the release of calming hormones, the improved sensitivity and understanding of baby’s needs from the close contact and the development of a greater independence and social confidence in a well-attached, secure toddler.

The last section of this part of the book deals with babywearing in special situations (such as premature infants or those with disabilities) and reassures parents that it is the close contact and the relationship with their child that matters here, which a sling can facilitate, not the type or the duration of sling use.

I found this section of the book extremely enjoyable, easy to understand and well argued. Evelin has a chatty style of writing, rather than a dry academic tone, which is very engaging.

Part two is about the practicalities of babywearing – how to carry your child

This begins by discussing some of the ways to carry your child, how long you can carry, when you can start, etc. She devotes some time to the importance of positioning (including why she does not recommend forward-facing out carrying). The section on what to look for in a good soft-structured carrier is well written, which is important as many high-street models do not take the child’s anatomy into account. She explains again why the tucked seated-squat position with knees raised is optimal, and how unsupported thighs lead to a straight backed position, where head and shoulders fall backwards (thus often “corrected” by stiff head supports). Babies should be carried high up and snugly, to avoid slumping.

Woven wraps are discussed in some detail. Evelin is clearly a wrap lover! She talks about their construction and how to recognise a good quality wrap, and how to care for them. She describes how to tie a simple reef knot (with pictures), and the importance of snug and even tightening. She has picture tutorials with descriptions of some common front and hip carries (her favourite is the lateral hip carry!) and one simple back carry. I’m not sure how easy these will be to follow for a parent new to wrapping; trying to hold a book while also putting baby into a sling is not easy!  I imagine most people will not learn to wrap from this book; I expect it will be used more as an encouragement or reminder!

She discusses how to use the cradle carry, which has fallen out of favour in recent years due to some of the risks involved if done badly. She suggests this carry is only really suitable for very small babies if parents are reluctant to carry upright in a wrap. I suspect this section was important when the book was first published, given the situation in Germany at the time (the belief that it was harmful to the spine to have small babies upright). She talks about the necessity of avoiding the chin slumping onto the chest, and how important it is to ensure breathing is unobstructed and the face is free.

The penultimate section deals with ring slings, mei tais and onbuhimos, and the dangers of the “ill-thought out design” of voluminous bag pouch slings (several of which are now illegal due to fatalities).

Lastly, Evelin discusses why she believes the forward facing out carrying position is not to be recommended – due to the strain on hips and spine, the reduction of eye contact and communication. In addition, a baby is unable to turn away from a constant exposure of very diverse stimuli. “As adults we have learned to differentiate between important and unimportant impressions, and we have the corresponding experience and ability to blank out signals… an oversupply of stimuli must ultimately be worked through, often in the evening.”

What did I think of the book?

Babies expect to be and need to be carried; Evelin is passionate about promoting this in the healthiest, most beneficial way possible, and  I think this book is to be celebrated! I very much enjoyed reading it and am happy to have a copy in my library for people to browse. I think it it achieves its aim of being an excellent introduction to babywearing for the interested parent, with a great deal of fascinating, convincing information and education, and will form a great springboard for parents who wish to take the plunge and try things for themselves.

It does show its age and origin as a translation a little here and there, but not in a way that impedes understanding. There is one mention of the “TICKS” guidelines, which presently form a large part of the advice the UK sling professionals give out. In the UK we discuss airway a great deal, which has come about due to local pressures and local media reports, and this book was not originally written for the UK market in the current situation.

I hope that the next edition will be even more up-to-date for UK readers, with some tweaks to the choice of colours for the text. Some people have commented they found coloured text inside coloured boxes hard to read – this wasn’t a problem I had, fortunately, but it is worth being aware of. I appreciated the “breaking up” of the text layout to reduce reading fatigue, and how easy it makes it to flick through the book for a quick jogging of the memory of the main points. The photography is beautiful; however, as a professional who teaches others how to use their slings, I was aware of some of the flaws in the wrapping showcased in the book; this often happens when photographers and models are not experienced babywearers themselves and don’t quite understand what needs to be demonstrated. Some of the best images of carriers in use come from those who use them daily..  perhaps this could be looked at for the next edition?

Many thanks to Sue at Pinter and Martin for sending me a complimentary copy of this lovely book, which I will treasure, loan out to visitors to my sling library, and most of all, three cheers for Dr Kirklionis!