US consumers are being warned about the dangers of carrying babies up to four months old in a sling carrier as there is a possible risk of them suffocating if carried incorrectly.

The U.S. Consumer Product Safety Commission (CPSC) made the announcement in Washington on Friday and said that it is researching 14 infant deaths linked to sling-style baby carriers over the last 20 years, three from last year.

A sling carrier is made of soft cloth and looks rather like a sling that you wear when you break your arm (it goes over one shoulder and holds the baby in front on your chest to one side). It allows you to carry the baby with your hands relatively free and unemcumbered so you can keep baby close to you while you walk around the house, the park, or the supermarket.

Because they keep the baby physically close, sling carriers have also become popular as a way to increase bonding, calm fractious babies and ease breastfeeding.

12 of the babies who died were under four months old said the CPSC, explaining that in the early months of life the muscles in a baby’s neck aren’t strong enough for the infant to be able to control its head. Thus when the frabic of the sling presses against the baby’s nose or mouth, or if its head sags into the sling and the chin bends in towards the chest (restricting the airway), the baby does not have the strength to move its head to a safer position. The result is a dwindling oxygen supply and eventually, if breathing is still obstructed, suffocation.

Also, under such circumstances babies can’t cry for help, reducing the opportunity for the person carrying the infant to become alert to danger.

The CSPC stresses that if you use a sling to carry a multiple birth baby (eg a twin), or an infant who was born prematurely, or is ill or fragile, or whose weight is low, you should be extra careful and even ask your pediatrician about whether it is safe to use a sling at all.

The commission said many of the babies whose deaths they are investigating were either born prematurely, had breathing difficulties (eg because they had a cold) or they were a low birthweight twin.

The CSPC press release shows diagrams and captions of the correct and incorrect ways to carry a baby in a sling.

The correct way shows the baby able to hold its chin up, with face visible, nose and mouth free and unobstructed. The various incorrect ways show the baby slumped or too low in the sling (in a “C” shape), face covered, hunched with chin tucked into chest, or with face pressed tight against the sling wearer.

The CPSC also recommends if you carry a baby in a sling that you:

  • Make sure you can see the baby’s face at all times.
  • Check the baby’s face is never covered.
  • Be vigilant: check frequently.
  • Make sure if you feed the baby in the sling that you change its position afterwards so its head is facing up and clear of the sling and your body.

The CSPC has added baby slings to the list of durable infant products that require a mandatory standard. Meanwhile they are working with the worldwide standards agency ASTM International to try and get a voluntary standard introduced as quickly as possible, and their staff are also investigating sling products to see if further action should be taken.

The ASTM has a consumer safety specification (ASTM F2236 – 09a) for soft infant carriers, but it states that this does not cover products generally referred to as “slings”. It presumably refers to more substantial carriers that look more like a rucksack worn back to front, where the baby is generally held in an upright position, although the specification does say that the baby is “suspended from one or both shoulders of the caregiver”.

Presumably one of the important issues to be addressed in developing a standard that covers slings, is the definition of what exactly is a sling, and how it differs from other types of “soft carriers”. A search of a typical baby product website shows around 100 different styles and products, some of which are described as slings, and others are not, and it is not easy to see the distinction.

According to a report from the Associated Press last week, Derrik Fowler, a baby from Oregon, was one week old when, according to court records, he died of positional asphyxia (suffocation) while being carried in a sling. His parents are suing the sling manufacturer.

The CSPC urges consumers to report dangerous products or product-related injuries..

Sources: CSPC, AP, ASTM.

Written by: Catharine Paddock, PhD