Dear Nanny: Difference Between SSC and MT

Dear Nanny,

I was looking at reviews for a BabyHawk Mei Tai and the BabyHawk Oh Snap. They both have good reviews, but I was looking at the pictures and they basically look like the same carrier. What's the difference?

Thanks,
Confused in NY

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Dear Confused in NY,

Mei Tais are a different type of carrier. They are (usually and traditionally) unstructured carriers. They have a square or rectangle of fabric with a strap coming out of each corner. It will hold baby in basically the same position as soft structured carriers (SSC) like the BabyHawk Oh Snap. Mei tais are meant to be worn at waist level, SSCs are meant to be worn at hip level usually. You can also do high back carries in MTs, but not usually in SSCs.

MTs are often not padded or have minimal padding. They are comfy, and I love them, but if I am going to be wearing for hours I choose my KinderPack (an amazing SSC) over the MT. MTs are easier to wear while pregnant. SSCs have more padding and structure, making them more comfy for long periods. The BabyHawk Oh Snap is a great SSC. It is very large, and is often used just as a toddler carrier. It doesn't fit newborns or small babies well.

I have a BabyHawk MT, two CatBird MTs, and a Kozy MT. I like the CatBird and Kozy ones much better than the BabyHawk. The CatBird and Kozy MTs have a little more padding in the shoulders, the straps don't get twisted like in a BabyHawk MT, they are built of a sturdier and stronger fabric, the CatBird has a hideaway hood where the BabyHawk has a headrest, and both the CatBirds and Kozy are wider and taller than the BabyHawk - meaning they can be used longer. This is pretty much personal preference however. BabyHawk MTs are undeniably well-made, and a favorite of many people.

With MTs, you can fold down the extra fabric before tying it to customize the height for your baby, say, for instance, that baby wants to ride arms out. You can also use a shoestring to customize the width of a MT so baby always has the proper knee to knee coverage. (See Using a Mei Tai for a Small Baby for more info).

SSCs are great for older babies and toddlers. They don't offer great positioning for newborns, but it technically can be done.  Sized SSCs will give you the best fit (like KinderPack, Tula, Kanga, Bamberoo, and Two Mamas Designs).Mei tais on the other hand can be used from birth, but you'd get better positioning in a wrap or ring sling for a tiny newborn. Mei tais are nice if you have different aged babies and different sized wearers too. They are nice if you want one carrier to use from birth through toddlerhood, and aren’t interested in wrapping.  A bigger MT can be used from birth, so go with a larger sized MT. Kozy and CatBird Baby both make excellent larger bodied MTs.

Take a look at my review of the CatBird Mei Tai. Also, take a look at my list of the types of carriers and when to use which carrier.

Hope this helps!

Katie

Dear Nanny: Why Not Face Out?

Dear Nanny,

I heard that facing out in a baby carrier is not good for babies. Is this true?

- Just Wondering

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Dear Wondering,

A FFO (Front Facing Out) carry is not recommended for a few reasons:

1. An overstimulated baby can't hide their face. Babies are learning and experiencing everything for the first time. It can be hard to take it all in sometimes (this is why toddlers often throw tantrums), so they get overwhelmed. When this happens they hide their face and close their eyes to calm down. A baby facing out has nowhere to go when they feel overwhelmed. It can be hard to tell if baby is getting overwhelmed while FFO – they won’t always cry or scream if this happens. 
2. Babies take their cues for how to react by looking at their parents’ faces. If they can’t see your face they won’t know how to react, and they can’t get your reassurance. This is a critical learning technique. 
3. *A FFO carry can not properly support a baby's rounded back or developing hips. Your baby’s spine won’t fully form into an S-shape until toddlerhood, and a rounded back cannot be supported by a facing out carry. Also baby’s hips are partly made of cartilage. Cartilage is elastic. If the legs and hips aren't properly supported, hip dysplasia can occur. Baby’s legs should be supported from knee to knee, with their knees higher than their bums.
4. It's harder for the parent to assess baby's needs. When you can’t see your baby’s face, it can be harder to tell if they are getting tired, hungry, or restless. Harder, but not impossible. 
5. It's harder on the parent's back than a FFI (facing in). A FFO position is not ergonomic for the wearer. Especially with a heavier baby. A baby facing in with a proper carry adds the weight to your center of gravity. While facing out, the baby’s weight throws off your center of gravity. 
6. A newborn without complete head control should never face forward in a carrier, because of the stress on their neck and inability to keep their head upright. Not to mention that a newborn can't see more than a 8-12in in front of their face anyway.

*If you have a baby that is 3-6ish months old, you could use a ring sling and do a Kangaroo carry for a FFO carry that won’t strain baby’s developing body.

If you absolutely must do a FFO carry, get a carrier that offers good support. A CatBird Pikkolo or a Beco Gemini offer as much support as possible for a FFO in a SSC. Woven wraps can do FFO carries that support baby's hips too. FFO carries should only be done for a limited amount of time.

But my baby can't see well facing in!
Most babies won’t care. A baby who is used to facing out may have a harder time adjusting though. At about 6ish months you could do a hip carry in a ring sling, SSC, mei tai, or woven wrap. A hip carry gives baby plenty of things to look at. Another favorite is a high back carry with a mei tai, some SSCs, or a woven wrap. A high back carry allows baby to look over your shoulder, but they can still sleep or hide their face if they want. Young babies can be carried in high back carries in woven wraps, or burp carries in ring slings.

-Katie

For more information on safe infant positioning, see my Infant Positioning post.

The Pinch Test

A picture from Britax

Loose harnesses in a carseat can be very serious. In a crash a child can be ejected from the seat if the harness is too loose. That is why I am going to talk about the pinch test, a simple way of telling if your carseat straps are too loose.


How to do a pinch test:

1. Buckle your child into their carseat. The child should be wearing regular clothing, not bulky sweaters or jackets. In a crash your child's clothing will compress, and if the straps are not snug enough they may be ejected from the seat
2. Pull up on the harness by your child's shoulders
3. Try to pinch the straps as shown in the photo above. Some people prefer to use three fingers instead of one to pinch because it keeps them from tightening the straps too much
4. If you can easily fold the strap in half, than it is too lose - proceed to the next step. If you can't easily pinch the straps, then you are good to go!
5. Grab the straps by your child's stomach and pull them up to remove slack. If your seat tightens the straps from the bottom (not because the tightener is at the bottom of the seat, but because it pulls in slack from the bottom) then skip this step.
6. Pull the harness adjuster strap and try pinching again. If it is snug you are good to go, if not keep tightening until it is snug.

How to tell if the straps are too tight:

1. If you can't put a finger under the strap it is too tight
2. If you can put a finger under, but your child can't take a deep breath, it is too tight

It is not unsafe to have a harness too tight, just uncomfortable for your child.

Note: the chest clip should be buckled at arm pit level - too low or high can cause severe injuries in a crash.

A quote I love that details how tight a child's harness should be is: "A [carseat] harness should be as tight as the band of a woman's bra, and loose harnesses are about a useful as loose bras."

Dear Nanny: Why Rear-Facing Until age 2?

Dear Nanny,

I read that children should rear-face in carseats until age 2. Why did the recommendation change? I have also heard of people doing "extended rear-facing." What does that mean? Thanks for your help!

- Carseat Confused

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Dear Carseat Confused,

There was a study done in 2007 that proved that children under 24mo are 5.23x safer rear-facing than forwards facing. This study, along with others caused the American Academy of Pediatrics to revise their previous stand of 'rear to a year' in carseats. Now the official recommendation is that children should be rear-facing to at least two years old, or when they outgrow their rear-facing seat.

The study was done with children aged 24mo and under, so we do not now the exact data for how much safer a child is rear-facing past 24mo. 24 months is not an exact number. It is not the magic age that makes children safer. We would all be safer rear-facing in a car - but that would make it difficult to drive ;). This is where extended rear-facing (ERF) comes in.

A young child's body is very different from the adult body. The head is significantly larger, which puts strain on a small neck, and the bones (in this case, specifically the spine) and muscles are not fully formed. When rear-facing the forces from a crash are spread out more evenly over a child's body, meaning that the child's body is under less strain. Also, a child's head is much better protected while rear-facing, so the pressure that would cause a forward facing child's neck to snap is much lessened.

In Sweden, children are rear-facing until four years old, and then moved directly into a booster seat (side note, it is much safer to have a 4yo harnessed forward facing than in a booster seat). They have significantly lower rates of death and injury to children under 4 in cars than we do in the US. Many families in the US are picking up on this trend of extended rear-facing. When they buy a rear-facing seat, they get one with high height and weight limits so they can rear-face longer. These families are rear-facing until 3, 4, 5, and even 6 years old. This is around the time that the ossification of the spine is complete, which is why parents are choosing to do ERF so long.

I would like to note that rear-facing is only safe in a carseat that fits your child and your car properly. Check the fit of your carseat by finding a CPS (child passenger safety) technician near you at www.seatcheck.org. Most carseats are installed incorrectly, so even if you think you did it right, have it checked.

Here is a link to the study: http://fcs.tamu.edu/safety/passenger_safety/certified-tech/rear-facing2.pdf
And a link to the AAP's policy statement: http://pediatrics.aappublications.org/content/early/2011/03/21/peds.2011-0213.full.pdf+html
And here is a link to a great video by thecarseatlady.com: http://vimeo.com/thecsl/2011aap

- Katie

Buying a Playard

Graco Element Pack N Play, Oasis

There are Two Types of Playards: Care Stations and Play Areas.

Care Station Playards

• Playpens still come as low, netted beds used to keep babies safe from harm. However, many these days now come as care stations. 
• Care Station Features: 
• Bassinet feature 
• Changing table 
• Vibration and music settings 
• Attached diaper stacker 
• Since the AAP recommends keeping baby in the room with you for the first few months, many parents use the bassinet feature of the play yard for nighttime use, and the attached changing table saves you a few midnight trips to baby’s room. 
• Play yards also make great travel beds, because they fold up to the size of a stroller (though, unfortunately, the changing table does not fold) 
• Play yards are also a great thing to keep at the grandparent’s house so they have somewhere for baby to sleep and be changed when they visit 
• People with limited space sometimes use play yards instead of cribs altogether. Though, play yards do not have to go through the same kind of testing that cribs have to.

Play Area Playard:

• Play area types of play yards are used not for sleeping, but rather for keeping baby from harm. Usually from older siblings poking or the dog’s licking. 
• Also used outside to keep baby off the ground, or a toddler out of the streets. 
• These are brightly colored (not at all conducive to sleeping) and often feature toys attached.

Here is a piece of an article from PEDIATRICS regarding safety in using playards or bassinets for infant sleep:
"If a portable crib/play yard or bassinet is to be used, it should meet the following CPSC guidelines: (1) sturdy bottom and wide base; (2) smooth surfaces without protruding hardware; (3) legs with locks to prevent folding while in use; and (4) firm, snugly fitting mattress.121 In addition, other AAP guidelines for safe sleep, including supine positioning and avoidance of soft objects and loose bedding, should be followed. Mattresses should be firm and should maintain their shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the bassinet, playpen, portable crib, or play yard. Only mattresses designed for the specific product should be used. Pillows or cushions should not be used as substitutes for mattresses or in addition to a mattress. Any fabric on the sides or a canopy should be taut and firmly attached to the frame so as not to create a suffocation risk for the infant. Portable cribs, play yards, and bassinets with vertical sides made of air-permeable material may be preferable to those with air-impermeable sides.122 Finally, parents and caregivers should adhere to the manufacturer's guidelines regarding maximum weight of infants using these products.122,123 If the product is a combination product (eg, crib/toddler bed), the manual should be consulted when the mode of use is changed."

Published online October 17, 2011NEOREVIEWS Vol. 128 No. 5November 1, 2011
pp. e1341 -e1367
(doi: 10.1542/peds.2011-2285)

http://neoreviews.aappublications.org/content/pediatrics/128/5/e1341.full#sec-16

These are safety tips from HealthyChildren.org, their source is: TIPP—The Injury Prevention Program (Copyright © 2011 American Academy of Pediatrics, Updated 9/11)

• Never leave the side of a mesh playpen lowered because a baby can become trapped and suffocate.
• When your child is able to sit or get up on all fours (or when he reaches 5 months), remove any toys tied across the top of the playpen.
• When your child can pull himself to standing, remove any large toys that could be used as steps.
• Check the top rails for tears and holes because teething children often bite off chunks of the covering. If the tears are small, you can fix them with heavy-duty cloth tape. If the tears are large, you may need to replace the product.
• Make sure that there are no tears, holes, or loose threads in the mesh and that openings are less than 1⁄4 inch across. Make sure the mesh is securely attached to the top rail and the floor plate. If staples are used, make sure they are not missing, loose, or exposed.

Bjorn Original Review

Baby Bjorn Original

This is my review of the Bjorn Original Baby Carrier from Amazon.com

I am going to preface this by saying that I actually did use this, and I do not find it practical for day to day babywearing needs.

Build:
The way that baby's legs hang down without support puts pressure on baby's developing spine and hips. Any product that supports baby thusly should only be used for very short periods of time. A baby carrier is usually used for long periods of time. A properly positioned baby in a carrier would have their legs supported from knee to knee, with a deep seat for their bottom. The carrier's back would come to at least their arm pits. A newborn can be worn legs out or in, if in legs should be froggied.

Comfort:
Horrible. One of the most uncomfortable things I have ever worn. Once baby hits about 15lb I can't stand to carry them for more than a few minutes. And this is coming from someone who can wear a ring sling for hours.

Positioning:
I already talked about how baby hangs, but this is addressing how baby faces. A newborn (0-3mo) should always face in for two reasons. 1) They do not have the requisite head control or neck strength to do this and 2)Due to underdeveloped nervous systems, babies can be easily over-stimulated with nowhere to hide when forward facing. A baby carried facing in can turn their head away if the world becomes to much for them. Note: A baby will not necessarily cry if they are over-stimulated. They may close their eyes, become irritable, tense up, or try to turn away. Older babies can be worn in high back carries, like those done in a woven wrap or mei tai to see over the wearers shoulder.

Ease of Use:
This is the only area that I can give props to Bjorn. These carriers are simple to use, which has probably contributed to their popularity.

What I Would Recommend:
What else is out there that is comfortable for baby and wearer?

• Ergonomic Carriers: I love KinderPacks way more than ErgoBaby Carriers, but either is a good choice for proper knee to knee positioning
• Mei Tais: These ancient Chinese baby carriers have survived centuries because they are comfortable for baby and wearer. A high back carry can be done in a MT. I personally adore my CatBird Baby MT, but others swear by BabyHawk.
• Wraps: These have a learning curve, but once you get the hang of them they are wonderful! A stretchy wrap like the Moby can be used for newborns, and woven wraps can be used for all ages.

To learn more about the kind of carriers available, check out the forums at TheBabyWearer website. It is free to join, and the community is wonderful!

When to use Which Carrier

So, I have been asked several times if I really need all the baby carriers I have. I have decided to answer it here to share my wisdom (or lack of it) here.

Well, no. Not technically, but it sure makes my life easier! Some carriers are better for long periods of time, and terrible for 'popping' baby in and out. Some carriers are great for newborns, but are terrible for toddlers. Some are perfect for most of the year, but give you heatstroke in the summer. I choose my carrier depending on the outing, the size of the child/ren I plan on carrying, and the weather. I may use a SSC in the morning, a mei tai in the afternoon, and a ring sling in the evening.

Here is my list of carriers and the outings/age of the child appropriate for them. (Click to view larger)

• Amauti Coat: Strictly for very cold weather. Newborns to toddlers. May stress your back after awhile if you aren't used to it.
• Frame Backpack: Hiking or all day trip. Older babies and toddlers. Any time of year if baby is dressed appropriately. 
• Soft Unstructured/Asian Style: There are several kinds, but my experience so far has only been with MTs, so I am sticking with that. Podaegis and Onbuhimos are similar though.
• Mei Tai: All year round, will need a cover in colder weather. Infants-toddlers. Great for running errands, going to park, etc. Depending on padding, can be used all day, but I prefer shorter jaunts
• Soft Structured:
• Ergonomic: I use this when I have a decent walk ahead of me. Once baby's in, I leave them there for a decent amount of time. Can be used in place of a frame backpack. Unless it has a mesh panel, it is no good for hot weather. Older babies and toddlers
• Sling:
• Pouch: 6mo+ is best IMHO. Short jaunts or frequent ups and downs. All year round except exceptionally hot weather
• Ring: newborns - toddlers. Short jaunts or anytime with a newborn. Most of the year, may need a mesh or linen one for summer
• Wrap:
• Stretchy: newborns and young babies only (no matter what they claim the weight limit is), not for warm or hot weather. Can carry comfortably for hours.
• Woven:  Newborns - preschool. Comfortable for long periods of time. Depending on weave and fabric, may not be comfortable in very hot weather

For more information on the types of baby carriers, see my post Types of Baby Carriers