A coroner has warned about the risks from the “babywearing” trend after a six-week-old boy died while being breastfed hands-free in a sling.
James Alderman, known as Jimmy, was in the baby carrier while his mother moved around their home at the time of his death.
He was in an unsafe position and after five minutes his mother realised he had collapsed, an inquest heard. Resuscitation began straight away, but the baby sadly died in hospital three days later.
Lydia Brown, Senior Coroner for West London, has warned that there is “insufficient information” for parents about the safe positioning of young babies in carriers, particularly when it comes to breastfeeding.
Copies of her Prevention of Future Deaths Report were sent to sling manufacturer Beco and Madeleine Boot, a babywearing teacher, as well as the NHS and the Department for Health.
Ms Brown has called for industry standards promoting the safe use of slings and warnings about their risks because there is a danger that young babies could suffocate.
“Babywearing” is a popular phenomenon, worth more than a billion dollars globally, where a child is strapped into a harness or wrapped in a sling so they can be carried by a parent hands-free.
Supporters of the technique say it is practical and helps babies bond with their parents through close contact.
However, critics warn of the risk of suffocation because babies cannot lift their own heads if incorrectly positioned. This risk is increased for babies who are premature or have a low birth weight.
An inquest heard that Jimmy died on October 11, 2023 after being accidentally suffocated.
The baby, who was six weeks and six days old when he died, was feeling well other than having a slight cold.
His mother was breastfeeding him within a sling which was worn “snugly”, not tightly, and although she could see his face when she looked down, he was too far down for this position to be safe.
The coroner said: “Baby Jimmy was being breastfed within a baby carrier worn by his mother.
“After five minutes she found that he had collapsed and although immediate resuscitation was commenced he died three days later on 11 October 2023 in St George’s Hospital.
“Jimmy died because his airway was occluded as he was not held in a safe position while within the sling.
“There is insufficient information available from any source to inform parents of safe positioning of young babies within carriers and in particular in relation to breastfeeding.”
A UK consortium of sling retailers and manufacturers have shared an acronym, TICKS, to establish safe positioning for babies in slings.
The acronym stands for Tight, In view at all times, Close enough to kiss, Keep chin off the chest and Supported back.
Ms Brown noted there was no advice for parents regarding the risk of babies slumping in carriers, and the consequent risk of suffocation, particularly in babies under the age four months.
This is despite a “significant increase” over recent years in the use of such equipment, she said.
Ms Brown also found that there is no public advice that hands-free breastfeeding young babies is unsafe because of the risk of suffocation and not being able to meet every TICKS requirement.
The coroner added that the available NHS literature provides no guidance or advice.
Ms Brown said there appeared to be no helpful images of “safe” versus “unsafe” sling and carrier postures. She said the only “tips” available are on the National Childbirth Trust (NCT) website, “but these are in fact unhelpful.”
They say that you can breastfeed a baby in a sling but that the baby should be supported at all times.
Witnesses at the inquest said information readily available to the public which is not too complex but consistent in its messaging would be welcomed to advise and instruct parents.
Ms Brown said that there is a risk of deaths occurring again in the future if no action is taken.
She said: “There is very little information available to inform parents of safety and positioning advice of young babies in carriers/slings and in particular nothing in relation to breastfeeding in carriers/slings.
“This is notwithstanding a significant increase over recent years in the use of such equipment.
“The question of whether it is safe to breastfeed ‘hands free’ is not addressed or referred to in the public domain or manufacturers literature.
“The NHS available literature provides no guidance or advice. The only current ‘tips’ are provided on the National Childbirth Trust (NCT) website but these are in fact unhelpful.
“Young babies are at risk of suffocation.
“Consideration should be given to industry standards to promote the safe use of slings/carriers, to warn users of the risks and whether any such standards should be voluntary or mandatory.”
Ms Brown concluded that Jimmy suffered an accidental death as a result of hypoxic brain injury, out of hospital cardiac arrest and accidental suffocation.
NHS England, the Department of Health and Social Care, the Office for Product Safety and Standards and the British Standards Institution are required to respond to Ms Brown’s report by February 21, 2025.
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