Baby Ergonomics

Breastfeeding

My experience with nursing positions

Breastfeeding a fresh baby presents a number of ergonomic challenges. If the baby is large, the baby is heavy and awkward. Otherwise, the baby is awkward. The baby may or may not latch well or suck well or stay on the breast if the baby is uncomfortable while breastfeeding. A large amount of advice in print and on video is available to help correct form while breastfeeding a fresh baby, in order to ensure breastfeeding is established. You can also hire lactation consultants to help. Twins, obviously, make everything about four times trickier, and I can't imagine higher order multiples.

Side lying nursing can make getting a baby to sleep much easier (or at least possible); if it works well enough that mama can sleep through some or all of the nursing session(s), it makes life much, much easier. While the books say that sidelying is easier for c-section mothers, I could not convince Teddy not to kick my incision. I did not get this to work until well after I had healed from the surgery.

When the baby is not so fresh, it becomes a lot less important to keep the baby in a line while feeding. In fact, it may become very important not to try to do so; Teddy kicked up a lot of fuss after a while. With increased ability to move himself, distractions means that Teddy could take the breast with him -- partway at least -- when he turned his head or his self to see what that was all about.

In any event, I now have to sometimes take him to bed and lie down in the dark bedroom to nurse, because there's just too much to see and do to stay latched and eat. I understand that toddlers sometimes try to do somersaults at the breast. That sounds a little painful.

Holding the Baby

Just holding a fresh baby is tricky. Everyone emphasizes the importance of supporting the fresh baby's neck and head, which is important during the first few days, but perhaps is overemphasized. Most people holding a baby who is not their own (or is newly theirs) cradle the baby in their arm while sitting. Unfortunately, you can't do this forever, and it's really hard to do anything else while the baby is positioned this way. Also, babies typically like to be moved around, just the way that everyone likes to change their position occasionally.

If your baby needs help burping, there are a number of ways to position the baby to help the burps move along; most child care bibles will suggest at least one. Nearly everyone you know has a favorite. It's worth collecting a few ideas and seeing what your baby likes and what is not too destructive of your wrists.

When babies are unable to get where they want to go, they may let you know and insist you take them there. When Teddy was almost five months old, his distance vision improved suddenly. If he saw something a few yards away, he could not be satisfied until he was carried over to investigate in detail. As his grasp improved, he needed to get close enough to the small items in the nest around my rocking chair to pick them up and investigate them. It was quite bizarre the day he decided to pick up the bulb aspirator and stick it up his own nose. I hadn't realized a baby that young had such precise hand control. I certainly had not realized that as hard as it could be to hold him to breastfeed, or carry him or wear him when on walks, it was infinitely trickier to help him move himself to wherever he wanted to go.

Playing with the Baby

The coolest play-with-fresh-baby (2 months old) that I ever saw was done by one of my husband's good friends (groomsman at our wedding). He had a way of transferring the baby from hand to hand, dropping the baby slightly, that he could do seated, and those plus more tricks while walking around slowly, that our baby found both calming and interesting. This was especially incredible, as this was during a trip when Teddy was regularly overstimulated by what most people did to play with him (get right in his face and make faces and sounds for the most part, and occasionally wave toys at him).

By that point, my husband and I both were having wrist problems. He had carpal tunnel symptoms; mine involved the thumbs. We were asking -- and have continued to ask -- other parents whether they had any similar symptoms from carrying their fresh babies. Some parents have no particular recollection one way or the other. Some (including the wonderful man with the biscuit walk) remembered having a few problems, but not in detail what they were or when they resolved. Mine seemed to improve over time as my thumbs, hands and wrists got stronger. Both my husband's and mine felt better when they got (comparative) rest from handling Teddy.

Carrying the Baby in the Bucket

The bucket is probably best carried in what I call the "market basket" hold: in the crook of one's arm, with the forearm and hand held rigidly up, bucket firmly at the side. This works much, much better than a straight arm carry, or a two arm carry. You may have something that works even better. Baby plus bucket inevitably ways more than 10, possibly close to 20 pounds and will be off-centered, which will strain your back. It can also

Strolling

We primarily use the stroller as a grocery cart to go to the good grocery store about a mile and a half away. The infant seat carrier we have as a first stroller (we're looking for the next one, as Teddy is about to outgrow the infant car seat) is about the right height for both of us, but in the past I've had strollers where I could not take a decent stride without kicking the basket, or the handle was too low and I had to stoop over. I'm currently researching a jogging stroller, partly for jogging, but mostly because the city sidewalks are quite broken up, and regular strollers don't handle the ones that don't have curb cuts particuarly well.

Wearing the Baby

I knew before I had the baby that there were huge issues associated with baby wearing. Do not believe glowing reports about how wonderful it is to wear your baby. It is only wonderful if you can find a baby carrier that fits your body appropriately, and that is easier for some body shapes than others.

The Snuglis, which we don't particularly like, but which currently work best for us as front carriers (Teddy is just now old enough to be carried on the back and will shortly be old enough to hip carry as well), have awful straps and not enough adjustment. The hip belt tends to slide up on me (I'm female and I go in as I go up; there seems to be no way around this problem). I can't cinch the kid in tight, because the straps cut into my 36I boobs. I've had mastitis twice already; I do not need to do this again.

The baby bjorns lack a hip strap (the ones we have do; I understand the active carrier has a waist or hip belt). The X in the back tends to slide up high between my shoulder blades and I need another person's assistance to get it to come down. Generally speaking, I don't have another person's assistance.

We don't have a ring sling or a pouch style sling. Sometimes I wish I had bought one. The rebozo was difficult to get adjusted properly; every time we tried, Teddy lost it completely and we had to stop.

I know people who bought dozens of carriers. One woman in particular is taller than me (and I'm not short at five foot eight inches) and has even bigger breasts. I have concluded that certain things make baby wearing tricky.

Most men seem to do better than most women with the structured carriers (bjorn, snugli), probably because the straps don't ride up and the breasts don't get in the way. Narrow shoulders mean the shoulder straps don't line up correctly. Slings apply pressure on the breasts, which is not inevitably a problem, but larger breasts make this worse. Body fat can squish in unexpected ways that prevent straps from working as intended.

There is also some technique involved in wearing a baby. You have to move slowly. Even a brisk walk is, most most women, most babies and most carriers, probably a little too fast. It helps to lean back slightly. And there are more tricks that I have not yet figured out.

Traditional carriers (slings, pouches, etc.) are used in their native settings to carry all kinds of things other than babies, which means people who use them to tote a baby around have a lot of practice using them before they pop a baby in one, and their musculature is more accustomed to them.

Baby carriers are great things. Just try a mile or so walk with a baby in arms without the benefit of a carrier, and you'll certainly grasp why fabric carriers hold so much appeal. I am, however, here to tell you that if I'm in a mood to interact only with the baby -- I don't feel like calling a friend, for example, on the cell, and have gone walking with the baby with the express intention of distracting him enough so I can make the call -- I'd rather carry my baby in my arms than in a carrier. It hurts less.

Our Experience with BabyWearing

Sleeping

Babies sleep in all kinds of places. In a room by themselves. In a room with a parent. In a room with both parents. In a bed by themselves. In a bed with a parent. In a bed with both parents. There are a lot of political issues associated with these various options. It is most effective for people to sleep where they can actually get some sleep. Each family can best determine this for themselves, although they may be able to make use of the experience of others, along with accurate information about how babies sleep.

That said, sleeping and babies present ergonomic challenges. Transferring a baby who has fallen asleep into another location can contort a caregiver horribly, whether that is from in arms in the rocker to the crib, or from sitting up in bed nursing to lying down in that same bed. Those who sleep with their baby will also contort themselves to avoid crushing the baby, or moving suddenly, or falling out of the bed (either themselves, the baby, or other people in the bed).

Baby Elimination

Changing tables are an effort to make diapering easier, by getting the baby at a comfortable height. Once the baby is moving around, however, changing tables only do so much good. Our counter-by-the-sink setup is similar, and provides a lot more distraction with the mirrors, the sink and faucet and so forth. While it's a little hard on the wrists and hands to put the baby down, un-diaper the baby, clean and rediaper the baby, adding time over the sink or over the potty is a lot more complex. It would be a lot easier if Teddy just didn't wear a diaper at all, but, like babies around the world, was naked on the bottom. My husband and child care providers are not so enthusiastic, so ergonomically, we have the worst of both worlds.


Copyright 2006 by Rebecca Allen
Created January 11, 2006 Updated March 8, 2006