Key takeaways: The TICKS checklist: Tight, In view at all times, Close enough to kiss, Keep chin off the chest, and Supported back. Never let your baby’s chin rest on their chest or their face press into fabric. Check your baby often.
Carrying your baby in a sling, wrap, or carrier can soothe crying and make daily life easier. But babies, especially young or premature babies, can suffocate if they’re positioned with the airway blocked. Following a few simple rules keeps babywearing safe.
The TICKS Checklist
This checklist, developed by the UK Sling Consortium, is widely used:
T: Tight. The carrier should be snug, holding your baby close against you. Loose fabric can let your baby slump and restrict breathing.
I: In view at all times. You should be able to see your baby’s face by glancing down. The fabric shouldn’t cover their face.
C: Close enough to kiss. Your baby’s head should be high enough on your chest that you can kiss the top of their head by tipping your head forward.
K: Keep chin off the chest. Make sure there’s space (about a finger’s width) between your baby’s chin and chest. A curled position with the chin pressed down can restrict breathing.
S: Supported back. Your baby’s back should be supported in a natural position, with their tummy and chest against you. If you bend over, support their back with one hand and bend at the knees.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. My book covers everyday newborn care month by month, plus the warning signs that mean it’s time to call the doctor.
Additional Safety Tips
- Avoid bag-style slings that hold babies in a curled position, which the CPSC has linked to suffocation deaths.
- Follow age and weight limits for your carrier.
- Check for wear and tear on seams, buckles, and fabric.
- Hip-healthy position: the carrier should support your baby’s thighs from knee to knee, with knees higher than the bottom in an “M” position.
- Don’t babywear while cooking, drinking hot liquids, running, or doing anything risky.
- Watch for overheating in warm weather.
- Don’t let your baby sleep in the carrier for long periods unsupervised; move them to a flat sleep surface.
- Premature babies or babies with breathing or medical problems: talk to your doctor before babywearing.
Breastfeeding in a Carrier
It’s possible, but afterward, reposition your baby upright with the face visible and chin off the chest.
The Bottom Line
Babywearing can be wonderful for bonding and convenience. Follow TICKS every time: tight, in view, close enough to kiss, chin off chest, supported back.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
- Products That Aren’t Safe for Sleep: Loungers, Inclined Sleepers, and Weighted Sacks
- Hip Dysplasia: Screening, Swaddling, and Babywearing
- Contact Naps, Car Naps, and Swing Naps: Safe Transitions to the Crib
Sources
- UK Sling Consortium. The TICKS rule for safe babywearing. https://babyslingsafety.co.uk
- US Consumer Product Safety Commission. Infant slings and carriers safety alert; safety standard for slings (16 CFR Part 1228). https://www.cpsc.gov
- Batra EK, Midgett JD, Moon RY. Hazards associated with sitting and carrying devices for children two years and younger. J Pediatr. 2015;167(1):183-187.
- International Hip Dysplasia Institute. Hip-healthy babywearing. https://hipdysplasia.org
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
