Recently I strayed into an online facebook ‘advice’ group and found a woman asking a seemingly innocent question: “which baby carrier should I buy?” Her requirements were simple, one of which was the ability to face outwards. Lots of baby carriers offer this, and better still we now have a good selection of ergonomic baby carriers which have this feature, including Beco Gemini, Ergo 360, Baby Bjorn One and the Lillebaby Complete. In an ideal, empowering but not a judgemental world, she would have been told of her options and wished the best of luck in her babywearing journey. I would like to report that had happened, and if she had been in my baby carrier advice group, it would have. No, sadly, it did not.

Oh dear, she had used the magic word which would open up a catalyst of responses, she had no idea what she had let herself into. Forward facing, often typed as FFO or called world facing and outward facing, is one of the hottest of topics in some of the babywearing cliques. In their view, it is akin to dangling your child upside down from a four storey building. I have seen the most voracious of replies to this query in the past. At present, we have NO evidence it does cause harm and therefore, I cannot advise against FFO. I of course reserve the right to change my advice on this matter in the future in view of new research that contradicts this current opinion. But at present, based on all the available research, there is no reason not to world face once your child has good head neck support.

The history of the Anti-forward-facing-movement

Before I talk about the responses, let’s look at the history of the modern movement in being anti-FFO. And hands up, up until a couple of years ago I was in that camp. I look back in shame now at the people I had informed FFO was bad for their child. But it was something I had believed as ‘everyone knew it’. My turnabout came after doing my Trageschule Certified course and meeting the owner of Lillebaby, Lisbeth at a trade show.

In doing my baby carrier course, it was drilled into us, go back to the source, go back to the source, don’t read what you believe online, always go back to the source. At the same time, I went to a trade show in America looking for new brands and products to introduce to our customers. The one brand I had not heard of, but kind of accidentally met was Lillebaby. At this stage Lillebaby, which had been launched in 2001, and taken control of their brand back in-house and were just about to relaunch it. I visited their booth and whilst I liked the carrier, I discounted it. Why? It had an option for little ones being carried facing outwards and this was an instant NO in my book. She asked me why, I trotted off the spiel I had, and she just asked where is your proof? I looked at her in a strange way with a kind of, but everyone knows this look are you mad? Its repeated everywhere, any simple search online can bring up a plethora of articles on this. Again she asked me, where is your proof? I left the show determined to go back to the source, as taught in Trageschule, and find the proof!

Of course, I could not find any real proof that facing forward did any damage. And so began my complete 360-degree journey into realising, there is a lot of misinformation regarding this topic online, and I was wrong. Looking at the history of baby carriers, the anti-FFO movement appeared to begin when Ergo launched their carrier back in 2001(ish). Ergo realised their main competitor was Baby Bjorn who dominated the market, and their carriers had an FFO. So Ergo unleashed a lot of ‘blogs’ and informative articles pointing out the dangers of FFO, how it will damage your child’s hips and give them hip dysplasia. The Hip Dysplasia Institute have a graphic showing how a narrow-based carrier is not good for a child with hip dysplasia. Without looking too deep into it, it all seemed to fit together and so the anti-FFO movement was born, with Ergo as its hero, the David against the Goliath of Baby Bjorn.

What we know about hip dysplasia is that baby carrier can NOT cause it. Ergonomic carriers are better if a child has hip dysplasia, and narrow-based carriers should be avoided if you have a child who has been diagnosed.

baby carriers, babywearing positions

Along the way, more was added to it. The infamous Boba blog added 9 reasons why not to face out, with overstimulation being one of them. Ironic, that Boba now manufactures a forward facing carrier themselves (the Beco Gemini), but hey… let’s just overlook that little fact as it ruins the anti-FFO brigades campaign. The overstimulation argument is one which has grown the most feet recently (probably in response to the true facts on hip dysplasia being more widely known). There is research published which suggests that babies who are facing forward can get stressed as they don’t know how to respond to what they see. But this research was conducted in a very busy shopping mall in a forward facing pram. The baby could not see, feel or hear their parents and therefore did not get the parenting cues to know how to respond. When they turned their head to see their parents, they were just looking at a pram. This is very very different from carrying your baby closely when the child can feel and hear their parents, and even turn their head to see them. Nevertheless, this research has been blindly correlated with the anti-FFO campaign. Even when baby is showing no signs of stress and looks perfectly happy, they respond with well you do not know the damage you are doing, they could get nightmares weeks later over this (yes, I have actually seen someone argue that!).

At the same time as the shopping mall pram research was undertaken, another vital study was done. This time it proved that young babies who were carried more cried less and were generally happier. Fantastic. Let’s look at this in more detail. Oh, look… it was in America in the 90’s. Whilst there is no resource confirming the carrier used, giving the timing and the availability of carriers in America, it is highly probable that the carriers used, and the carrying positions used were FFO. So wait, what? The one bit of research confirming babies who are carried cry less and are happier was probably done using FFO carriers, completely contradicting everything the FFO movement claim regarding over stimulation. But hey, why ruin a good story right?

So let’s look at what proof the anti-FFO movement have that FFO causes damage to children or causes over stimulation. I ask this question a lot. No one has ever given me anything more than a list of blogs to read (some by Ergo, who have now completely removed them all as they manufacturer a forward facing baby carrier, and one by Boba, who now also manufacture a FFO carrier – ironic?). A consultant recently, in my group, felt she had the proof. Oh, please, let’s read it. “Insert random German Dr names opinion is this”. Oh, ok, can we have the published article for this (which would have to be peer-reviewed and claims and opinions subjected to proof). Her reply? “Oh, he could not get the paper published, but it is his opinion and I believe him”. Okay then. The words he could not get the paper published but it is his opinion, speak volumes. His opinion failed the strict requirements needed to be published, suggesting it was nothing more than his opinion, and hey we are all entitled to opinions!

The myth of the 20-minute rule

The anti-FFO movement had a major juggernaut thrust into it when Ergo Baby Carriers, their ‘David’, launched a world facing baby carrier. Whhhaaaaaaaaaaaaaaaaaaat? Oh, the backlash was unreal. Their David had turned into a Judas. All their blogs and information being anti-FFO were quietly removed. Why did Ergo do this? Perhaps they realised, FFO was not the demon they had made it out to be and there was no proof it did any harm? Perhaps they realised the vast majority of people want to FFO and they were losing a huge share of this market? Who knows. I remember the launch of the Ergo 360 vividly. There were thousands upon thousands of comments slating Ergo. Within this backlash, Ergo took the decision to ‘appease the crowd’ and suggest a ’20 minute rule’. It was not in the original instructions but just in a Facebook comment responding to the backlash. This seemed to work. The anti-FFO brigade could accept this carrier as long as people only used it for 20 minutes, as that really could not do much harm. Another piece of Ergo marketing and influencing was done. The 20-minute ‘rule’ was born. For the anti-FFO brigade, (completely ignoring the fact it was just done in hindsight to appease their followers), let’s enforce this EVERYWHERE when all else, in the mission to stop people FFO, has failed. Let’s just let them have their FFO (if they really must) but ONLY for 20 minutes.

The idea of imposing a one size fits all rule on babies, is just, well ludicrous. People online have no idea of the baby/toddler involved, their age, their personality, their confidence, their inquisitiveness, their ability to handle new information. Yet, that does not matter, just 15-20 minutes is ‘allowed’. To say a 6-month old baby, who is very tired and ready to sleep should have the same worldview as a 2.5-year-old just awake and ready to explore the world, just shows how ludicrous the rule is. However, this rule pervades and whilst people are now acknowledging FFO does not cause hip damage, they still persist with being anti-FFO based on potential mental damage if you don’t follow this ‘rule’. Again, where is the proof? I always ask. I just get told, everyone online ‘knows’ this… or the manufacturers say it. Well, happy to be corrected but neither Ergo nor Boba, Lillebaby or Baby Bjorn mention this anywhere.

What the International Hip Dysplasia Institute has to say

baby carriers, forward facing baby carrier

The International Hip Dysplasia Institute, another David in the anti-FFO brigade, now recognise specific products as ‘Hip Healthy’ to help educate the public. It is given, after reviewing the product for NO FEE, to products that consider the importance of healthy hip development during infancy. This is especially important during the early stages of hip development in the first few months after birth. Much to the chagrin of the Anti-FFO brigade, they have awarded it to four carriers which offer a forward facing position, the Ergo 360, The Bjorn One, Beco Gemini and the Lillebaby Complete. After years of using the Hip Dysplasia website and graphics as confirmed ‘proof’ FFO was damaging, sadly they are now out of favour with the Anti-FFO’ers. Their response? They have just decided money must be behind this move. Yep, seriously, they have been accused of being bribed and taking money. The HDI has always stated that it is better to carry in ergonomic seated positions, and that narrow based carriers are not ideal. They have never made a declaration with respect to FFO, the Anti-FFO brigade just ‘assumed’ it. Now they have made their position clear, in endorsing ergonomic FFO products, they are accused of just doing so for money. HUGE SIGH!

So we know there is no proof of any damage in FFO carriers, at present, it is just misinformed opinions and hearsay. If you see a mom asking about FFO carriers, point out the options and wish her the best. Remember our motto, empower and support, don’t judge.

Sorry, this was long-winded. But once again I just want to remind people that ALL BABYWEARING IS GOOD and that at all times we should support and empower parents in THEIR choices (unless we know it to be actually dangerous).

When asked about forward facing my reply would normally sound like this:

"Oh great that you have chosen to carry your baby, I am delighted for you. There is a lot of misinformation online with regards to forward facing, but current expert opinion is that it is fine once you are not carrying a newborn baby and your child has good neck control (5/6mths onwards). You can world face for as long as you and your baby are both happy and comfortable. Take your cues from your baby, if they are sleepy, they might have had enough from looking around turn them around to sleep.

If you have any more questions or need specific advice just join our Facebook group and chat with our staff, who are fully qualified Trageschule babywearing consultants.