Baby Wearing Injuries Presenting to Emergency Departments, 2011-2020: A Dangerous Fashion Trend

Background: Baby-wearing (BW) is an old practice that has seemingly undergone a revitalization, with large upswings in market consumer product sales and increasing compound annual growth rates across the United States (US).1 Federal law requires that BW products, including soft infant carriers, sling carriers, and framed baby carriers, comply with their respective safety standard. All BW products must supply consumer warnings as it relates to infant fall and suffocation hazards.2 As BW product use becomes more prevalent, injuries to worn infants will continue to present to emergency departments (ED) despite the current safety measures. The aim of our investigation is to better characterize the epidemiology and impact of baby-wearing related injuries (BWI) presenting to emergency departments (ED) in the US.

Methods: Data from the National Electronic Injury Surveillance System were retrospectively analyzed for patients aged ≤5 years who sustained an injury associated with a BW product (baby harness, baby carriers or slings, baby carriers (not specified), other baby carriers, baby slings and wraps, framed baby carriers, and other soft baby carriers) from 2011 through 2020. Variables analyzed included, but were not limited to, patient age, involvement of a caregiver fall, and mechanism of injury. National estimates were generated from 601 actual cases.

Results: From 2011 to 2020, an estimated 14,024 patients presented to US EDs due to BWI. A total of 22.0% (n=3,085) of BWI resulted from a caregiver fall. A total of 61.0% (n=8,548) of injuries occurred in children ≤5 months of age, with 19.3% of these infants requiring hospitalization, and 83.7% of these children injuring their heads. The products most often associated with injury included: baby carrier, not specified (45.2%, n=6,338); baby carriers or slings (30.9%, n=4,330); or other baby carriers (16.1%, n=2,260). Traumatic brain injuries/concussions were the most common BWI diagnosis (59.1%, n=8,284), with 20.8% of these injuries requiring hospitalization. Most patients were injured by falling from the product (52.1%; n=7,279).

Conclusion: BW is a prevalent child-rearing technique. While many of these injuries were evaluated in the ED and discharged home, some still required hospitalization. Traumatic brain injuries and concussions more commonly required further medical attention than other diagnoses. In addition, injuries in children ≤5 months of age also required hospitalization more often as compared to older children.

BW is an old childcare technique that has received new life. Yet for all of its suggested benefits: better couplet bonding, parental freedom to complete activities of daily living, and exposure of the infant to new environments, there is a catch. BW is associated with head injuries in the most vulnerable infants, those ≤5 months of age. Health care providers should take care to caution and educate parents regarding the proper use, recommended ages and potential risks for BW.