The importance of keeping baby’s chin off their chest in a sling.

Positional Asphyxia


Keep chin off chest is one of the TICKS rules for babywearing. One that since the birth of my second baby has been very prominent in my thoughts. He has struggled with his oxygen saturation levels at birth and has a tendency towards seizures and breath holding, where he turns blue and needs oxygen to get him breathing properly again. While we were in hospital with him he was hooked up to a monitor that measured his ‘sats’. It soon became evident that he was stable at sats of 80-87. The preferred and safe level is 90 and above. Brwsing through The Babywearer Forum and found a post about laboured breathing videos on Youtube and thought I would share the information to you.(I haven’t linked to the videos but if you search for ‘slings snoring’ you will come across some of the ones discussed in the post)


What does blood saturation (sats) mean? Briefly because this isn’t meant to be a physiology blog! Here is description from Wisegeek

” Blood oxygen saturation level refers to the percentage of a person’s red blood cells that are loaded or filled with oxygen. Oxygen is carried by the red blood cells to organs, such as the brain and the heart. If the blood oxygen level is too low, not enough oxygen is carried to the organs. Without an adequate blood oxygen level, the body cannot function normally.”

My baby’s sats were measured by a tiny pad velcroed round his foot and although I wondered how on earth it measured how much oxygen there was in his blood I had other things to worry about to ask.(but if you are interested there is info on it here)

The TICKS rules of babywearing came about after the tragic deaths of babies in the USA, these babies were carried in SlingRider carriers (which have since been discontinued) I have been quoting TICKS and showing parents how to position their babies properly in slings for a couple of years now, however after having to learn more about oxygen saturation levels I realise exactly what it looks like to have a baby who is turning blue from asphyxiation. A very scary experience.


First time in a sling, very tired, apprehensive but happy mama.

So wearing him in a sling was something that I was quite worried about. Would he be able to breathe ok in one. Our first attempt at carrying him involved a stretchy and a pretty unconventional position, a sort of modified cradle carry. He wasn’t able to be in an upright tummy to tummy position and we wanted to be able to see him (we were just learning how to observe him rather than rely on the monitor as we didn’t want to take that home). We were relieved to find that his sats greatly increased once he was in the sling, he got up to 99 at one point.

As he has grown and with help from a local osteopath he has strengthened and is now able to ride round in a sling in an upright position.

So I wanted to  post on how to recognise breathing difficulties (this applies to anything babies sit in car seats, bouncy seats etc), as opposed to snoring or noise related to snotty noses. (or premature babies or those with respiratory illness who will be noisy breathers).

Signs to recognise obstructed airways:

  • The noises change once the baby’s position is altered, ie the head is tipped back or a hand is placed against the back and gently pushes to straighten the spine. As soon as the baby’s position is altered the noises stop immediately.
  • The noises sound forced and high pitched
  • The breathing looks laboured, you can see the chest heaving up and down with each breath
  • Rapid breathing. The normal rate for breathing for babies is between 40 and 52 breaths per minute.
The TICKS rules of babywearing were designed to help parents ensure that their babies are properly supported in their slings so the airways are not obstructed.
Tight – the sling needs to be tight to hold the baby close to you and  prevent baby slumping down which would allow the chin to fall onto the chest.
In view at all times – so a quick glance can allow you to see your baby’s face to ensure all is well.
Close enough to kiss – means that your baby will be in view at all times and you can hear if their breathing becomes laboured/noisy
Keep chin off chest – to prevent obstructing the airways
Supported back – again prevents the baby slumping down in the sling.
So position-wise if you are carrying cradle carry position you need to make sure your baby’s bottom is in the deepest part of the sling, so they are in more of a sitting up position to an actual laying down one. You can fold a towel to put under them to give more support if they are small. There is a very informative article about this by M’Liss Seltzer on correct positioning with some excellent photos here.Looking back on carrying my first son I realise that I had him in less than optimal positions and there were times his breathing was very noisy. I so wish someone had helped me and explained how to position him properly and how to tie slings correctly (it would have saved a lot of frustration on both our parts)


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2 thoughts on “The importance of keeping baby’s chin off their chest in a sling.

  1. I am just about to buy a sling so this is excellent information, I hadn’t realised how important it was to position my baby properly. Thank you

  2. I am so glad you shared this , I have seen some babies in slings with their chins tucked in and really struggling to breathe. All parents need to know this.

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