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BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accessAdult-worn sling and baby carrier safety: exploring parental practices, knowledge and information needsRebecca L J Strong, Sophie R Lovell-Kennedy, Laura M Grieve, Helen L BallTo cite: Strong RLJ, Lovell- Kennedy SR, Grieve LM,et al. Adult- worn sling and baby carrier safety: exploring parental practices, knowledge and information needs. BMJ Paediatrics Open2026;10:e004696. doi:10.1136/ bmjpo-2026-004696 Received 3 March 2026 Accepted 13 May 2026 Durham Infancy & Sleep Centre, Department of Anthropology, Durham University, Durham, UKCorrespondence to Dr Helen L Ball; h. l. ball@ durham. ac. ukOriginal research© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.► https:// doi. org/ 10. 1136/bmjpo- 2026- 004693ABSTRACT Background This project responds to concerns regarding infant deaths occurring in adult-worn slings and carriers (AWSC), the use of which is increasing in the UK. We aimed to explore how and why UK parents and carers use AWSC, their knowledge of AWSC-safety and where they find information about using AWSC.Methods An online survey for parents/carers about AWSC-use was designed in collaboration with a parent advisory group who also tested the survey usability. The survey was circulated via mail-lists and social media by the Durham Infancy and Sleep Centre, as well as AWSC-user groups and baby safety organisations.Results The survey captured 1470 responses from mainly white UK mothers aged 26–45 years with infants under 12 months. 96% had used an AWSC for multiple reasons (mobility, bonding, soothing, being ‘hands-free’). Most AWSC- use began in early infancy; families purchased AWSC from physical or online shops. Manufacturers provided little safety guidance and many parents were unaware of specialist resources (eg, sling libraries). Social media, blogs and websites were popular sources of information. 25% of respondents were unfamiliar with existing UK AWSC safety guidance and a further 25% felt it lacked crucial information.Conclusions The survey outcomes highlight the importance of universal AWSC-safety information provision in pregnancy and early post-partum, targeted to mothers, fathers and other infant-carers. This should be disseminated via widely used and trusted platforms with signposting to specialist sources of support and guidance.INTRODUCTIONHuman infants are unusually helpless baby mammals requiring close contact with a caregiver to meet their biological needs for milk, comfort, safety and thermoregulation. 1 Carrying enables this close contact, and adult-worn slings and carriers (AWSC) have been widely used across cultures and history to meet infant needs while allowing mothers to remain mobile. 2–6 Today, many babies spend all or some of their time in a sling or carrier in contact with a caregiver’s body.7 8 However, while baby-carrying is a common behaviour around the world, methods for carrying babies vary across countries and cultures.9 In recent years, use of AWSC (also known as ‘baby-wearing’) has grown in popularity in the UK, USA and elsewhere in the Global North,10 as responsive and proximal parenting practices have become widespread.11 12 Global market reports suggest that the sling/carrier industry is growing at a rate of 5–10% per annum.13 Yet, despite increased popularity of AWSC, there is limited guidance on safe use for UK parents available in the public domain even though there are risks associated with unsafe use.14 In the UK and overseas, several high-profile deaths of babies being carried in AWSC or following injuries incurred while in AWSC have caused alarm among coroners and the media.15–17 These cases have raised concerns about the safe use of AWSC and resulted in calls to strengthen the scope and accessibility of publicly available guidance.18WHAT IS ALREADY KNOWN ON THIS TOPIC⇒ The use of adult-worn slings and carriers (AWSC) is increasing in the UK and other parts of the Global North but there is an absence of research to under- stand how parents are using AWSC or their knowl- edge of AWSC safety.⇒ Young babies (under 4 months) are vulnerable to po- sitional asphyxia if AWSC are not used safely.WHAT THIS STUDY ADDS⇒ UK parents begin using AWSC in early infancy but receive little guidance on how to choose AWSC or use them safely.⇒ Parent safety information should include awareness of positional asphyxia, the importance of active monitoring and safe feeding and sleeping during AWSC- use.HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY⇒ This study provides evidence to inform a UK-wide safe AWSC-use campaign with signposting to spe- cialist support. This guidance will be co-produced by infant safety organisations, AWSC-user organisa- tions and the research team. ### Page 2 2 Strong RLJ, et al. BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accessAt the outset of this study, previous UK guidance on AWSC-use (known as TICKS), primarily created by the AWSC industry and charity sector (UK Sling Consor- tium), was not comprehensive, did not offer underpin- ning evidence and was not being updated. Furthermore, the UK National Health Service (NHS) did not offer specific guidance on AWSC-use and directed parents to TICKS and UK infant safety charities (eg, The Lullaby Trust and Royal Society for the Prevention of Accidents (RoSPA)) which also signposted to TICKS.19 Although sling libraries exist in many UK cities and towns providing support for all types of AWSC-use, it is not clear how well- known or used these resources are, or whether the guidance independently produced by AWSC manufacturers, retailers, baby- wearing consul- tants, sling libraries and charities concerned with infant safety was comprehensive, consistent, accessible and used by families. This project aimed to understand how, why and when UK parents and carers with infants under 1 year of age chose to use or not to use AWSC, to assess parents’ knowledge of AWSC safety and awareness of guidance and sources of information regarding AWSC-safety and to identify what was lacking in existing UK provision of AWSC-safety information so that these gaps might be filled.METHODS Survey designAfter conducting a systematic review (SR), 14 a series of parent- facing questions was compiled to guide survey data collection. These were based on the research iden- tified in the SR, and the questions posed by coroners, parents who have experienced infant loss and organisa- tions concerned with preventing infant deaths (table 1).Survey testingThe survey comprised multiple-choice and short answer questions (with conditional branching). A draft was shared and discussed with the parent advisory group (PAG) (see Patient and Public Involvement statement) who gave feedback on further topics for inclusion, suggesting questions and amendments. After revision by the research team, the PAG sense-checked the final survey questions and ensured instructions were clear and conditional branching worked correctly.Survey distributionThe survey was circulated to parents/carers of infants through the Durham Infancy and Sleep Centre’s email and social media channels, and via professional organisa- tions and charities associated with infant care and safety who shared it through their own email lists and social media channels. All parents/carers who met the inclu- sion criteria, regardless of AWSC experience, were invited to complete the survey; those not meeting the inclusion criteria (ie, not UK-based, not currently caring for an infant under 12 months) were filtered out. Completers were advised that survey outcomes would be shared on our social media and email channels when published.Survey durationThe survey was live for a 6week period between April and May 2025. In the final week, we closed recruitment to AWSC users and emphasised recruitment of non-users due to a relatively low number of responses from this group.Patient and public involvementInvolvement of patients was not relevant, but the views of parents were. During survey design, PAG members were recruited via an advert on our social media platforms andTable 1 Parent-facing questions to be addressed by the survey 1 When and why do parents decide to use an AWSC? 2 When and where do parents purchase their first AWSC? 3 What types of AWSC do parents purchase for babies of different ages? 4 What AWSC- safety information (if any) do parents receive at the point of purchase? 5 At what infant age do parents commence using an AWSC? 6 Are parents aware of the factors contributing to positional asphyxia in AWSC? 7 What concerns do parents have about using an AWSC? 8 What benefits do parents identify from using an AWSC? 9 Where do parents seek information about AWSC use if they have further questions? 10 How do parents learn about proper AWSC fit and positioning of their baby? 11 Do parents/carers share AWSCs? 12 What unanswered questions do parents have about AWSC use? With these questions in mind and following the relevant components of CHERRIES (Checklist for Reporting Results of Internet E-Surveys: an international guideline used to improve the transparency, quality, and reproducibility of web-based survey research), 25 and guidance for online survey use,26 we compiled a draft online survey using the Qualtrics survey platform. AWSC, adult- worn slings and carriers. ### Page 3 3Strong RLJ, et al. BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accessvia direct contact with local AWSC groups. The concerns of parents whose babies had died, as well as coroners, were conveyed to us via The Lullaby Trust. Two virtual PAG discussions were hosted, each with 10 invited partic- ipants. PAG members reviewed the draft survey, provided feedback on its content and on the time and effort required to complete it and tested the final version. PAG participants received a gratuity of shopping vouchers.Data cleaning and analysisData were downloaded from Qualtrics and imported to MS Excel for cleaning, summarising and analysing. A common problem in conducting online surveys is their vulnerability to fraudulent responses and multiple submissions, and we were alert to the need to check for ineligible responses.20 Entries that were incomplete or contained no useful data were excluded from the final data set. Multiple responses from the same Internet Protocol (IP) address within a short time period were also examined for eligibility. Of 2177 responses recorded in Qualtrics, 171 were automatically discarded as respondents declared their infant to be over 12 months old, and one declined to provide consent, leaving 2005 responses. A further 382 entries were incomplete, and so these were also excluded leaving 1623 responses. In some cases, a second entry from the same IP address that had specified an over-age child was submitted immediately afterwards specifying a younger age. These cases were examined individually. We found 153 duplicate responses came from the same IP address as ineligible responses regarding over-age infants, submitted soon after the previous attempt, containing identical details except for a younger infant age—but without sufficient age gap for this to be a younger sibling. These 153 entries were designated as likely to be fraudu- lent and excluded, leaving 1470 responses. The final dataset was analysed descriptively by the production of tables and graphs, and where comparisons were appropriate χ2 tests were used to compare frequen- cies for categorical outcomes. Free text responses were coded and analysed using thematic categories.RESULTSOf 1470 eligible responses, over 90% were from white mothers aged 26–45 years. One-third of infants were aged 0–3 months at the time of survey completion, and approximately one-third were resident in Southeast England (table 2). First and subsequent infants were equally represented across age-quartiles (figure 1).Use of AWSCs96% (n=1404) of respondents used an AWSC with their current infant. Most decided to do so before (n=647, 46.1%) or during pregnancy (n=578, 41.2%), and 96.6% (n=1356) began doing so during the first 3 months of their babies’ lives. Awareness of AWSC came via friends and family (19.6%), social media (15.2%) and seeing other parents using AWSC (22%); however, a wide array of other influences were noted (23.1%) such as Scot- land’s baby box (which provides a stretchy wrap carrier) and own prior experience. AWSC preferences differed by infant age and changed as babies got bigger, heavier and stronger. For younger babies, wrap-carriers and structured carriers were popular, but wrap-carrier use declined, and ring-slingsTable 2 Characteristics of included and excluded responsesIncluded (n=1470) Excluded (n=707)RespondentMotherFatherOtherNot captured 99.1% (n=1457) 0.4% (n=6) 0.5% (n=7) -- 85.9% (n=607) <0.7% (n≤5) 1.3% (n=9) 12.4% (n=88) Respondent age (years)Under 1819–2526–3536–4546–5556–6566+Not captured <0.4% (n≤5) 2.9% (n=43) 65% (n=955) 31.1% (n=457) 0.6% (n=9) <0.4% (n≤5) <0.4% (n≤5) -- <0.7% (n≤5) 3.4% (n=24) 55.2% (n=390) 26.3% (n=186) 1.6% (n=11) <0.7% (n≤5) <0.7% (n≤5) 12.4% (n=88) Current infant age (months)0–3 months4–6 months7–9 months10–12 monthsOver 12 monthsNot captured 33.2% (n=488) 28.6% (n=421) 22.4% (n=329) 15.8% (n=232)► --► -- 17.5% (n=124) 14.4% (n=102) 9.9.% (n=70) 13.4% (n=95) 32.1% (n=227) 12.6% (n=89) First child 53% (n=785) 33% (n=230) EthnicityAsianBlackMixedWhiteOtherNot captured 1.4% (n=20) 0.7% (n=10) 2.4% (n=36) 94.6% (n=1391) 0.7% (n=11) <0.4% (n≤5) 2.7% (n=19) 0.7% (n=5) 1.6% (n=11) 81.8% (n=578) 0.7% (n=5) 12.6% (n=89) UK region:ScotlandWalesNorthern IrelandNortheast EnglandNorthwest EnglandSoutheast EnglandSouthwest EnglandMidlands, EnglandNot captured 6.8% (n=100) 2.8% (n=41) 1.8% (n=27) 13.4% (n=197) 11.5% (n=169) 30.9% (n=454) 15.5% (n=228) 15.5% (n=228) 1.8% (n=26) 6.4% (n=45) 3.1% (n=22) 2.4% (n=17) 10.9% (n=77) 9.9% (n=70) 26.6% (n=188) 11.3% (n=80) 14.0% (n=99) 15.4% (n=109) Sling/carrier user:YesNoNot captured 96% (n=1404) 4% (n=66) -- 48.1% (n=340) 1.8% (n=13) 50.1% (n=354) ### Page 4 4 Strong RLJ, et al. BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accessand structured carrier use increased as infants aged. Overall, 54% of AWSC-users reported using multiple AWSC types over time, primarily for parent comfort. A few participants in each age group reported using ‘pouch’ slings. These can be hazardous for young infants if carried in a cradle position which pushes their chin onto their chest. No single reason emerged as a primary motivation for AWSC-use; mobility within and out of the home, bonding with and being close to baby, soothing baby when fussy, helping baby fall asleep and being ‘hands-free’ to do housework were all popular reasons. Respondents also wrote-in additional reasons such as prams being expensive and difficult to store. Responses from non-users (n=66) explained their reasons for not using AWSC. Some had concerns about safety (n=29, 44%), while others could not get an appropriate size/fit, or thought their baby too young or too small to safely use an AWSC (n=21, 32%). Others lacked confidence, found AWSC uncomfortable to wear or did not wish to encourage infant dependency. Most AWSC-using mothers carried their babies up to 3 hours per day; a quarter carried for 4–6 hours per day at 0–3 months, declining with age. A small proportion (n=117, 7.6%) carried for prolonged periods (7+ hours per day) primarily in the first 3 months. Across all infant age groups, over 90% of fathers reportedly carried babies in AWSC for under 3 hours a day (see figure 2). 20% of participants had breastfed their baby while using AWSC, with the smallest proportion in the first 3 months, increasing in each age group suggesting that parents and babies became more confident and skilled with breastfeeding in AWSC over time as babies became more physically competent (figure 3). In comments, 280 mothers described how they breastfed while using an AWSC; for many this involved loosening the AWSC and repositioning the baby with some sitting down and supporting the baby with one hand or arm. Returning the baby to their original position and re-tightening the AWSC were emphasised by respondents. Both new and experienced parents struggled with AWSC- use. Common challenges included: positioning the baby (n=825, 58.8%) and achieving parent comfort (n=818, 58.3%), followed by getting the baby into the AWSC (n=591, 42.1%) and fastening it securely (n=482, 34.3%).Sources of guidanceMost respondents had purchased an AWSC themselves (n=1085, 77.3%), 507 (23.2%) were gifted, 79 (3.6%) received one in Scotland’s baby box and very few (<1%) purchased secondhand or a reused one from a previous child. Some respondents selected more than one option. Most purchasing was done online (n=961, 88.6%), with fewer than 3% (n=36) receiving help from a virtual sales assistant or chat function to select an AWSC, but even in- store only 30% (132/441) of purchasers received advice. In contrast, of 543 parents accessing a sling library or babywearing educator, n=414 (76.2%) received personalised advice on choosing and using the product. Parents learnt how to use their AWSC by reading the manufacturer’s instructions; obtaining information from social media, babywearing websites and blogs andFigure 1 Number of first-time and experienced parents across infant age quartiles.Figure 2 Carrying duration of mothers and fathers by infant age group. ### Page 5 5Strong RLJ, et al. BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accessattending sling libraries. Participants generally used multiple information sources (figure 4). Babywearing educators (31%) and sling library coordi- nators (26%) were trusted groups considered qualified to give AWSC guidance, with midwives (9%), health visi- tors (11%), General Practitioners (GPs) (3%) and shop assistants (5%) less so. Some parents (13%) took advice from friends or family with AWSC experience. Although new parents cited NHS and charity websites as sources of AWSC information, experienced parents cited baby- wearing websites or sling libraries. Fewer than one fifth of participants (19%) considered health professionals to be qualified to give AWSC advice.Awareness of safetyThree- quarters of participants (n=1067) said they followed TICKS guidance; 14% (n=195) had not heard of TICKS, and 10% (n=136) were unsure. In line with TICKS, 96.2% (n=1352) of AWSC-users initially kept their infant’s ‘face in view’ and ‘close enough to kiss’ at 0–3 months, declining with infant age (4–6 months=71%, 7–9 months=38.6%, 10–12 months=19.7%). Respondents across all infant-age groups felt TICKS was practical and kept their baby safe, but a quarter of respondents (25.1%) felt TICKS had missing compo- nents. Respondents wrote-in 622 comments reflecting a need for information on baby positioning, fit checks, duration of carrying, feeding babies in AWSC and babies sleeping in AWSC. A further 94 comments related to safety issues such as monitoring infant temperature and being alert for overheating, the safety of babies’ airways, what should be considered in the case of infant illness and how to identify other potential hazards. Lastly, 106Figure 4 How did parents learn how to use their AWSC? AWSC, adult-worn slings and carriers.Figure 3 Proportion of breastfed infants who were fed in an AWSC by age. AWSC, adult-worn slings and carriers. ### Page 6 6 Strong RLJ, et al. BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accesssuggestions related to clearer graphics, signposting to in-person expertise, provision of explanations behind guidance, inclusion in manufacturers’ instructions and AWSC-safety training for health professionals. Most parents (n=1150, 82%) did some research prior to obtaining an AWSC; over half (n=139/254, 55%) of the 18% that did not do research were unaware that trained AWSC educators existed. Sources consulted by parents who researched AWSC- safety included social media, babywearing blogs and websites and organisa- tions such as Lullaby Trust and NCT (a UK charity for pregnancy, birth and early parenthood). Fewer than 15% used a sling library (figure 5). Trusted information sources for AWSC-safety informa- tion included organisation and charity websites (n=635, 25%), sling libraries (n=496, 20%) and babywearing websites or blogs (n=445,18%). Although social media was the most popular source of AWSC information, it was considered a trusted source by very few respondents (n=160, 6%) (figure 5).DISCUSSIONUK parents made decisions to use AWSC prior to or during pregnancy and began doing so early in their infant’s life. They were motivated by multiple reasons: mobility within and out of the home, bonding with and being close to baby, soothing baby when fussy, helping baby fall asleep and being ‘hands-free’ to do housework. Respondents predominantly purchased their own AWSC, mostly online, while some received them as a gift. New parents experienced uncertainty over which AWSC to purchase or how to use it safely; for some non-users these concerns prevented AWSC- use. First- time parents were more likely to use a structured baby carrier than expe- rienced parents who more frequently used fabric ring or wrap carriers; however, parents changed the type of AWSC they used over time as their babies grew. Most babies were carried for periods of <3 hours, but younger babies were sometimes carried for 7 hours or more per day. Breastfeeding while using AWSC was practised more by mothers with older infants than younger ones. Guid- ance on AWSC-selection or safe-use was rarely offered at the point of purchase, particularly when purchasing online, while sling libraries provided personalised infor- mation on fitting, positioning and other aspects of AWSC safety. Parents generally researched AWSC prior to obtaining them but those that did not seek informa- tion were often unaware of safety guidance: parents may be reliant on manufacturers’ guidance unless signposted to specific safety information and specialist AWSC educa- tors during pregnancy. New parents sought information from NHS and charity websites, but experienced parents favoured babywearing or sling library websites. Health professionals were not considered to have good knowl- edge about AWSC-use and parents would benefit if health professionals had a trusted source of AWSC information that they could share. Strengths of this study involve the large sample size with good representation across infants of different ages and from a broad geographic spread of participants across the UK, who provided detailed and comprehensive answers to free-text questions. The survey was primarily completed by AWSC-users due to being organically shared by multiple baby-wearing and sling support groups and organisations. This means the survey outcomes under-represent the views of casual or infrequent AWSC users and non- users. Limitations also include a notable lack of responses from fathers and other caregivers and non-white mothers. To offset the imbalance between users and non- users, we analysed responses in subgroups toFigure 5 Parents’ actual and trusted sources of information for AWSC-safety. AWSC, adult- worn slings and carriers; NHS, National Health Service. ### Page 7 7Strong RLJ, et al. BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accesscompare first- time versus experienced parents, with particular attention paid to data from first-time parents with babies under 3 months of age as the highest-risk group. The low number of young babies being breastfed in AWSC may have been linked to public awareness of the recent death of a 6week- old baby who died while being breastfed in a carrier.18 Two other studies have explored AWSC-use in Western settings, the most recent of which involved interviews with 17 UK mothers to investigate perceptions of barriers and enablers to babywearing.21 The other, conducted in the USA, was a randomised trial that examined AWSC as an intervention to reduce symptoms of post-partum depres- sion (PPD) and breastfeeding outcomes. 22 23 Sufficient data on AWSC- use were reported in both studies to provide comparison with the present survey outcomes. Consis- tent findings included early decision-making in choosing to use AWSC and an association between accessing a sling library and increased knowledge of AWSC-use. Mothers in both the current and previous surveys21 reported day-to- day life being facilitated by AWSC. Practicalities of AWSC and safety were identified as barriers to AWSC-use in both studies. Differences in outcomes highlighted that mothers in the previous survey found breastfeeding in AWSC to be difficult or inconvenient to do,21 whereas respondents to our survey described how they did this. Although other researchers found AWSC-use to be phys- ically demanding and painful/tiring/uncomfortable for some mothers,21 the respondents in our survey did not highlight this as a barrier to AWSC use. Both our survey and that of Little et al22 found that in-person support at the point of acquiring AWSC affected safe use; parents who did not receive information immediately were less likely to seek it out and use it,22 which corroborates our survey findings that parents who did not seek AWSC-use information were unaware of safety guidelines. AWSC use was associated with reduced PPD symptomology and greater duration of breastfeeding. 22 23 Both studies involved small samples (n=1721 and n=100 22 23 compared with the present survey). We have shown AWSC are a popular mode of infant care in the UK for multiple reasons. This study provides evidence that many AWSC-using parents are unaware of safety guidance, emphasising the need for a nationwide campaign to raise awareness of safe AWSC use. As most parents commence carrying their babies in early life when they are at their most vulnerable, information on how to choose appropriate AWSC and how to use them safely is needed in pregnancy. New safety information should be designed and disseminated widely and provided at AWSC point- of- sale. Parents should be signposted by manu- facturers, retailers and health professionals to trusted sources of guidance containing explanations that help parents understand the key issues involved in keeping their baby safe while using an AWSC (including but not limited to positioning of infant, attention to airways, inap- propriate parental behaviours while using an AWSC and fit of AWSC for different adults who may share them). Breastfeeding a baby while in a sling has been raised by coroners as a cause for concern.18 Parents with babies of all ages reported breastfeeding while using AWSC; guidance must be tailored for infant age, emphasising that younger babies are more vulnerable to positional asphyxiation due to weak neck muscles and large heavy heads. Information about how to find specialist support via sling libraries and baby-wearing educators should also be made available to all parents. Organisations with inter- ests in infant safety and AWSC use must work together to generate and disseminate information for parents about the safe use of AWSC that is clear, consistent, accessible, usable and focuses directly on infant safety. Future research should explore whether international guidance or evidence exists regarding the duration of AWSC use for 0–3month-old infants to inform parents or to reassure them if limits are not necessary. Research is also needed on whether babies are ever at risk of over- heating in AWSC and how this can be ameliorated, as this is a primary fear expressed by parents. It may be useful to explore how different AWSC suit different adult body-types, and why parents choose to use pouch or bag slings which have been identified as particularly hazardous for young babies 24 ; research on this topic would be useful in devising information to dissuade them from using these products. Research should be undertaken with non-white populations in the UK to explore how AWSC-safety guidance interacts with customary carrying practices for different cultural groups, and finally research is needed with fathers and partners who choose to babywear to explore the benefit of them doing so for themselves and their children.Contributors The project was designed by HLB, SRLK and LMG. The survey was designed by RLJS, SRLK and HLB with input from the PAG and implemented by RLJS. Data were analysed by RLJS and LMG. The manuscript was drafted and edited by RLJS, SRLK, LMG and HLB. The final manuscript was approved by RLJS, SRLK, LMG and HLB. HLB (corresponding author) is the guarantor.Funding This work was supported by UK charity funding from The Lullaby Trust and Teddy’s Wish, project number 275.Competing interests HLB serves on the Lullaby Trust Scientific Advisory Group (voluntary role). SRLK, RLJS and LMG have no competing interests to declare.Patient and public involvement Patients and/or the public were involved in the design, conduct, reporting or dissemination plans of this research. Refer to the Methods section for further details.Patient consent for publication Not applicable.Ethics approval This study involves human participants. Approval to conduct this survey was obtained from Durham University Anthropology Department Research Ethics Committee (ANTH-2024-2239-2286). All responses were submitted anonymously, and all participants were asked to confirm whether they consented to inclusion of their answers in the final dataset prior to submission.Provenance and peer review Not commissioned; externally peer reviewed.Data availability statement Data are available upon reasonable request. Anonymised data generated during the current study are available from the corresponding author (HLB) on reasonable request.Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. ### Page 8 8 Strong RLJ, et al. BMJ Paediatrics Open 2026;10:e004696. doi:10.1136/bmjpo-2026-004696Open accessORCID iDHelen L Ball https://orcid.org/0000-0003-2255-121XREFERENCES1 Falk D. The “putting the baby down” hypothesis: Bipedalism, babbling, and baby slings. Behav Brain Sci 2004;27:526–41.2 Rosenberg KR, Golinkoff RM, Zosh JM. Did australopithecines (or early Homo) sling. 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