The world health organization reports that 80-90% of normal populations irrespective of race will at one point in
time develop pain in the lower back. Though it has been easy to discuss etiological factors for back conditions such as job type, sports, life style, smoking, alcohol, trauma , body proportion and infections, the mechanisms that underpin the complex symptoms have not been exhaustively explained. Pregnancy and the necessary conditions imposed by nursing a baby through the first 18 months of life bring impressed forces to bear on the back bones of the mother and the child she is nursing. The bones of the back are designed in such a way that there are curves, four for a mother and two for a new born child-the other two will develop when the child is able to hold his neck without support, and later when he begins to sit down unaided. These curves help the back bone to bear weight 16(sixteen)times the weight that can be handled by a vertebral column without bends—this is in accordance with engineering principles and in concert with Newtonian Physics(Hooks law). The implication is that any attenuation or exaggeration of these natural curves will be amplified into clinical problems the magnitude of which will be modified, depending on several other considerations.
It has become fashionable for young African mothers to put their babies in slings and place the slings on their necks with the babies spread out turtle posture, in front or back depending on what activities engaged them at the time. This is different from the older African method of carrying babies across the back with clothe belts of specific texture and size . It is also different from the relatively more expensive use of open or hooded wheeled baby carriage where babies are placed in more comfortable positions
This discussion highlights how the use of baby slings can harm the bones of the back and lead to early degeneration of the inter vertebral joints . For a mother, resulting back problems such as low back pain may not develop immediately, but later when mother is older. For the child, all sorts of problems involving not only the spine and backbone but other parts of the body such as heart, lungs, and even arrest of growth may occur. Mothers find them selves paying frequent visits to clinics because of one problem or the other. Some babies may become very restless and cry endlessly, refusing any methods of pacification, even breast milk, because, they are unable to speak out their ordeal, discomfort and pain
The problem of low back pain is worse for mothers who celebrate pregnancies with very short periods between pregnancies. In deed multi parous women that have had repeated exposure to the pregnancy hormones relaxin and progesterone( both are associated with excessive joint laxity and increased tendency for joints to sublux) are more likely to encounter probems.
Older mothers are particularly vulnerable ; their bones are already getting soft (osteoporotic) because levels of estrogen the female hormone responsible for maintenance of strong bones( via estrogen receptors in osteoblasts), begin to go down as from age 38.
Working mothers who also do much house hold activities such as cooking, washing, floor washing etc. are at increased risks .Also included are Mothers not getting enough sun light(required by custom to shield self and remain indoors), malnourished mothers not taking enough milk and calcium
Others;
Tall mothers, height above 1.8meters. Short mothers, height below 1.4m,
Mothers with huge breasts, and mothers habitually wearing high heeled shoes
Mothers and babies who are homozygous SS or carry the trait-AS or SC,AC-In these conditions there is abnormal hemorheology(abnormal blood flow pattern) ,such that red blood cells die in large numbers when they try to move across tiny blood vessels of the capillary beds. The consequences arising from the fragile sickle shaped red cells and their markedly reduced deformability manifest in the form of frequent vaso- occlusive sickle cell crises
Mothers engaged in occupations which require them to stand for more than three hours or more in one or two stretches . In all these situations, the bones and joints of the back and the muscles that link them are engaged in more work than they are bioengineered to do, and the consequences from prolonged exposure to wear and tear will declare themselves sometime in the life of the individual-depending on duration.
Mothers of old and in fact in rural communities who carry babies on their backs follow some carefully learned procedures, babies are not immediately strapped on the back immediately after meals, during periods of illness and when they are engaged in physical activities which involve much repeated bending and standing——during prolonged periods of standing, sitting, stooping and squatting, babies become quickly uncomfortable and try to draw attention of mothers by crying, squeezing their trunks and trashing, mothers from higher socioeconomic background pay attention and respond affectionately ,others simply carry on
Positioning the babies involves the following
The shoulders are abducted and laterally rotated maximally, The hips are also in maximum abduction and lateral rotation
The neck is in extension and rotated in one direction to keep the face and chin away from mother’s upper back. The neck in normal humans has seven flat bones , with slots or holes placed at the extremes of the sides where huge blood vessels pass to and from the brain and skull. The bones of the neck are arranged in such a way as to allow for more nodding(flexion-extension) movements than rotatory/twisting ones. When mothers strap babies across the back, the neck is either allowed to oscillate between rotation, extension and flexion, or held to one side in twisted position with the blood vessels equally twisted ,resulting in narrowing or kinking .The neck bones and muscles provide protection for very important organs necessary for metabolism /growth and immunity of the growing child. These muscles can go into spasm ,and then fatigue with excessive metabolic wastes-the child will be in pain for as long it takes his mother to change his position or someone points out to her that child is in distress.
For the growing brain, any little disruption will affect something some where within the vast array of neuronal organization.
With the baby in sling or strapped on the back, thorax/chest region is curved backwards to reduce the normal kyphotic angle and the lumbar/waist region curved forward in excessive lordosis, but the prominent buttock of the African mother immediately limits anterior ward excursion of the baby’s pelvis, and so baby is held like a bow.
With the baby strapped into position in mothers back, the following changes can be observed —the thighs are held onto the back and sides of mothers abdomen so the legs are effectively prevented from dangling without support. With the baby sling, the legs dangle freely, but blood vessels and nerves are at increased risk of being trapped.
With the child on mothers back, the normal kyphosis (backward curve ) of the child’s backbone is distorted as it is forced into the hollow of mother’s back.
Abdominal organs-liver, spleen, intestine, and stomach are pressed into the little space left.
The lungs, heart and thick muscle of respiration-diaphragm which separates the trunk into the upper thorax and lower abdomen are all closely packed into this space.
Venous return to the heart may be affected. The bladder which is an abdominal organ up to age six in children is included here . The genitals –testicles particularly in males is also squeezed on the area of the waist of mother. The ligaments which hold the bones of the back together are forced into tension at three points mainly—the neck, thorax and lumbar regions. The ligaments and muscles which holds bones of the shoulders and waist together are also under tension.
When the sling is adjusted to hold baby close, the abdominal aorta; a huge blood vessels that supplies blood to the internal organs of reproduction, the bones and muscles of the waist , thighs, legs and feet , may be so compressed as to affect blood flow . Baby slides down and there is increased tendency for one group of muscles to slacken while the opposing groups go into exaggerated tension. As is often the case, Baby cries and trashes to draw mothers attention who draws sling tighter— This results in greater tension in the cervical (neck) and thoracic (chest) portions of the back bone. At some point, diaphragm is splint, reducing the thoracic capacity and child may find it difficult to breathe well; chest diseases which mothers cant explain.
Some mothers prefer to have the baby in front, resting partly on the abdomen within the sling, the resulting problems depend among other issues on whether or not the mother has abdominal type obesity, height and lifestyle, size of the baby etc . Similar to what has been discussed, the head dangles here and there-a condition not very healthy for the growing brain, which in life appears like tooth paste but contains nerve bundles arranged in awesome and sophisticated pattern. Unlike the back, there is no free space when baby is hung in front, and the child’s abdomen presses on that of his mother much like pushing one ball of doughnut against another. Apart from causing great discomfort for the child, his back bone is excessively bent backwards to fit into the sling, – and each time mom tries to adjust baby inside the sling, the joints and the different parts of the back bones which are still soft (fusion not complete until about age six) are jolted and slammed against other parts , the results though similar to what was discussed earlier are worse when baby is in the sling in front of a fat, tall heavily breasted Mom. For reasons that have been explained, there will be episodes of unexplained illnesses every now and then, involving, nearly every system or portion in the growing child. Developmental milestones may not be grossly affected but subtle deviations from normal will be observed often ascribed to growing pains, teething, malaria, seasonal variation disorders, spiritual problems etc
Suggestions
Keep babies preferably out of slings
If you must use baby slings, use the types that are adjustable and have enough pockets to house body segments-don’t use baby slings for extended periods of time –imagine your self in that position.
Observe, feel and listen to baby-particularly when in the sling—these are easier said, especially when someone else and not the mother is carrying baby in sling, and mother is not around to see how much pain and suffering baby is going through. Some mothers/parents in developed countries install what is referred to as ‘I am seeing you’’ soft ware into home video systems that capture activities in the home and enable them communicate with whoever is nursing their babies while they are away.
If you can afford it, get the hooded or open baby carriage system which comes in various forms, For those who can not afford such sophisticated products, any other arrangements will do-provided baby is placed to lie as comfortably as possible There are some that can be detached, assembled and placed as desired in cars, floors, tables, in offices and other safe places depending on the size and age of the baby. The bigger ones that can be pushed are now the vogue. Expensive quite alright but with small families, as opposed to large ones, they are affordable to those who plan.
