Does Infant Carrying Promote Attachment?

“Baby carrying strengthens the bond between you and your baby.” This is a statement you often hear from baby carrying advocates, be it experienced mothers, babywearing consultants or midwives. It really only takes one look at a calm secure parent and her or his quiet, relaxed, content and alert baby in a good baby carrier to instinctively sense that this statement is probably quite true.

These are very fundamental questions: Should I give ample physical contact to my baby? Or, should I leave it more or less physically separated from me in the hope that this best fosters independence? For many parents, instincts and intuition are sufficient guidelines for their parenting choices. However, such instincts can be challenged by conflicting views, purported by some experts in the field. Some will argue that giving too much physical contact to a baby will make it clingy and dependent in the long run.

One informational resource for such vital decisions comes from the field of science, in this case the science of child development. In a landmark study conducted in 1990, a team of researchers from Columbia University, New York, set out to explore this very question. The study was titled “Does Infant Carrying Promote Attachment?[1]” This study was designed to test the hypothesis that increased physical contact would promote greater maternal responsiveness and more secure attachment between infant and mother. Secure attachment has been found to correlate with autonomy and healthy independence.

The research team was greatly inspired by the work of one of the absolute pioneers in the field of Attachment Theory, Mary D. Ainsworth. In her classic studies, in 1967, in Uganda and the United States, Ainsworth found that the amount of time mothers held their infants was related to the “security-of-attachment rating” that the infants received[2].

Mothers who, in the first months of life, held their infants for relatively long periods, and were tender and affectionate during the holding, had infants who, at 12 months of age, had developed secure relationships with them[3]. In contrast, if mothers were inept in handling their infants and provided them with unpleasant experiences during holding, the infants developed an anxious-ambivalent pattern of attachment.

Several studies have found that mothers of avoidant infants had rejected or sought to minimize physical contact with their infants[4],[5],[6]. Thus, the research team argued, there is evidence that the amount and quality of physical contact between mother and infant is related to security of attachment. By increasing the quantity of physical contact, the experimental treatment of baby carrying may afford the mother opportunities to show affectionate and tender behavior, thus affecting the quality of interaction.

The research team chose mothers from a low socio-economic background as participants for the study. These mothers were expected to have a range of social risk factors, which are likely to affect the quality of the attachment the mothers are able to form with their baby[7]. They would, therefore, also be the mothers most likely to gain from an intervention aimed at improving the attachment quality. If the mothers were already “good enough,” it would be hard to tell the difference – to establish if baby carrying improves the quality of attachment.

After having given normal birth to a healthy child, the mothers were randomly assigned to either an experimental group that received baby carriers (more physical contact) or to a control group that received infant seats (less physical contact). The research team took careful precautions to rule out the risk that some mothers might already, prior to the onset of the study, be enthusiastic baby wearers. This could potentially confound the results.

On the day after giving birth, the potential participants were read a list of different baby items and asked whether or not they would use each of the items if it were given to them as a gift. Embedded in the list were a soft structured baby carrier and an infant seat. Those who had already decided to use a baby carrier or who would not consider using one were eliminated from consideration. The study was explained in detail to those women who indicated that they were willing to use either a baby carrier or an infant seat.

In order to obtain an objective estimate of the amount the soft baby carriers were used, pedometers were sewn inside them. Usage questionnaires administered during the test indicated that the mothers used the assigned “tools” frequently.

At 3½ months of age, the babies were filmed during a play session with their mothers. The research team rated the mothers’ ability to respond to their babies’ vocalizations. This was achieved through detailed second-to-second analysis of the observed interactions. The mothers in the experimental (carrying) group were found to be more responsive than control mothers to their babies’ vocalizations.

When the babies were 13 months old, the Ainsworth Strange Situation was administered[3]. This is a test which puts the infant through a series of increasingly (but mildly) stressful incidents, including brief separations from the mother, and being left alone with a stranger in an unfamiliar place. The baby’s specific pattern of response to the separations and reunions correlates to a specific pattern of attachment.

The three patterns analyzed in the current study were the secure attachment, the anxious-avoidant attachment pattern and the anxious-ambivalent pattern. The secure attachment pattern denotes healthy autonomy and independence, accompanied by good social skills. The anxious-avoidant pattern makes the child appear independent, but regrettably with poor social skills and empathy and a latent tendency to display aggression. The anxious-ambivalent pattern results in a typical clingy and dependent child.

The research team found that in the control group 38% of the babies were securely attached, and conversely, 62% insecurely attached. The majority of the insecure attached babies were anxious-avoidantly attached. In the experimental group 83% were securely attached, and only 17% insecurely attached.

The function of having a control group in a scientific study is to inform what the outcome would have been if the intervention of baby carrying had not taken place. Evidently, a very significant change took place in the attachment between mother and child when mothers carried their babies, instead of adopting the more or less standard procedure of less physical contact. The researchers could conclude that when at-risk mothers carried their babies, carrying would indeed “strengthen the bond between mother and child.” Also, the nature of this bond was found to be healthy.

Compared to other types of attachment-related interventions for at-risk mothers, the intervention of providing baby carriers turned out to be extraordinarily effective[8]. The research team speculated on the mechanisms that might be involved in the dramatic change of the mothers’ caregiving skills. Research in monkeys has demonstrated that mothers who have been exposed to maternal neglect in their own childhood tend to be negative towards their offspring, and, also, spontaneously reject physical contact. However, if exposed to sufficient amounts of physical contact with their offspring, their behavior would be modified.[9],[10]

Research conducted in the decades following this study, indicate that the neurohormone oxytocin might be involved in the remarkable effect of baby carrying that the study brought to light.

Some mothers have not had the most rewarding childhood or have been struggling with a difficult pregnancy and birth, perhaps combined with economic worries, high pressures of work or a fragile marriage. All these factors are known to put the strength and quality of the bond to one’s child at risk.

Luckily, it does seem that the intuition that babywearing will strengthen that vital bond has been borne out by this careful study.

  1. Anisfeld E, Casper V, Nozyce M, Cunningham N. Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment. Child Dev 1990;61:1617–1627
  2. Ainsworth, M. D. S. (1967). Infancy in Uganda: Infant care and the growth of love. Baltimore: Johns Hopkins University Press.
  3. Mary D. Salter Ainsworth, MDS, Blehar MC, Waters E. & Wall S. Patterns of Attachment. A Psychological Study of the Strange Situation. Lawrence Earlbaum Associates. 1978 Hillsdale, New Jersey
  4. Egeland, B., & Farber, E. A. (1984). Infant-mother attachment: Factors related to its development and changes over time. Child Development, 55, 753-771.
  5. Main, M. (1977). Analysis of a peculiar form of reunion behavior seen in some day-care children: Its history and sequelae in children who are home-reared. In R. A. Webb (Ed.), Social development in childhood: Day-care programs and research (pp. 33—78). Baltimore: Johns Hopkins University Press.
  6. Main, M., & Stadtman, J. (1981). Infant response to rejection of physical contact by the mother. American Academy of Child Psychiatry, 20, 292-307.
  7. Spieker, S. J., & Booth, G. L. (1988). Maternal antecedents of attachment quality. In J. Belsky & T. Nezworski (Eds.), Clinical implications of attachment (pp. 95-135). Hillsdale, NJ: Erlbaum.
  8. Juffer F, Bakermans-Kranenburg MJ & Van Ijzendoorn MH. Promoting Positive Parenting. P. 74. Lawrence Earlbaum Associates. 2008. ISBN 0-8058-6352-
  9. Harlow, H. F., & Suomi, S. J. (1971). Social recovery by isolation-reared monkeys. Proceedings of the National Academy of Sciences, 68, 1534-1538.
  10. Suomi, S. J. (1973). Surrogate rehabilitation of monkeys reared in total social isolation. Journal of Child Psychology 6- Psychiatry, 14, 71-77.
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Dr. Henrik Norholt is a member of The World Association of Infant Mental Health. He holds a Ph.D. from the LIFE faculty of Copenhagen University and is a resident of Copenhagen, Denmark. He has been studying the effects of baby carrying as it relates to child psychological and motor development through naturalistic studies since 2001.

He is actively engaged in the study of current and past research into baby carrying through his large international network of family practitioners, midwives, obstetricians, pediatricians and child psychologists and shared his insights with the subscribers to Ergobaby’s blog.

January 4, 2012