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Navigating NYC with a Baby

January 24, 2019

Sarah Li-Koo, MD, FAAP, CLC

It’s wintertime in NYC, and whether you are meeting up with friends and family or perusing the holiday markets, you are probably trying to figure out whether and how to bring your little one along. Let’s talk about some of the ways to tote around our babes around the city comfortably and safely.

Carriers

Carriers are a great way to keep baby snuggled up as you navigate the often-packed streets of the city. There’s no need to negotiate a stroller through a crowd if baby is tucked in close to you.

There are many different carriers on the market, and the most popular ones generally fall into three categories: wraps, slings, and structured harnesses. There are wraps that are “pre-wrapped”, where loops of fabric are already stitched together, and there are wraps that are a longer swath of fabric that you would loop and tie together yourself. A sling is similar to a wrap but is a loop of fabric that usually has rings to help with fit and adjustment. A structured harness has shoulder straps to wear baby like a backpack.

Whichever type of carrier you choose, remember to keep baby in an ergonomic position, meaning that the hips should be supported from the hips to the knees to make sure that baby’s hips develop properly (https://hipdysplasia.org/developmental-dysplasia-of-the-hip/prevention/baby-carriers-seats-and-other-equipment/). Avoid positions where the hips dangle, or where they are horizontal like in a cradled position in a sling. A cradled position in a sling can also tip the chin downwards and pinch off baby’s airway, so in general, it is not a recommended position to carry a baby in. Make sure you also follow the manufacturer’s recommended guidelines for each product, including when it is okay to turn a baby forward or to wear a baby on the back for a structured carrier. Some structured carriers also require an infant insert.

Strollers

Strollers also come in many types. Some are more lightweight, so they may be easier to carry up and down subway stairs. Some are more substantial, with an undercarriage for holiday groceries and gifts.

Like carriers, different strollers are appropriate for different applications and ages. A full-size stroller can often be used from newborn and up with a bassinet attachment option, and you may be able to also attach a car seat depending on the model. An umbrella stroller, while it is more compact and space-saving, would be used for older infants and children. A jogging stroller for parents on the go would also be more appropriate for an older baby.

Remember that if your baby is not yet sitting up with good head control, he or she is not yet developmentally ready for a seat that is more upright and requires the tone and coordination for this position. A baby generally begins to sit up with assistance then independently between 4 to 6 months. Conversely, a bassinet stroller attachment is not safe for a baby who can sit up and possibly pull themselves out of one. You may be thinking of draping a blanket over your baby’s stroller to cover him or her while walking through a crowd. It may be safe to do so with a light breathable blanket, like a muslin blanket, and for very brief periods of time. Keeping a blanket over the stroller means you cannot see the baby and might also impede ventilation, so be mindful if you are doing this.

Car seats

Car seats, when used appropriately, can keep baby safe during holiday travels. During the cold winter months, make sure there are no extra layers from a thick puffy jacket or footmuff between the car seat or car seat straps/harness and the baby. There are certain coats and footmuffs that can be safe, but check that there is no slack in the seat belts when they are used in the car seat (https://thecarseatlady.com/warmandsafe/). The newest recommendations from the American Academy of Pediatrics (AAP) also reinforces that riding rear-facing is the safest position for young children in the car, even to 4 years old (https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx). There are also expiration dates for car seats since they can become warped, brittle, or technologically outdated over time. Check your car seat for its expiration date, and for the range of safe weights and heights that it can accommodate.

Additionally, note that some ride-share and private taxi companies can provide a car seat. However, this seat is typically for children older than 1 and forward-facing, which is not recommended by the AAP. Yellow cabs are exempt from requiring car seats for young passengers and allows for children up to 7 years old to sit on an adult’s lap, which is also against AAP’s safety guidelines.

Public Transportation

Riding subways, buses, and trains are another option for our littlest urbanites. The MTA offers some guidelines when traveling with baby, including safety at stations and inside their vehicles (http://web.mta.info/safety/). Vigilance is important to ensure young curious children are kept close and supervised. Infants and children may also be sensitive to noise, and continued exposure to loud sounds like rumbling subways could impact hearing (https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Tips-Preserve-Childs-Hearing-Holidays.aspx). Ear muffs or other hearing protection devices may be appropriate to filter out louder sounds. Packed subways and buses may also mean close proximity to sick individuals during cold and flu season, so commute mindfully.

Let us know if you have any questions or comments!

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