The neuro-musculoskeletal health consequences of infant back carrying for mothers and surrogate caregivers in ILembe District of KwaZulu-Natal, South Africa

Abstract

Posterior infant carriage is the traditional method of transporting and caretaking of toddlers, while mothers perform domestic, agricultural, and/or commercial duties. This method of infant carriage has raised health related concerns by the medical fraternity who treat women for shoulder, upper and lower back pain. The objective of this study was to determine whether the traditional African method of posterior infant carriage produces neuro-musculoskeletal pain during, and after, carriage. One hundred South African mothers and/or surrogate caregivers (aged 18-40 years) willingly participated in an observational study. The ILembe Royal Court, community leaders and participants were briefed about the study prior data collection. Thereafter, the ILembe Royal Court and the participants provided gatekeeper’s approval and informed consent, respectively. Participants completed an infant carriage health-related questionnaire and undertook a battery of anthropometric tests. Their average age, body mass, stature, and infant mass were 29.36±7.68 years, 69.72±18.92 kg, 1.558±0.051 m, and 12.81±3.99 kg, respectively. Many participants (89%) acknowledged experiencing neuro-musculoskeletal pain in their lower back (36.01%), upper back (26.54%), shoulders (18.48%), neck (8.05%), legs (3.31%), knees (3.31%), arms (2.84%), toes (0.9%), and fingers (0.47%) during and after infant carriage (t-test p<0.0001). Participants whohad neuro-musculoskeletal pain carried heavier infants (12.97±3.99 kg) (effect size p=0.6). Posterior infant carriage adversely affects the neuro-musculoskeletal health of mothers and surrogate caregivers. It is recommended that mothers and surrogate caregivers undergo physical conditioning to alleviate the neuro-musculoskeletal pain and injuries associated with habitual infant carriage.