Safe Swaddling

Many parents find that swaddling provides comfort and helps with sleep and settling patterns. When babies are swaddled, care should be taken to swaddle properly so the baby is safe and healthy.

Improper swaddling can damage a baby’s hips. In the womb the baby’s legs are in a fetal position with the legs bent up and across each other.

Using a tight wrapping or swaddling technique with the legs straight out can loosen the joints and damage the soft cartilage of the socket leading to hip dislocation or dysplasia.

There are many ways to swaddle babies by using blankets or commercial products designed for swaddling. In order for swaddling to allow healthy hip development, the legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints.

The baby’s legs should not be tightly wrapped straight down and pressed together. Swaddling infants with the hips and knees in an extended position may lead to long term hip damage

The hip is a ball and socket joint that is held together by ligaments.
In the womb, babies generally lie with their hips in an outward position. this helps the hips develop normally.

In some babies the ligaments around the hip are loose which usually corrects during the first few months of life.

If the looseness persists the hip joint not form property leading to a condition known as “developmental Dysplasia of the Hip” (DDH). In some severy cases the hip may come out of the socket - dislocation of the hip.

WRAPPING AND DDH

There are a number of ways to wrap babies safely. The main thing is to leave enough room in the wrap for the legs to move freely. The legs should be able to bend at the hips with the knees apart to allow the hips to develop normally.

BABY SLEEPING BAGS

Many babies are happy and secure in special baby sleeping bags. These sometimes have inadequate room for the hips to splay, bend and kick, so it is important to check whether your baby is constricted by the sleeping bag.

Some cultures have a tradition of tight swaddling. A high incidence of hip dislocation was noted in Navajo Indians who strapped their babies to a cradle board. Before this practice changed  one third of Navajo babies developed hip dislocation. Once this practice stopped the rate of hip dislocation decreased to the same levels as the rest of the US population.

In other cultures where the baby is carried with their legs splayed around their mother’s waist such as Nigeria, hip dislocation and dysplasia is virtually unknown.