2014 BellyBelly RAK Recipient.
Swaddling putting newborn hips at risk
From Practical Parenting/Yahoo7
We don't know what caused DD's hip dysplasia, but tight swaddling was encouraged in hospital, even though DD was diagnosed with clicky hips at birth. This time around I'm hoping to arm myself with a safer technique to keep both baby and baby's hips happy.A leading UK children’s surgeon says well-meaning mothers may be damaging their babies’ hips by swaddling them too tightly as newborns
It’s one of the techniques new mums are taught before they leave hospital after giving birth – how to tightly swaddle their babies to help them settle faster and sleep better by recreating the security of the womb.
But a top UK children’s surgeon is calling for an end to the practice, saying it is partly to blame for a rise in hip problems among infants.
Professor Nicholas Clarke, a consultant orthopaedic surgeon at Southampton General Hospital, says that swaddling babies too tightly can result in hip dysplasia, a condition where the baby’s hip joints are weakened. He claims that forcibly straightening the baby’s legs in a tight swaddle prevents it from flexing and strengthening the weakened joints, with the outcome being a higher number of babies requiring invasive surgical treatment.
‘This form of swaddling used to be very commonly used across the world but, with the help of major educational programmes such as the one used to eliminate the problem in Japan in the 1980s, it was all but eradicated and cases reduced drastically,’ says Professor Clarke.
‘Now, I and my colleagues across the UK and in America are witnessing its revival, with swaddlers being advertised on the internet that tightly wrap babies. For the hips, that is exactly what you don’t want to happen.’
GALLERY: What happens straight after birth?
Professor Clarke says he is not opposed to all swaddling, but expresses grave concern at what he sees as a re-emerging trend to swaddle babies as tightly as possible.
“I advocate swaddling in the right and safe way, which means ensuring babies are not rigidly wrapped but have enough room to bend their legs – they don’t need to have their legs straightened as there is plenty of time to stretch before they start to walk,” he explains.
“But, and this is worrying the orthopaedic community, it seems to be increasingly fashionable among parents to follow the re-emerging trend of tight swaddling.”
Professor Clarke says the trend is driven by retailers selling swaddling wraps which promise to be ‘Houdini-proof’.
‘We need to focus on ensuring the years of hard work and effort made by thousands of clinicians across the world to drive out tight swaddling is not unravelled in a matter of months and that means stepping in immediately.’
All newborn babies in Australia undergo a hip check at birth, and again as part of their six-week check. The preferred treatment for hip dysplasia is the use of a Pavlik harness or Spica cast to keep the hips at right angles for an extended period of time. However, in serious cases, and those which are not picked up at these early screening checks, surgery is required.
Signs that your baby may have a problem with his or her hips include:
One leg appearing shorter than the other
An extra deep crease on the inside of the thigh and/or uneven buttock creases
Dragging one leg when crawling, or walking with a limp
If you are concerned about your baby’s hips, speak to your GP, midwife or Child Health Nurse.
For information on swaddling your baby safely, refer to Professor Clarke’s guidelines for protecting your baby’s hips when swaddling.
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I've read this too. We also don't know what caused DD's DDH, but I suspect it was a combo of genetics (I have a clicky hip, it pops when I move) and lack of room in my belly, not swaddling. Next baby, like you, I'll be doing everything I can to avoid it.
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We put ds in those swaddle things and he is fine we just got him one in a bigger size anyway so he could use it longer
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Interesting. I've never been a very "good" swaddler and I would pretty much just swaddle baby's arms and their bottom half was free to wriggle.
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That was me too. But then, neither of mine have liked being swaddled and usually protest until they wriggle out. So I gave up on it.
2012 BellyBelly RAK Recipient.
DS always screamed at the tight swaddles, so we used the stretch ones with the zip up the front, he could move around but didn't startle.
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2014 BellyBelly RAK Recipient.
I've seen the ready-made-swaddle style blankets that I think you're talking about and they give a bit more around the legs and hips too. The style I was taught in the hospital was just with a blanket and held tight around the arms, legs and hips so DD couldn't really move them, giving her the "security" of the same feeling as she had whilst in the womb.
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So the recommendation should really be that if you swaddle, baby should be able to bend their legs. Not so difficult to achieve, rather than discouraging it outright, which people will ignore.
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When I was taught by the hospital how to swaddle they said "it can never be too tight, in fact the tighter the better". We didn't swaddle though, bub didn't like it.
Excuse my sucky spelling, I'm on my iPhone
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I'm using Love To Swaddle Up bags with DD2 and they are awesome! They actually mention on their site about hip dysplasia and how their bags give babies security but allow sufficient movement.
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I swaddled but more to stop the startling with the hands and to stop DD from hitting herself in the face, not for the legs. Interesting article.
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I wonder if increased rates of hip displaysia are related to better screening and diagnosis rather than just swaddling?
2014 BellyBelly RAK Recipient.
I wonder that too, FabFiona. I know there are a lot of instances where baby is found to have clicky hips at birth and then all is well afterwards and as swaddling is so widely used, it can't be the sole reason for hip problems. I guess if there is already a possibility of it happening, then another method of wrapping should be encouraged to help the hips adjust into position after birth.
Taurean - I just looked those up, they look great. Think I'll invest for this baby.
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They're well worth it. I borrowed a couple from a friend and DD2 loves them. I tried transitioning her to a GroBag last night (DD1 transitioned fine at 9ish weeks) but she didn't settle until we put her back in swaddle bag - and she went straight to sleepI'm going to buy the next size up and will try the 50/50 ones to transition her to arms out. They're such a great idea.
BTW, we were taught to swaddle our girls in hossi but I did notice the swaddle was always wider (looser) around their legs giving them a bit of room to move. The focus seemed to be more on their arms and chest but I was personally under the impression that 'the tighter the better' was the way to go.
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Interesting article.
There is such a range with hip dysplasia, I can see that tight swaddling could lead to an increase in certain areas.
DD had hip dysplasia, on one side there was virtually no socket - she came out like that - swaddling would have made zero difference.
DS does not have hip dysplasia but on his first ultrasound (ultrasound was automatic due to sibling with the condition) he was borderline and had to have another at six weeks at which point he was considered ok - (the hips keep developing after birth so I can see why swaddling in the early days could have an impact). He was never swaddled (only maybe in the hospital once or twice where they seem hell bent on it for some reason) - nothing to do with hips but because I don't like the idea of it at all - I would hate it personally so wouldn't do it to my two (each to their own though, I know some adults love tight heavy blankets). I also could never get my head round the concept, they have a startle reflex yes but to me it seemed easier to let them get used to startling themselves and falling back to sleep when they are newborns than later on (worked ok with my two - but all babies are different).
Anyway I can see how tight swaddling (also heard the can never be too tight etc etc) could have led to DS hips not developing so well over those six weeks due to restricted movement. I do think there is better diagnosis now, and I suspect the fact babies are bigger than they used to be, carried less (wraps and other carriers often position babies legs in a good position for hip development), mothers are more sedentary - office jobs etc, all has an impact on its incidence.
Whether or not there is a resurgence in tight swaddling as mentioned in the article I am not sure, but in hospital swaddling was something that seemed to be deemed absolutely necessary and there was no mention of any disadvantages of swaddling.
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....
Whenever I teach mums how to swaddle I have always done it so even though bub is secure, their limbs still fall in a natural comfy position for them.
either I'm a terrible swaddler - and a bad midwife for not being able to teach it =P or, I'm ahead of the times =P
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I have heard of this before, but as hinted at in the article, the kind of swaddling in question was super super tight swaddling, a practice mostly used in different cultures and different to what most of us would think swaddling is. I think it involves different materials to what a lot of wraps you would buy here now, materials that would give you more ability to get it really tight?
Years and years ago I spoke to midwife who had been in a developing country (can't remember where, perhaps Asia somewhere?) working on a project to discourage the super tight swaddling practice due to the hip problems, and she described it as different to the 'wrapping' that I do now.
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You're right about the hospitals/midwives all being insistent on swaddling - I got into trouble because the midwife would come in and DS would unswaddled just with a blanket tucked over him fast asleep...I'd wrap him up for as long as it took for her to nick off
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