Swaddling babies tight could lead to hip problems

By Dr. Ananya Mandal, MDMar 13 2012

Swaddling babies is back in vogue as many mothers are convinced that wrapping babies tightly makes them feel more secure. However a children's surgeon at Southampton General Hospital has warned that the practice of tight swaddling, where both the arms and legs are wrapped up, is causing an increase in hip problems.

Professor Nicholas Clarke, a consultant orthopedic surgeon, said that swaddling is causing a rising number of cases of hip dysplasia. He explained that babies’ hip joints are loosened by hormones released by the mother during labor to ease their birth. Swaddling, however, forcibly straightens the babies’ legs for the first three to four months of life, leaving them unable to flex and strengthen their weakened joints.

Prof Clarke was speaking to mark Baby Hip Health Week, designated by the charity Steps. He said, “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…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.”

Up to 100 babies are screened at Southampton General Hospital’s hip clinic every week – around one in every 20 full-term babies has some level of instability – and swaddling-related incidences are increasing. Although treatment, which involves fitting a harness to keep the legs bent up day and night for six weeks, is successful in 85 per cent of babies, some will suffer permanent damage.

Prof Clarke said, “While many cases of hip dysplasia are down to genetics or other conditions, swaddling is becoming an increasingly prevalent cause once again and that is extremely frustrating because it is something parents can control, yet only last week a mother brought her baby to my clinic tightly wrapped.”

“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 explained. “But, and this is worrying the orthopedic community, it seems to be increasingly fashionable among parents to follow the re-emerging trend of tight swaddling.”

Prof Clarke, who last year revealed one in five children assessed in his clinic for bone problems were suffering from poverty-linked Victorian bone disease rickets due to vitamin D deficiency, is now calling for the relaunch of an awareness campaign to address the problems. He added, “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 unraveled in a matter of months and that means stepping in immediately.”