Fears raised over swaddling babies
Tuesday 29th October 2013, 12:10AM GMT.
A resurgence in the practice of swaddling babies has prompted leading medics to warn that it could cause hip problems in babies.
The ancient method used to be a universal practice but has since fallen out of favour as experts warned that it can cause developmental hip abnormalities.
But the technique has become fashionable again because of its perceived calming effects, said paediatric orthopaedic surgeon Professor Nicholas Clarke.
Indeed in 2010/11 demand for swaddling clothes in the UK soared by 61%, he said.
But Prof Clarke, who works at Southampton University Hospital, said there is a growing body of evidence that the technique – which involves binding babies in blankets with their arms restrained and legs stretched out – can lead to hip problems.
Writing in the Archives of Disease in Childhood, Prof Clarke said that this is because it forces the hips to straighten and shift forward, risking the potential for misalignment . This in turn is associated with a risk of arthritis and hip replacement in later life, he said.
He said that parents should be given advice into “healthy swaddling practices”.
He wrote: ” In order to allow for healthy hip development, legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints.
“The babies’ legs should not be tightly wrapped in extension and pressed together.
“It is now essential that midwives, neonatologists and paediatricians provide the correct advice in relation to healthy swaddling practices.”
Jane Munro, quality and audit development adviser at the Royal College of Midwives, said: “There are concerns about the growing use of swaddling because of the possibility of overheating the baby, and the increased risk of cot death. Also, as this research suggests, swaddling, and especially tight swaddling, may also affect the baby’s natural posture.
“Normally a baby will lie with the hips flexed, and swaddling may reduce the degree to which the baby can keep this natural position. We advise parents to avoid swaddling, but it is also crucial that we take into account each mother’s cultural background, and to provide individualised advice to ensure she knows how to keep her baby safe, able to move and not get overheated.”
Andreas Roposch, consultant orthopaedic surgeon at Great Ormond Street Hospital, said: “There is indeed evidence that swaddling can affect the normal development of infants’ hips. Similar effects may be seen in all devices or manoeuvres that place the legs in a purely straight position for prolonged periods in this critical age of early infancy. Swaddling should not be employed in my view as there is no health benefit but a risk for adverse consequences of the growing and often immature hips.”
Dr Alastair Sutcliffe, reader in General Paediatrics at the Institute of Child Health, University College London, said: “Swaddling has been known to be associated with an increased risk of congenital dislocation of the hip (CDH) for many years.
“The archetypal example is in traditions where a baby is carried with their legs splayed around a mother’s waist (e.g. Nigeria) there is a virtually unseen rate of CDH. Whereas in a country where swaddling is employed (e.g. far eastern countries) there is a much higher rate of CDH.
“I would advise that if a baby needs to be wrapped up to get off to sleep that parents do this in a sympathetic and loose manner, and not tight especially around the babies’ hips.”