swaddling

Is swaddling the devil’s hug?

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Yesterday the UK press was abuzz with headlines screaming about the damage parents are doing to their children by swadddling. Here’s a summary of what’s been going on…

 

Why is this in the news now?

An orthopaedic surgeon in the UK, Prof Clarke, published an opinion piece in Archives of Disease in Childhood highlighting some potential issues with swaddling.

 

What’s the main concern?

That the position some babies are put in for swaddling predisposes them to hip dysplasia.

Swaddling forces babies to lie with their hips extended and their legs adducted, rather than in the more natural flexed and abducted position.

The suggestion from previous studies is that there is an association between swaddling and developmental dysplasia of the hips. Babies who are born with hip dysplasia may have persistent dysplasia if swaddled, rather than allowing it to resolve.

 

Is swaddling all bad?

No, and if you’ve ever had a baby yourself, you’ve probably done it, as stats show that the vast majority of people do swaddle. In fact, studies cited by Clarke demostrate that swaddled infants sleep longer and, in preterm babies, swaddling improves neuromuscular development.

 

What is the right position if swaddling a baby?

This video by the International Hip Dysplasia Institute explains nicely how to swaddle without damaging the hips:

But essentially, don’t swaddle too tightly as it can encourage dysplasia and possibly dislocation. The hips should be free to allow some movement, but you can swaddling tightly round the arms.

 

What’s the medical community’s take on this?

It’s been reported pretty much everywhere and there has been vocal professional support. Spokespeople from Great Ormond Street Hospital, the Royal College of Midwives, and the Institute of Child Health are in agreement that swaddling isn’t good for hips. Some are even advising against swaddling completely.

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About 

Tessa Davis is a paediatric emergency registrar from Glasgow and Sydney, but currently living in London. Tessa tries to spend time with her 3 kids in between shifts. @tessardavis | + Tessa Davis | Tessa's DFTB posts

One Response to "Is swaddling the devil’s hug?"

  1. Henry Goldstein
    Henry Goldstein 3 years ago .Reply

    Thanks for the rapid review, Tessa!

    I’ve heard several clinicians advocate for swaddling on the basis of two points, firstly that it settles the child to sleep more quickly.

    Secondly, that the practice decreases the risk of SUDI/SIDS, with respect to the baby ‘swimming’ around the crib – I can’t find any evidence for this, and in fact both the SIDSandKIDS organisation and a recent review in Paediatrics looking at SIDS & safe sleeping agree with Dr Clarke’s piece;

    http://pediatrics.aappublications.org/content/128/5/e1341.full.pdf

    Plus, SIDS and KIDS provides some good information for those keen to swaddle or ‘wrap’;

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