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Swaddling Done Right

By Dr. Charles Price, MD

Swaddling Done Right

Swaddling your baby can calm and soothe her as well as reduce crying and any pain she may be experiencing.

Parents today are often taught to swaddle the baby’s entire body to create a tight cocoon, but did you know that this restriction of movement in the lower half of her body can lead to hip dysplasia?

Hip dysplasia in babies

Hip dysplasia is the most common abnormality in newborns and occurs when the top of the femur (leg bone) isn’t properly located in the hip socket or when the hip socket doesn’t develop properly.

Each year, as many as 75,000 babies are treated for hip dysplasia in the U.S. Your baby may be at risk if she was:

  • Born in the breech position (rump first)
  • Has a history of dysplasia in her family
  • She’s your first-born and female

How you swaddle your newborn can make a critical difference to hip development. The good news is that catching this condition early, and using proper swaddling, means the problem can usually be reversed.

Problems with hip dysplasia

Mild hip dysplasia often can’t be detected right away, and over time, it causes the hip to wear out quite like a tire wears out when it’s out of balance. Often it first shows up as arthritis in later life.

Hip dysplasia is the most common cause of hip arthritis in young women and is responsible for as much as 10% of all total hip replacements in older adults.

Importance of correct swaddling

Incorrect swaddling can also cause the hips to dislocate. Your baby’s hips joints are flexible around the rim of the socket and her legs were folded up in the womb. Straightening her legs and holding them straight can put too much pressure on her immature hip joint, especially during the first 3 months. It takes about 3 months for her hips to become more stable, during which time her movement has stretched her leg muscles gradually.

Although most babies can tolerate tight swaddling that restricts leg movement, don’t take that risk. If your child was swaddled tightly, ask your pediatrician to check for dysplasia.

Swaddling Tips

  • Wrap a blanket or other wrap firmly around the arms, but loosely around the legs, allowing the hips to move freely.
  • Avoid stretching your baby’s legs straight or pressing them together.
  • Encourage baby’s hips to be spread and bent as if riding on a horse. When carrying your baby, allow her to wrap her legs around your body for proper hip development.
  • Instead of a blanket for swaddling, consider using a sleep bag that has a swaddle for the arms but roomy bottom for the hips, such as the HALO SleepSack (as pictured).

Also Read: Promoting The Breast Crawl

Charles Price, MD, is a pediatric orthopedist at the Winnie and Arnold Palmer Hospital for Children and the director of the International Hip Dysplasia Institute, hipdysplasia.org.


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