Newspaper article

Incorrect Infant Swaddling May Lead to Hip Dysplasia, Doctor Warns

Newspaper article

Incorrect Infant Swaddling May Lead to Hip Dysplasia, Doctor Warns

Article excerpt

The age-old practice of swaddling -- bundling a baby tightly in a blanket to reduce crying and promote sleep -- has regained popularity in recent years. Some research suggests that 90 percent of babies in the U.S. and Canada are swaddled during their first few months.

But there's a "right" and "wrong" way to swaddle, as a British pediatric orthopedic surgeon, Dr. Nicholas Clarke, points out in a paper published today in the Archives of Disease in Childhood. And it's important, stresses Clarke, that parents, pediatricians, midwives and others know the difference.

That's because swaddling the wrong way -- with the baby's legs extended and pressed together -- may lead to developmental dysplasia of the hips, he says.

A common condition

Hip dysplasia, or dislocation, occurs when the bones of the hip joint do not align correctly. It's one of the most common congenital disorders. One out of every 20 infants born full term have some kind of hip instability, according to the International Hip Dysplasia Institute.

In most cases, this instability resolves on its own -- without any kind of treatment -- during the baby's first few weeks or months. That correction can become delayed, however, if the baby is repeatedly swaddled in a way that forces his or her hips to straighten and shift forward in a misalignment, says Clarke.

Developmental hip dysplasia in infancy is associated with an increased risk of osteoarthritis and hip replacement in middle age.

In Japan, where tight, straight-legged swaddling has been traditionally practiced, an educational campaign aimed at grandmothers in the 1970s resulted in a more more than fivefold reduction in the rate of hip dysplasia.

On the other hand, three Australian physicians reported in 2012 that their medical institution had experienced a recent threefold increase in the incidence of developmental hip dysplasia in young children, which the physicians suggested might be caused by a resurgence of swaddling.

Balancing the risk

"In order to allow for healthy hip development, legs should be able to bend up and out at the hips," writes Clarke. …

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