How Safe Swaddling Can Help Avoid Hip Dysplasia

There are so many reasons that swaddling is great for babies. It can help babies sleep better and longer, stop them from scratching themselves, and even decrease the risk of Sudden Infant Death Syndrome (SIDS).

But there’s one thing that swaddling is not good for, particularly swaddling that isn’t done correctly.

Hips.

Yes your baby’s hips could be getting damaged through incorrect swaddling, causing them to suffer hip dysplasia, a problem that can cause issues throughout their lives.

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Developmental Dysplasia of the Hip (DDH)

Recent studies have shown that incorrect swaddling can increase the risk of a child developing Developmental Dysplasia of the Hip, or DDH. The condition is a common childhood condition in which the hip joint does not fit into the normal position due to abnormal development and/or lack of growth of the joint’s ball and socket. DDH can result in months, if not years, of medical treatment, and if not diagnosed it is one of the leading causes of early-onset arthritis in the hip. Despite all of this, knowledge about the condition in Australia is very limited.

Developmental Dysplasia of the Hip is the most common cause of hip arthritis in adults. In babies it occurs far more frequently in girls, and 1 in 20 full-term newborns have some hip instability, which can lead to the condition. Risk factors for Developmental Dysplasia of the Hip include presenting in breech, a family history of the condition, multiple births, and various foot deformities. It’s important to know that hip dysplasia isn’t always present at birth, which is why the name is Developmental Dysplasia of the Hip, indicating that it develops in the weeks and months following birth.

Signs and Symptoms

There are a few things you can look out for in your children that are indicative of DDH, and it’s important for parents to keep an eye on these symptoms as they aren’t always spotted by doctors. Watch out for:

• A clunk or click when moving the hip,
• Uneven thigh creases,
• Crooked buttock crease,
• Leg(s) difficult to spread apart,
• Weight on one side when sitting,
• Different leg length,
• Avoiding weight bearing,
• Walking on tippy toes on one side, and
• Limping when walking.

Correct vs. Incorrect Swaddling

There’s nothing wrong with swaddling, provided you do it right, but when you practice incorrect swaddling there is an increased risk of your baby developing DDH. Incorrect swaddling involves having your baby’s legs wrapped tightly and straight down or pressed together. When babies are young a straight-legged position can cause the hip joint to loosen. You should also avoid any sleep sacks or swaddling pouches that tighten around the thigh.

Correct baby swaddling involves:

• Positioning your baby with their hips bent and knees apart, like a frog
• Allowing room around the hips and legs for movement
• Wrapping the upper body firmly, but not tightly
• Following the SIDS and Kids guidelines for swaddling, to prevent the risk of SIDS

Parents who aren’t sure about swaddling may find it better to swaddle just the arms of their child, while making sure there aren’t loose blankets in the crib (which increase the SIDS risk). Remember that swaddling shouldn’t continue forever. Once your baby can roll onto their tummy and back again during play, you should stop swaddling. This usually happens at around 4-6 months, and swaddling a baby past this point may hinder your baby from returning to their back during sleep, which can increase the SIDS risk.

Healthy Hips Week 

In order to raise awareness about hip dysplasia in Australia, as well as increase education, support and resources for people working with and impacted by hip dysplasia, Healthy Hips Week is an awareness week that occurs in April each year. The week is all about highlighting the importance of knowing risk factors and potential indicators of hip dysplasia, particularly in children where a later diagnosis can result in more complex problems.

Healthy Hips Week was created by Sarah Twomey, a mum and occupational therapist who has first-hand knowledge of dealing with the condition. Her young daughter Eve was diagnosed with DDH when she was just three weeks old, and spent the next 10 months, 23 hours a day, in a full-body harness and then a hip brace. After a year of being in the brace, Eve was allowed to spend her days without the brace, but was required to sleep in it. Now aged 4, Eve requires yearly reviews to monitor her hip development. Sarah said:

“I was bewildered when Eve’s two-month stint in a hip harness turned into a two-year ordeal.”

It was during this time that Sarah became aware of the needs of hip dysplasia-affected families who were often overwhelmed and uninformed about the condition. This inspired her to set up the not-for-profit organisation Healthy Hips Australia, and to create Healthy Hips Week.

Get involved with Healthy Hips Week this year and raise awareness of this all too common condition today.

Resources:

Safe Swaddling Guidelines

Hip Dysplasia Awareness