Swaddle with Care to Protect a Baby’s Tiny Hips

Posted On Wednesday, 28 November 2018
Swaddle with Care to Protect a Baby’s Tiny Hips

Infant swaddling is a common practice, as many parents and caregivers believe it can help soothe their baby and improve sleep. It entails wrapping an infant in a light cloth or blanket to provide a kind of cocoon. Although swaddling has been shown to reduce crying and promote sleep, if not done properly, it could harm an infant’s tiny hips.

Wrapping the blanket too tightly puts a baby at risk of developing a condition known as hip dysplasia. Basically, it means the infant’s hip does not grow properly. The condition is often referred to as “developmental dysplasia of the hip” or DDH.

Think of the hip as a "ball-and-socket" joint. In a normal hip, the ball at the top part of the thigh bone fits firmly into the socket, which is part of the pelvis. When a baby develops hip dysplasia, it can range from mild to severe. The ball may be loose in the socket or it may partially come out of the socket. Sometimes it dislocates out of the socket completely. Surprisingly, even with a dislocation, the baby typically does not have pain.

Untreated hip dysplasia can cause serious problems later in life. With the more severe form, which is a complete dislocation of the hip, children could develop an abnormal way of walking, experience hip or back pain and potentially need a hip replacement at an early age. Even those with untreated mild dysplasia may be more likely to develop arthritis and hip pain in their teens or early adulthood, and they may need surgery.

The Correct Way to Swaddle a Baby

Parents and caregivers are advised to take special care when wrapping their bundle of joy. Swaddling should allow ample room for the baby to move his legs, with plenty of space to bend his hips and knees. One safe option is to use a sleep sack that leaves lots of room for the baby’s legs. If using a blanket, we advise parents to keep it loosely folded around the baby’s legs so there’s room for them to bend and move apart.

To ensure that the baby has enough room for breathing, parents should be able to fit two or three of their fingers between the infant’s chest and the blanket or sleep sack.
Babies should be placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). It’s especially important to avoid positioning a swaddled baby on his stomach or side. The American Academy of Pediatrics advises that parents should not swaddle a baby past two months of age, as babies may start to roll over by 2.5 months.

According to a study on swaddling and the risk of SIDS in the journal Pediatrics, it’s essential for parents to monitor their baby to ensure he remains on his back and does not roll over.

In addition, it’s important for caregivers to make sure that the blanket used to swaddle does not become unwrapped, as this could raise the risk of suffocation.

Swaddling can also increase the chance your baby will overheat, so check on your child to make sure he isn’t getting too hot.

Emily Dodwell, MD

Dr. Emily Dodwell is a pediatric orthopedic surgeon. She specializes in pediatric trauma of the upper and lower extremities, and lower extremity reconstruction including treatment of limb length discrepancy, congenital and acquired deformities, and care of children with neuromuscular conditions. Dr. Dodwell treats children from birth to 20 years of age, and sees patients with a wide variety of problems including fractures, ligament and tendon injuries, joint dislocations, congenital deformities such as hip dysplasia and clubfoot, cerebral palsy, gait abnormalities, growth disturbances, and disorders such as osteogenesis imperfecta, SCFE, Perthes disease, and skeletal dysplasias.

Dr. Dodwell is from Kingston, Ontario, Canada, just north of New York State. She completed an undergraduate degree in engineering, and then her medical doctorate at Queen's University in Kingston, Ontario. She completed her orthopedic residency training at the University of British Columbia in Vancouver, British Columbia. She obtained her research and public health degree (MPH) at the Harvard School of Public Health and attained her sub-specialty training as a pediatric orthopedic surgeon at the Hospital for Sick Children and University of Toronto in Toronto, Ontario. She was recruited to work at Hospital for Special Surgery due to her excellent training and experience in pediatric orthopedic surgery and surgical outcomes research.

Dr. Dodwell is a clinician scientist, and an Assistant Professor of orthopedic surgery at the Weill Cornell Medical College. She frequently lectures and mentors medical students, residents, and fellows on clinical topics and orthopedic research. Dr. Dodwell is the principal investigator on a number of ongoing multi-center prospective trials in pediatric orthopedic surgery. She currently holds grants from the Pediatric Orthopedic Society of North America, AO North America, and the Hospital for Special Surgery Clinician Scientist Development Grant.

She is dedicated to improving pediatric orthopedic care through orthopedic research. Her main research interests relate to surgical outcomes and disparities in health care for pediatric orthopedic patients.

Dr. Dodwell treats patients in Manhattan at the Hospital for Special Surgery and New York Presbyterian Hospital (Cornell), and in Queens at New York Hospital Queens (Flushing).

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