Swaddling Can Lead to Hip Replacements Later in Life

Swaddling, or wrapping babies up so movement is tightly restricted, is undergoing a resurgence, triggering warnings from experts who say it can lead to developmental hip problems.

Once a universal practice, swaddling fell out of vogue throughout much the world, but is becoming fashionable again due to its perceived calming effects, explains pediatric orthopedic surgeon Nicholas Clarke in the Archives of Disease in Childhood.

According to his report, nine out of 10 infants in North America are swaddled during their first six months of life. Meanwhile, demand for swaddling clothes rose by 61 percent in the UK between 2010 and 2011.

However, while evidence suggests that swaddling helps to induce sleep and quiet excessive crying, the researcher points out that there is a growing body of research linking the practice to developmental hip abnormalities. These abnormalities form because swaddling forces the hips to straighten and shift forward, heightening the risk of misalignment associated with osteoarthritis and hip replacements later on in life.

As evidence, Japan saw a 50 percent decrease in the prevalence of hip dislocation after an educational program was implemented discouraging grandmothers from swaddling their grandchildren.

Clarke admits that many babies are born with hip abnormalities, with factors including breech birth or a family history of problems. Still, he argues, mechanical factors after birth also play a role, and while many of these cases resolve spontaneously, swaddling may delay the process.

Swaddling can be safely practiced so long as it doesn't prevent the baby's legs from bending up and out of the hips, which allows for the development of hip joints. Neither should the legs be wrapped and pressed together, he notes. Any commercial product should include a loose pouch or sack for the legs and feet.

Health care professionals, Clarke adds, play an important role in warning parents about how to swaddle their children safely so as to prevent problems down the road.