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Orthopedist Warns of Hip Dysplasia with Infant Swaddling — Physician’s First Watch

Medical News |
October 30, 2013

Orthopedist Warns of Hip Dysplasia with Infant Swaddling

By Amy Orciari Herman

An orthopedist warns about the risk of hip dysplasia associated with swaddling and urges clinicians to promote "safe swaddling" in Archives of Disease in Childhood.

He cites evidence that unsafe "swaddling forces the hips into extension and adduction and predisposes to dysplasia," which is of particular concern given that swaddling has seen a resurgence in many areas. It's frequently recommended to promote sleep. In North America, he notes, roughly 90% of infants are swaddled during their first months of life.

With "safe swaddling," he says, "legs should be able to bend up and out at the hips" to allow "natural development of the hip joints." The legs should not be wrapped tightly or pressed together.

He concludes: "It is now essential that midwives, neonatologists and pediatricians provide the correct advice in relation to healthy swaddling practices."

Martin Stein, a pediatrician with NEJM Journal Watch, said: "Swaddling is preferred by many parents as a way to soothe a baby, prevent excessive crying, and promote sleep in a supine position. I agree with the author's cautionary note: do not wrap the legs tightly in extension."

In 2011, the American Academy of Pediatrics teamed up with two U.S. specialty societies to promote "hip-healthy" swaddling.

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