Healthy Hips Australia -
Safe Swaddling Guidelines
Swaddling is not something we simply know how to do:
There are many benefits to swaddling during the first months of life; it provides security and comfort, aides in settling and establishing sleep patterns.
To help natural hip development during swaddling:
- Position your baby with their hips bent and knees apart; a bit like a frog.
- Allow room around the hips for movement.
- Wrap the upper body firmly, but not tightly. Consider swaddling the arms only.
- Follow SIDS guidelines – links below.
- Stop swaddling once your baby is rolling, back to tummy and onto back again, during playtime, as it may prevent your baby from returning to their back during sleep (around 4-6months of age).
- Wrap legs tight and straight down / pressed together. At this stage in life, the hip joint can be loosened in the straight-legged position.
- Use sleep sacks and pouches that tighten around the thigh.
Why is this important?
Research indicates inappropriate swaddling can increase the risk for developmental dysplasia of the hip (DDH). DDH is a common childhood condition where the hip joint does not fit in the ‘normal’ position due to abnormal development and/or lack of growth of the joint’s ball and socket. More information about DDH is available here.
Safe Swaddling Methods
Diamond – secure the arms individually. Twist the bottom of the wrap loosely so the legs are free to move within a sack, and tuck under your baby.
Square – secure the arms individually. Fold up the bottom of the wrap loosely over the chest, to create a pouch for free leg movement, then tuck under your baby.
Sleep sack or pouch – select those designed for free leg movement. A list of hip healthy products is available here.
The following video, by the International Hip Dysplasia Institute, demonstrates safe swaddling methods;
Does the method really matter?
- Hip dysplasia is rare in cultures where infants are carried with their hips spread apart (abducted). There is a ten-fold increase in the incidence in tribes carrying infants on cradle boards with legs held straight and together.
- When the Navajo Indians replaced moss for diapers in the1940s, a big decrease in DDH was noted. Even though the cradle board was still in use, the slight spreading of the hips, by the diaper, was thought to influence this.
- In 1975, a national program started in Japan to avoid swaddling with the legs straight, saw the incidence of hip dislocation drop from 3.5% to less than 0.2%.
Written: November 2015. Revised 1 April 2019.
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. Every effort is made to ensure this information is up to date, accurate and easy to understand. Healthy Hips Australia accepts no responsibility for any inaccuracies, information perceived as misleading. This can be reproduce with acknowledgement to Healthy Hips Australia. Handouts are available to download free of charge at www.healthyhipsaustralia.org.au