Swaddling warning warranted

Swaddling warning warranted

A warning against swaddling tends to provoke a response that is dismissive of the professionals raising the warning, as after all recommendations are changing all the time...right?

As a parent, health professional, advocate for hip dysplasia,  and Founder of Healthy Hips Australia, I endorse swaddling warnings about the impact that incorrect swaddling is having on the increasing incidence of late diagnosed hip dysplasia.

My message to those dismissing the warning, and all parents in general is this:

When we become parents, we learn on the job as we go. Every child is different, and each parent is too. Some parts of parenting are simple and enjoyable, others are down right hard, even smelly. We strive to give our best, sometimes trial and error or gut instinct is the way to go but, other times, listening to the ‘experts’ is best. Before you say, “but the experts keep changing the rules” – I agree, yes, they do. Experts are only human too remember, and many are parents as well; they advise about what it best practice now, and what is ‘best’ changes through research and learning. I write this as a parent of two, an occupational therapist and an advocate for raising awareness for hip dysplasia and the impact the popular culture of swaddling has on this condition.

I can not stress enough that I am not telling you to stop swaddling; I loved swaddling both my girls. Many a night, or should I say an early hour of the morning, swaddling soothed my girls (and I). Swaddling has been tried and tested to provide security and comfort, aid settling and help establish sleep patterns. It’s proven to aid in the reduction of the risk of sudden infant death (SIDS) syndrome as well.

Swaddle but allow for healthy hip development

Along with learning how to settle your baby, burp them, change a poo explosion, reduce the risk of SIDS, and navigate your way through the breast versus bottle, or controlled crying debates, I am asking you to also know about developmental dysplasia of the hip (DDH). You need to know the risk factors for it, the potential signs and symptoms of it, and the preventative measures you can take to decrease the risk of your bundle of joy getting it.

Why? The causes of DDH aren’t fully known, it is developmental therefore it is not always present at birth. Add to the mix that it is hard to detect, and referred to as a silent condition, as there may be no obvious signs and symptoms, and it’s no wonder many still say, “I thought only dogs got that”. In 2008, the Royal Childrens Hospital stated DDH was the fourth most common reported birth defect in Victoria. Paediatric Orthopaedic Surgeons are now saying that since 2013, there has been a threefold increase in the incidence of the condition. In 2018 the International Hip Dysplasia Institute declared hip dysplasia the most common birth abnormality in the world.

This isn’t an exercise to provoke fear

Despite my background as an occupational therapist, I was bewildered when my eldest daughter's two-month stint in a hip harness turned into a two-year ordeal. While my youngest daughter's journey was less stressful, I’ve become all too familiar with the need to assist hip dysplasia-affected families. Even as someone who worked in the healthcare system, I found it hard to navigate the experience of DDH with my children. That inspired me to launch Healthy Hips Australia.

There has been increasing media attention about the impact of swaddling on the risk of hip dysplasia, this information isn’t new. Research has shown for some time that some swaddling methods can leave fabric too tight around babies’ legs, which increases the risk of hip dysplasia. A safe swaddling education program in Japan, in 1975, saw the reported incidence of infant hip dislocation drop from 3.5% to less than 0.2% following the initiative.

Swaddling Technique: Incorrect (left) and correct (right).

Swaddling Technique: Incorrect (left) and correct (right). Source: Victorian Paediatric Orthopaedic Network


Knowledge is power

Hip dysplasia impacts people across the lifespan; it is the most common cause of hip arthritis in young women. Untreated, the hip joint can deteriorate until a total hip replacement is required. Early diagnosis yields the most favourable outcome. Read up on hip dysplasia and be proactive in discussing it with your Doctor if you have concerns.

The experts have your child’s best interests at heart

We can’t eliminate DDH altogether; genetics plays a factor, as does position within the womb. Please join me in accepting that more research into what is 'best', is needed, and be prepared to listen to what the experts have to say on this one.

Spica cast

Spica cast treatment for DDH

Help put hip dysplasia on the international agenda

Is DDH life threatening? No. Could your child suffer from a more serious condition? Yes.

Ask a parent of a child with hip dysplasia whether they felt their bonding, and memories of what ‘should’ have be an innocent childhood was impacted by treatment for the condition, and YES will be the answer 99% of the time. Our kids are resilient. Most close the chapter on this condition and go onto lead unaffected lives but, please, listen to the expert advice. Swaddle right, not tight from waist to toe, is the way to go.

x Sarah


For more information about hip dysplasia and safe swaddling; including links to recommendations from other organisations about this subject:


HHA Safe Swaddling Guidelines

DDH Signs & Symptoms

Written: November 2015. Revised April 2018.


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

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