London - Swaddling may have come back into fashion, particularly after speculation over how Prince George appeared to be wrapped as he left hospital.
But the centuries-old practice could damage a baby’s hips, a British surgeon warns.
Swaddling has become popular again because of its perceived calming effect, after falling out of favour following concern that it could overheat the baby and restrict growth.
Demand for swaddling clothes has soared by almost two-thirds in the UK in recent years and has been fuelled recently by the first pictures of Prince George in his mother’s arms – although there is no evidence he was fully swaddled. In the US, nine in ten babies are swaddled in the first six months.
But Professor Nicholas Clarke of Southampton University Hospital says there is growing evidence that it can lead to hip abnormalities. Professor Clarke, a paediatric orthopaedic surgeon, said binding or bundling babies in blankets with the arms restrained and the lower limbs extended may force the hips to straighten and shift forward, risking misalignment which could lead to osteoarthritis and hip replacement in middle age, or even dislocation.
In Japan a programme to encourage grandmothers not to swaddle their grandchildren has halved the rate of hip dislocation.
One baby in five is born with a hip abnormality but factors after birth also have a role and swaddling may delay improvement, Professor Clarke said in the Archives of Disease in Childhood. He said swaddling can be safe if it does not stop the baby’s legs from bending up and out at the hips, because this position allows for natural development of the hip joints.
“Commercial products for swaddling should have a loose pouch or sack for the babies’ legs and feet, allowing plenty of hip movement,” he said, adding that healthcare professionals need to give mothers advice about how to swaddle their child safely, so their legs are not tightly wrapped and pressed together.
Jane Munro of the Royal College of Midwives, said: “There are concerns about the growing use of swaddling because of the possibility of overheating the baby, and the increased risk of cot death. Also, as this research suggests, swaddling, and especially tight swaddling, may affect the baby’s natural posture.
“We advise parents to avoid swaddling, but it is also crucial that we take into account each mother’s cultural background.”
Andreas Roposch from Great Ormond Street Hospital, said: “Swaddling should not be employed in my view.”
Dr Alastair Sutcliffe of the Institute of Child Health, University College London, said: “I would advise that if a baby needs to be wrapped up to get off to sleep that parents do this in a sympathetic and loose manner and not tight, especially around the baby’s hips.” - Daily Mail