Swaddling baby too tightly could cause hip problems

The resurgence of the age-old practice of swaddling has doctors urging parents to take it easy when wrapping up their baby like a burrito.

Yes, swaddling has been around since before Mary needed to keep her newborn son warm in the stable, but the practice is becoming increasingly more popular among parents in the United States and Europe.

It might be just a swing in baby care trends that makes the old new again, but pediatricians are concerned that it can cause a relatively rare but easily preventable problem, said Dr. Ryan Muchow, a pediatric orthopedic surgeon at Shriners Hospitals for Children — Lexington.

What happens is those newborn legs have a lot of natural flexibility. Traditional swaddling has the blanket pulled tightly around legs that are straightened. The tension caused by the restriction of the legs can cause the ball of the hip to come out of the socket, causing hip dysplasia.

The baby would feel no pain and there would be few symptoms easily noticed by a parent until the child starts to walk, Muchow said. Then, those signs would include limping or walking on the toes of one foot, or waddling if both hips are affected, he said.

"It's a silent disorder," he said. "That's just the nature of the disease."

Only two to three children in 1,000 will develop a severe enough form of a hip dysplasia to require treatment, Muchow said.

The doctors at Shriners are following the lead of several national pediatric organizations, including the American Academy of Pediatrics, in promoting "healthy swaddling."

In healthy swaddling, the baby is secured at the shoulders but the legs are not restricted in a straight position, allowing for more natural movement while still providing a warm, cozy, environment.

Parents should talk to their pediatrician or family doctor if they have concerns or questions, Muchow said. Doctors can use an ultrasound to determine whether there has been hip damage to children younger than 4 months. After that, an X-ray would show if there is trouble.

Getting the word out is "not to scare parents," he said, but to provide them with a safe alternative to traditional swaddling.