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RCM advises parents to avoid swaddling

Posted: 29 October 2013 by Clare Wilson

Resurgence in swaddling prompts fears of rise in babies developing hip abnormalities.


New research from Professor Nicholas Clarke at University Southampton Hospital on the swaddling of babies has been published in Archives of Disease in Childhood.


The technique has recently become fashionable again due to its perceived calming effects, according to Clarke.


Demand for swaddling clothes rose by 61% in the UK between 2010 and 2011, and figures report that nine out of 10 infants in North America are now swaddled in the first six months of life.


Although there is evidence suggesting that swaddling helps induce sleep and soothes excessive crying and colic, there is also a growing body of evidence to show that it is linked to a heightened risk of developmental hip abnormalities.


Swaddling forces the hips to straighten and shift forward, risking the potential for misalignment. This may lead to an increased risk of osteoarthritis and hip replacement in later life.


Around one in five babies are born with a hip abnormality. Recognised risk factors include breech birth and family history, as well as mechanical factors after birth. Many of these cases resolve spontaneously, however swaddling may delay this, according to Clarke.


Jane Munro, RCM quality and audit development advisor, said: ‘This builds upon previous research and our advice remains the same. It is an issue that such a seemingly innocuous thing can lead to significant problems for the baby.


‘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 also affect the baby’s natural posture.


‘Normally a baby will lie with the hips flexed, and swaddling may reduce the degree to which the baby can keep this natural position.


‘We advise parents to avoid swaddling, but it is also crucial that we take into account each mother’s cultural background, and to provide individualised advice to ensure that she knows how to keep her baby safe, able to move and not get overheated.’


The paper is available online here.