Trendy mothers who swaddle their babies are causing rise in a hip problem that died out 25 years ago
Expert says if swaddling a baby it is vital they have enough room to bend their legs
Mothers who tightly swaddle their babies to prevent colic are causing a rise in a hip problem that disappeared 25 years ago, a doctor said today.
The practice – eradicated in the 1980s after educational programmes – is now back in fashion with some websites selling tight ‘swaddlers’ to keep babies warm, help them sleep and avoid the crying associated with colic.
But Professor Nicholas Clarke, a consultant orthopaedic surgeon at Southampton General Hospital, said the unsafe form of swaddling is leading to more cases of hip dysplasia.
The condition is where the hips are loosened by mothers’ hormones to relax ligaments during birth, but the swaddling is forcibly straightening the legs within the first three to four months of life.
This means babies who would otherwise recover naturally are unable to freely flex and strengthen weakened joints, making surgery essential.
‘This form of swaddling used to be very commonly used across the world but, with the help of major educational programmes such as the one used to eliminate the problem in Japan in the 1980s, it was all but eradicated and cases reduced drastically,’ said Prof Clarke, who spoke out as part of the STEPS charity’s Baby Hip Health Week 2012.
‘Now, I and my colleagues across the UK and in America are witnessing its revival, with swaddlers being advertised on the internet that tightly wrap babies. For the hips, that is exactly what you don’t want to happen.
‘While many cases of hip dysplasia are down to genetics or other conditions, swaddling is becoming an increasingly prevalent cause once again and that is extremely frustrating because it is something parents can control, yet only last week a mother brought her baby to my clinic tightly wrapped.’
Up to 100 babies are screened at Southampton General Hospital’s hip clinic every week with around one in every 20 full-term babies has some level of instability and swaddling-related incidences are increasing.
Although treatment, which involves fitting a harness to keep the legs bent up day and night for six weeks, is successful in 85 per cent of babies, some will suffer permanent damage.
Keen not to discourage safe techniques, Prof Clarke believes parents are no longer distinguishing between what is right and what presents a danger to their babies.
‘I advocate swaddling in the right and safe way, which means ensuring babies are not rigidly wrapped but have enough room to bend their legs – they don’t need to have their legs straightened as there is plenty of time to stretch before they start to walk,’ he explained.
‘But, and this is worrying the orthopaedic community, it seems to be increasingly fashionable among parents to follow the re-emerging trend of tight swaddling.’
Prof Clarke last year revealed one in five children assessed in his clinic for bone problems were suffering from poverty-linked Victorian bone disease rickets due to vitamin D deficiency.
He is now calling for the relaunch of an awareness campaign to address the problems.
‘We need to focus on ensuring the years of hard work and effort made by thousands of clinicians across the world to drive out tight swaddling is not unravelled in a matter of months and that means stepping in immediately,’ he added.
Colic, which causes distress and crying in babies, is a very common condition but its cause is unknown. It affects around one in five babies of both sexes and it usually resolves itself after around five months.
There is no evidence that colic has any long-term effects on babies’ health.
Natalie Trice, 37, of Marlow in Buckinghamshire, had a history of hip dysplasia in her family, with her sister and a cousin both sufferers.
Her son Lucas, now nearly three, had a late diagnosis of the condition when it was missed by doctors and a health visitor.
He has had two major operations – including one where surgeons split his femur – and has spent nine months of his short life in a body cast to properly position the hip joint.
A failure to treat hip dysplasia increases the chance of developing pain and early hip arthritis later in life, leading to early hip replacement.
The later children are diagnosed, the less chance of successfully treating it.
The family has now been given the all clear, but Mrs Trice said parents need to be more aware of the condition and the fact that swaddling could cause it or make the existing condition worse.
‘I swaddled both my children but Lucas’s condition was so severe it would not have made it any worse. If I had known about the possible consequences, I would not have done it and so I have a double guilt,’ she explained.
‘I would say to parents they need to know the right way of positioning their babies and to be aware of clicky hips, which is a symptom of the condition, and to be vigilant.
‘There is nothing wrong with swaddling, but do it properly. Having a child with hip dysplasia is pretty traumatic for everyone.’
She explained that she, her husband Oliver and their older son Eddie, five, were now looking to Lucas having his first birthday not in what she described as ‘that barbaric contraption’.
‘He’s had chicken pox in a body cast, which wasn’t fun, and he has had tantrums and I have experienced a general lack of compassion with people staring at me thinking I must have been beating him. But he is walking now and that’s very good.’