Hip-Healthy Swaddling

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Article by:

Cara Dumaplin

RN, BSN, Certified Pediatric Sleep Consultant

baby swaddled in b.e.s.t. swaddle demonstrating hip healthy swaddling

As a nurse and mom, I want every parent to feel confident swaddling their baby. Why? We know that when done correctly, swaddling can be "an effective technique to help calm infants and promote sleep." (2)

One important factor in swaddling correctly is making sure that you're swaddling in a hip-healthy way. 

What is hip-healthy swaddling? 

Hip-healthy swaddling means keeping the upper body snug while giving the hips and legs space to move naturally.

The International Hip Dysplasia Institute says that for hip-healthy swaddling (5)

  • hips must be free to move up and out (into an “M” or froggy position)

  • legs should never be forced straight down or pressed together

  • the swaddle must be loose around the hips

Here’s an example of how to swaddle and ensure that hips and legs are able to move freely:

Swaddling positions to avoid:

These common swaddling mistakes can put unnecessary stress on developing hip joints:

  • Wrapping legs tightly straight down toward the feet

  • Pressing both legs together inside the swaddle

  • Using a swaddle that is too small or wrapped too tightly around the hips, which can force the hips into an unnatural position

The b.e.s.t. swaddle was designed with hip health in mind. It’s completely size adjustable, it’s built with extra space around the hips, and it has an extra band to prevent breakouts while still allowing the hips to move freely. Plus, if your baby is in a Pavlik harness or brace, the b.e.s.t. swaddle’s inner band can be used by itself while your baby is wearing the harness.

Why does hip-healthy swaddling matter?

Swaddling properly with legs in a froggy position allows plenty of hip movement and helps prevent hip dysplasia (also known as developmental dysplasia of the hips or DDH).

Hip dysplasia happens when a baby’s hip joints don’t develop properly. It affects up to 10% of newborns.(1) Some newborns are born with it, and sometimes it develops after birth. 

When babies are diagnosed with hip dysplasia (DDH), they’re typically treated with a hip harness that positions their legs in an “M” or “froggy” position to help their hips develop properly. 

Does swaddling cause hip dysplasia?

Swaddling itself doesn’t cause hip dysplasia, but improper swaddling can contribute to it. When a baby’s legs are wrapped tightly straight down and pressed together for an extended period, it puts stress on the hip joint and can interfere with healthy hip development. This is why the swaddling technique AND the swaddle you’re using matter. 

image of hip healthy swaddling and how not to swaddle

When to talk to your pediatrician:

Hip dysplasia is typically screened for immediately following birth and during routine well-baby visits in the first months of life. If you notice your baby’s legs look uneven, one hip seems to move differently than the other, you have a family history of hip dysplasia, or you’re concerned for any reason, mention it to your pediatrician. 

What swaddle do you recommend for babies in a Pavlik harness or brace?

The b.e.s.t. swaddle is the perfect choice for swaddling a baby in a brace or harness and was designed with hip health in mind. I’d love to show you how the inner band of the b.e.s.t. swaddle works with the Pavlik harness. Notice how the baby’s chest and arms are swaddled, but their hips and legs are free.

image of baby in a pavlik harness wearing the b.e.s.t. swaddle by taking cara babies

NOTE: Swaddling guidance varies by harness and physician. While some physicians or institutions may say “no swaddling” with the Pavlik harness, they’re typically referring to swaddles that cover a baby’s hips and legs. In this case, check with your provider to see if the inner band of the b.e.s.t. swaddle is a good option for your baby. The inner band only contains your baby's arms and torso, leaving the legs and hips free. You can also talk with them about using Jacky, the swaddle transition jacket. Jacky was made so that the hips and legs are free, which can be helpful as babies are ready to transition out of the swaddle. 

Frequently Asked Questions about Swaddling and Hip Dysplasia

Swaddling itself doesn’t cause hip dysplasia, but improper swaddling can contribute to it. When a baby’s legs are wrapped tightly straight down and pressed together for an extended period, it puts stress on the hip joint and can interfere with healthy hip development. This is why the swaddling technique AND the swaddle you’re using matter. The b.e.s.t. swaddle by Taking Cara Babies was designed to make hip-healthy swaddling easy.

The safest position allows the hips to fall naturally into a froggy or "M" shape, with the knees bent and legs able to spread apart. The swaddle should be snug around the chest and arms, but loose around the hips and legs.

The hips should have enough room to move freely. 

Yes! The b.e.s.t. swaddle is thoughtfully designed to allow for natural hip flexion and abduction, which is the standard recommended by the International Hip Dysplasia Institute. 

Yes! The b.e.s.t. swaddle's inner band is the perfect choice for swaddling a baby in a Pavlik harness, Rhino brace or Denis Browne Bar because it keeps the arms and chest snug while allowing space for the brace or harness.


References

Sources
  1. International Hip Dysplasia Institute. Understanding Hip Dysplasia 
  2. Healthy Children (2022). Swaddling: Is it safe for your baby? 
  3. Moon, R. (2022). How to Keep Your Sleeping Baby Safe: AAP Policy Explained
  4. International Hip Dysplasia Institute. Hip-Healthy Swaddling
  5. International Hip Dysplasia Institute. New Warning About Swaddling
  6. Moon, R. (2022). Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment
  7. Kids Health. (2019). Developmental Dysplasia of the Hip
  8. International Hip Dysplasia Institute. Developmental Dysplasia of the Hip

Keep in mind that the information and content on this blog is for informational purposes and should not be considered medical advice. If you have questions about your child, please reach out to your doctor.

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