Arch Dis Child doi:10.1136/archdischild-2013-304143
  • Leading article

Swaddling and hip dysplasia: an orthopaedic perspective

Press Release
  1. N M P Clarke
  1. Correspondence to Professor NMP Clarke, MP 817, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK; ortho{at}
  • Received 7 August 2013
  • Revised 16 September 2013
  • Accepted 18 September 2013
  • Published Online First 28 October 2013

Historically infant swaddling was almost a universal practice. It involved binding or bundling babies in blankets with the arms restrained and the lower limbs extended. It remains common in the Middle East1 and in some ethnic groups with or without a board or cradle.2 There has been a recent resurgence of swaddling because of its perceived palliative effect on excessive crying, colic and promoting sleep. Approximately 90% of infants in North America are swaddled in the first few months of life.3

A recent systemic review4 concluded that in general swaddled infants do arouse less and sleep longer. Preterm infants showed improved neuromuscular development.

In the UK a recent Drug and Theraputics Bulletin review of the management of infant colic5 concluded that the current evidence base does not support the use of swaddling in its management. This review and the systematic review however noted the association of swaddling with developmental dysplasia of the hip (DDH), the latter concluding ‘attention to this adverse effect is of utmost importance’. DDH is one of …

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