text: Parents are risking their babies' health because of a surge in the popularity of swaddling, according to an orthopaedic surgeon. 
   
   The technique involves binding the arms and legs with blankets and is used to help calm a baby and prevent crying. 
   
   But Prof Nicholas Clarke, of Southampton University Hospital, said swaddling was damaging developing hips. 
   
   The Royal College of Midwives and other experts advised parents to avoid tightly swaddling a child. 
   
   Restricts movement 
   
   Swaddling has been widely used in many cultures globally. It is thought the blanket wrapping can simulate the feelings of being in the womb and calm the child. 
   
   But the technique holds the legs out straight and restricts movement, which can alter the development of the hip joint. 
   
   Swaddling should not be employed in my view as there is no health benefit but a risk for adverse consequences of the growing and often immature hips Andreas Roposch, Great Ormond Street Hospital 
   
   Writing in the journal Archives of Disease in Childhood, Prof Clarke argued: "There has been a recent resurgence of swaddling because of its perceived palliative effect on excessive crying, colic and promoting sleep. 
   
   "In order to allow for healthy hip development, legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints. 
   
   "The babies' legs should not be tightly wrapped in extension and pressed together." 
   
   Jane Munro, of the Royal College of Midwives, said it was a "seemingly innocuous" thing to do, but it posed "significant problems" for the baby. 
   
   She said there was also the risk of the baby overheating and a raised risk of cot death. 
   
   She added: "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 she knows how to keep her baby safe, able to move and not get overheated." 
   
   Video guidance 
   
   Andreas Roposch, a consultant orthopaedic surgeon at Great Ormond Street Hospital, said: "Similar effects may be seen in all devices or manoeuvres that place the legs in a purely straight position for prolonged periods in this critical age of early infancy. 
   
   "Swaddling should not be employed in my view, as there is no health benefit but a risk for adverse consequences of the growing and often immature hips." 
   
   Rosemary Dodds, of parenting charity the NCT, advised against tight swaddling. 
   
   "It is helpful to raise awareness of hip dysplasia in relation to swaddling. Some parents and babies seem to like swaddling, but it is important that babies do not overheat and their legs are not restricted. 
   
   "Videos are available on the NCT website showing parents who want to swaddle their baby how to do so safely." ||||| This article discusses swaddling - how to do it as well as the arguments for and against. 
   
   This article covers: 
   
   Swaddling describes the practice of wrapping babies, from the neck downwards, entirely in a cloth or thin blanket, with the aim of pacifying or calming them. 
   
   Why swaddle your baby? 
   
   Although not everyone agrees with swaddling babies, many cultures have used this practice throughout history, as it is thought that the feeling of being ‘contained’ or held within the blanket can help babies to feel settled or less fretful and can also help them to sleep. It is thought to have this effect because it in some way ‘recreates’ the restricted space of the womb and therefore stops the baby making its startle (Moro) reflex; however, it is not known what the long-term effects of swaddling a baby are. 
   
   If the purpose of swaddling your baby is simply to stop them thrashing around, then it may be best to use a muslin (particularly indoors), as it is important that your baby does not overheat. 
   
   How to swaddle a baby 
   
   Place a large cot blanket on the floor, and lay it in a diamond shape, folding the top point over to create a flat edge for your baby’s shoulders to lie among. Bring one top corner across to tuck under her bottom, and bring the bottom point up to tuck into this wrap. You can wrap the other top corner around her and tuck the corner in to secure in the material at her neck (this section has been copied from ‘Babycalming’ by Caroline Deacon, by agreement). The baby's legs should be able to move into a ‘frog position’, rather than being held straight (see Natural Positioning below). 
   
   Arguments against swaddling 
   
   Recently, some experts have reviewed studies on swaddled infants, and it has been suggested that swaddling could have implications for: 
   
   increased risk of cot death, 
   
   reduced breastfeeding at birth and/or 
   
   increased early weight loss 
   
   Additional concerns raised regarding swaddling have included increased incidences of developmental hip dysplasia, acute respiratory infections and overheating; however these may be circumvented by modifying the swaddling style used (see video above) and by avoiding extra bedding. 
   
   Natural positioning 
   
   Heavily swaddling a baby in order to breastfeed may feel easier, but allowing your baby freedom of movement with their hands leads to a more natural latch - babies naturally explore with their hands when breastfeeding. Your baby may also get very warm while breastfeeding, so it's safer not to have constrictive blankets. 
   
   An infant's natural hip position is 'frog' style – with legs drawn up and thighs roughly at right angles to the body. This helps the ball and socket joint develop properly in the hip. There is some evidence that excessive swaddling with legs 'straight down' prevents this joint developing properly (hip dysplasia or DDH). Babies’ legs need to be able to move in a more natural 'frog' position. 
   
   Keeping safe when swaddling 
   
   The Lullaby Trust (formerly FSID) makes the following recommendations: 
   
   Parents should be aware of the potential risks of swaddling their infant, particularly of the use of heavy materials for swaddling. 
   
   Don't cover a baby's head, and only use thin materials for swaddling. 
   
   Infants must NEVER be placed on their stomach when swaddled. 
   
   Other carers, such as grandparents, should also be made aware of your baby’s usual sleeping environment and practices. 
   
   Further information 
   
   NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. 
   
   You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area. 
   
   The Lullaby Trust (formerly FSID) has information on swaddling. ||||| 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 … ||||| Swaddling babies is on the rise: Add it to the long list of mixed messages new parents get about infant care. It helps fussy babies calm down, but given some health concerns, your swaddling technique (and frequency) should be checked out. 
   
   One of the first things many new parents learn these days is the craft of swaddling their infant children. I, for one, remember with a feeling almost approaching fondness the moment during parenting class when I had to demonstrate for all assembled how to swaddle a doll in a theoretically sound manner. (I did it, more or less, a rare personal triumph over my own lack of spatial relations skills.) 
   
   Swaddling is great. It has a way of transforming a wildly flailing, highly annoyed noise-emitting little vortex of fuss into a sweet, restful, convenient-to-carry bundle of joy – the kind you'd always anticipated bringing into your lives, and have been somewhat disappointed to see only intermittently among all the diaper changes and random meltdowns. 
   
   But – like basically anything baby related – the practice has a recently renewed sheen of controversy. Via BBC: 
   
   Writing in the journal Archives of Disease in Childhood, Prof [Nicholas] Clarke [of Southhampton University Hospital] argued: "There has been a recent resurgence of swaddling because of its perceived palliative effect on excessive crying, colic and promoting sleep. 
   
   "In order to allow for healthy hip development, legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints. 
   
   "The babies' legs should not be tightly wrapped in extension and pressed together." 
   
   Fear of hip damage runs side-by-side with other concerns about infants overheating (ah, the often grandma-instigated temptation of adding that second ... and third ... and fourth blanket) and a raised risk of crib death. Granted that the concerns largely focus on improperly restrictive swaddling (and/or parents who place swaddled infants to sleep on their faces, who are hopefully a small-to-nonexistent percentage of the population) but it's still scary stuff. 
   
   So: fantastic. Swaddling is the best way to help your infant sleep and make your lives as parents feel manageable, and it's also, of course, dangerous. Throw it on the pile of stresses of being a new parent, along with exclusive-to-the-point-of-exhaustion breast-feeding, controversy over co-sleeping, and the ambitious and almost certainly overstated diaper-free fad that seemed to be sweeping one small, extremely well-documented part of Brooklyn earlier this year. 
   
   The controversy over the safety of swaddling isn't, of course, new – the practice has gone into and out of vogue many times over the years. Early this year, Huffington Post noted a back-and-forth over the practice taking place in day cares, where a pitched battle was and still is being fought about the balance between absolute child safety (fears over hip problems or swaddled babies struggling with loose blankets or ending up on their faces) and child happiness (getting adequate sleep). 
   
   All that written, there is, thankfully, some agreement on methods of swaddling that avoid some or all of the risk: If you're a parent of an infant well-and-truly freaked out by all the back and forth there is a nicely written resource on the website of Britain's National Childbirth Trust that provides an overview of the practice, the risks, and (most helpfully) how to do it right, including a video called "How to Hip-Healthy Swaddle your Baby."
target: – Swaddling is by all accounts on the rise among new parents, but a pediatric orthopedic surgeon thinks it's a bad trend, reports the BBC. Wrapping a baby tightly with blankets restricts the infant's hips from moving freely and raises the risk that they won't develop properly, the UK doctor writes in the Archives of Disease in Childhood. "In order to allow for healthy hip development, legs should be able to bend up and out at the hips." In other words, "the babies' legs should not be tightly wrapped in extension and pressed together." Swaddling is thought to work because it mimics the feel of the womb and thus calms the baby. Great, writes James Norton at the Christian Science Monitor, this is yet more conflicting advice for confused parents. Controversy over swaddling isn't new, he adds, and his blog post provides a link to techniques that he says avoid most or all of the risk to infants.