Baby Hip Health Week 2012

As part of Baby Hip Health Week 2012 (10th – 17th March), the national charity STEPS is calling for parents and professionals to learn how to swaddle their babies correctly to help prevent hip dysplasia. 

A top children’s surgeon says the return of an “eradicated” practice of tightly wrapping babies in blankets to keep them warm and help them sleep is causing a rise in hip problems.

Professor Nicholas Clarke, a consultant orthopaedic surgeon at Southampton General Hospital, says the unsafe form of swaddling – which had almost completely disappeared by the end of the 1980s – is being increasingly adopted by mothers, with some websites selling tight ‘swaddlers’ claiming they can help tackle colic.

He warned the trend is leading to more cases of hip dysplasia – where the hips are loosened by mothers’ hormones which relax ligaments during birth – as forcibly straightening the legs within the first three to four months of life 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.”

Up to 100 babies are screened at Southampton General Hospital’s hip clinic every week – 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% of babies, some will suffer permanent damage.

“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.”

Although keen not to discourage safe techniques, Prof Clarke, who is also a professor of orthopaedic surgery at the University of Southampton, 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, who 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, is now calling for the relaunch of an awareness campaign to address the problems.

He added: “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.”

Take a look at our hip healthy swaddling and positioning guidelines

In addition, as part of the newborn infant physical examination programme (NIPE) every baby gets their hips checked at birth and the six to eight week check. However, most parents and health professionals do not realise the implications if a problem with the hips is not picked up as the tests are not 100% accurate.

Even if the hips appear to be normal it is important to be aware of signs that might mean there is a problem. The signs parents should look out for include:

•          one leg appearing shorter than the other
•          an extra deep crease on the inside of the thigh
•          crawling with one leg dragging or walking with a limp or a waddle.        

Whilst these signs are not conclusive, they may indicate the need for further investigation.

If you are concerned your child has a hip problem please seek advice from your GP or Health Visitor immediately since treatment is usually less complex the earlier it is started.

HELP US TO HELP OTHER PARENTS LIKE YOU:-  Host a 'Put the Kettle on' fundraising event whereby you hold a tea/coffee morning at home, work or in the community to spread the word about baby hip health and help raise vital funds at the same time Distribute the STEPS award winning leaflet on Baby Hip Health to your local surgery or clinic Get your story featured in a local magazine or newspaper to raise awareness. Alternatively send us your story and we will try and get media coverage for you.

Anyone wishing to get further advice,  tell their story to the media, distribute leaflets or wanting to host a "Put the Kettle on" event, please contact the STEPS Helpline on 01925 750271 or email info@steps-charity.org.uk Also please take a look at our website section about Baby Hip Health Awareness