Introduction

This presentation is designed to show parents and health care professionals how to safely wrap babies so their hips are not restricted.  Wrapping a baby's legs too tightly can hinder the normal growth and development of a child's hips.

Developmental dysplasia of the hip

In the womb, babies generally lie with their hips in an outward position. This helps the hip joint to develop normally.

The hip is a ball-and-socket joint that is held together by ligaments.

In some babies the ligaments around the hip joint are loose, which in most circumstances corrects during the first few months of life.

If this looseness persists, the hip may not form properly and lead to the child developing dysplasia of the hip.  In some severe cases, the hip may come out of the joint. This is known as dislocation of the hip.

Incorrect wrapping can have an effect on the growing hip joint and cause the hip to become unstable and dislocate.

That's why all parents and carers need to know how to wrap a baby correctly to minimise the chance of hip dysplasia.

What is wrapping?

Wrapping or swaddling a newborn can help them feel more secure and comfortable.  This may assist the baby to settle and establish regular sleep patterns.

Risks of wrapping

Many studies have shown that tight wrapping in the "papoose" position - with the legs held straight - can lead to hip dysplasia and dislocation.  When this practice is stopped the frequency of dislocation drops significantly.  So, when wrapping babies, it's now recommended to leave enough room for their legs to move freely.

Safe wrapping methods

In the next section we'll show you a number of ways to safely wrap a baby. Whatever method is used, the aim is to leave the legs free to move.  Safe wrapping is most important during the first three months of life, when looseness of the hips is most common.

Safe wrapping - diamond method

Lay a cotton or muslin wrap in a diamond position on a flat surface such as a change table.  Fold the top corner of the wrap under.

Lie the baby on the wrap, with its shoulders at the level of the top fold.

Gently place the baby's left arm by its side and fold the wrap across. Tuck the wrap under the opposite side. Next, place the baby's right arm by its side and fold the opposite side of the wrap over. Again, tuck it under. Leaving room for the legs to move, bring the lower wrap up, twist and tuck it under the baby. Check that the legs are free to move.

Safe wrapping - square method

Lay a cotton or muslin wrap in a square position on a flat surface such as a change table.

Lie the baby on the wrap, ensuring its shoulders are level with the top of the wrap.

Gently place the baby's left arm by its side and fold the wrap across. Tuck the wrap under the opposite side. Next, place the baby's right arm by its side and fold the opposite side of the wrap over. Again, tuck it under. Leaving room for the legs to move, bring the lower wrap up towards the chest and tuck the edges of the wrap under the baby. Check that the legs are moving freely.

Safe wrapping - using a pouch

There are a number of pouch-type garments available for sleeping. It is important to check that these garments provide free leg movement.

Take home message

Wrapping a baby can help them feel more secure.  Always remember to leave the baby's legs free to move.