Swaddling - how this affects baby hips

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What is swaddling?

Swaddling is an old technique of wrapping the baby in cotton cloth or blanket that helps comfort the baby as it resembles their mother’s womb. It reduces crying, maintains body temperature and helps develop a sleep pattern.

How to correctly swaddle your baby

Care should be taken to swaddle properly so the baby is safe and healthy. In order for swaddling to allow healthy hip development, the legs should be able to bend up and out at the hips. This position allows for natural development of the hip joints. The baby’s legs should not be tightly wrapped straight down and pressed together (refer to image below). Swaddling infants with the hips and knees in an extended position may increase the risk of hip dysplasia and dislocation.Swaddling should take place from birth to 8 weeks. Swaddling should stop when the baby starts showing signs of rolling.


There are 2 main ways to swaddle the baby.

Diamond swaddle

Steps to diamond swaddle:

  • Place a cotton cloth in a diamond shape on the bed, folding the top end in a triangle (refer to image 2).
  • Place baby on cloth so that the top of the fabric is at shoulder level (refer to image 3).
  • Tuck left arm down and wrap over the baby’s chest and tuck under the right side of the baby (refer to image 5).
  • Tuck the right arm down and wrap over the baby’s arm and chest.
  • Twist or fold the bottom end of the cloth and tuck behind the baby- make sure both legs are bent up and out (refer to image A). 

Square swaddle

Steps to square swaddle:

  • Lay the blanket square and place baby’s shoulder even with top of the blanket.
  • Tuck the left arm down. Wrap the cloth over the baby’s chest and tuck under the right side of the baby (refer to image 2).
  • Tuck the right arm down, wrap the cloth over the baby’s chest and arm and tuck the cloth under the left side of the baby (refer to image 3).
  • Bring the bottom of the blanket up and over the legs to the level of the chest (refer to image 4).
  • Tuck the left and right side under the baby by gently rolling from side to side- make sure the hips can move up and out (refer to Image A).

Some babies do not like their arms tucked in but enjoy the benefits of swaddling their torso and legs. In such instances, you can leave baby’s arms outside the swaddler by tucking the swaddler under baby’s armpits and wrapping the lower half of the body.

If you choose to use commercial swaddle products The International Hip Dysplasia Institute have a list of Hip-Healthy Products. These are 2 examples:

  • Ergo Pouch


  • Love to Dream


Alternatively please refer to the video on https://hipdysplasia.org/developmental-dysplasia-of-the-hip/hip-healthy-swaddling/

Risks for swaddling

  • Improper swaddling may lead to hip dysplasia or developmental dysplasia of the hip. When in the womb the baby’s legs are in a fetal position with the legs bent up and across each other. Sudden straightening of the legs to a standing position can loosen the joints and damage the soft cartilage of the socket.
  • Swaddling may increase the risk of sudden infant death syndrome (SIDS) dependent on development and age.
  • Improper swaddling can lead to impaired breathing.


  • Make sure the hips and legs are free to move into a healthy hip position.
  • Improper swaddling can lead to hip dysplasia or developmental dysplasia of the hip.
  • Swaddling done correctly can comfort, regulate body temperature and help develop sleep pattern for baby.
  • When using a commercial swaddle or sleeping bag look for those that provide ample room for the hips and legs. 
The Children's Hospital at Westmead
Sydney Children's Hospital, Randwick
Hunter New England Kids Health

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