The Orthopedic Section of the American Academy of Pediatrics (AAP) has just appointed a Task Force on DDH Prevention. While this is long overdue, it is a step in the right direction that has been initiated by IHDI members working with the orthopedic section. Richard Schwend, MD and Rachel Goldstein, MD will lead the task force with the intention of increasing awareness of potentially harmful swaddling practices. Dr. Schwend is Chairman of the IHDI Pediatrics Committee and Dr. Goldstein is Pediatrician Liaison of IHDI to Pediatric Societies.
Last year, Dr. Goldstein and colleagues published the results of a survey that showed fewer than half of pediatricians educate parents of newborns on the risks and benefits of swaddling. ( Acad J Ped Neonatol 2018; 6(5) : AJPN.MS.ID.555756) Of course, new parents have a lot to learn and pediatricians do try to educate as much as they can. However, there is room for improvement about swaddling education because incorrect swaddling can harm the baby’s hips and also increase the risk of SIDS and other more serious problems.
The American Academy of Pediatrics has published recommendations about swaddling that include the potential harmful effects on hip development. However, Dr. Goldstein’s survey shows that there is a need for greater efforts to spread this information to parents of newborn infants. In particular, the harmful effects on hip development are often overlooked. Up to one in ten newborn infants has loose hip ligaments and binding the legs together may cause hip dislocations even weeks after birth.
Last year, the American Academy of Pediatrics passed a resolution to make hip-healthy swaddling and safe-swaddling education more accessible to mothers and nurses in neonatal nurseries and newborn care units. Drs. Goldstein and Schwend will be helping promote those efforts in addition to searching for additional ways to prevent hip dysplasia. The IHDI educational statement about hip healthy swaddling has also helped bring attention to this effort.
Dr. Schwend is a Professor of Orthopedic Surgery at University of Missouri-Kansas City School of Medicine, Past President of Pediatric Orthopedic Society of North America and past Chairman of the Orthopedic Section of the American Academy of Pediatrics.
Dr. Goldstein is an Assistant Professor of Surgery at Keck School of Medicine of University of Southern California and Director of the Hip Preservation Program for Children’s Hospital of Los Angeles.