Baby Bug and Me non-electric blankets

The reports, as CPSC published them

1. No incident, no one hurt

   Made May 28, 2011 · , published by CPSC Sep 6, 2011

   The product, in the report: Tight swaddling products that hold the infant’s legs straight out and bound together

   The purpose of this communication is to raise awareness of a potential health concern for babies who are swaddled tightly. This practice may harm infant hips. A position statement from the International Hip Dysplasia Institute may be found at www.hipdysplasia.org. This position statement is supported by the Pediatric Orthopedic Society of North America with the following statement: POSNA Health Alert Regarding Infant Swaddling

   The Pediatric Orthopedic Society of North America supports the efforts of the International Hip Dysplasia Institute to educate caregivers and parents regarding the potential risks to hip development with certain swaddling techniques.

   Infant swaddling is a technique used to promote comfort and quiet of infants. POSNA cautions parents and caregivers that numerous studies in the medical literature have identified an increased incidence of Developmental Dysplasia of the Hip in infants swaddled with their hips in an extended and adducted position. If infant swaddling is used, POSNA suggests techniques and devices which place an infant’s hips in a flexed and abducted position. POSNA advises against forced or sustained swaddling with the hips in extension and adduction in the first months of life.

   POSNA supports the International Hip Dysplasia Institute’s efforts to increase awareness about this issue and to educate families about healthy hip practices. Additional information and background regarding the issue can be found at the web site of the of the International Hip Dysplasia Institute @http://www.hipdysplasia.org and American Academy of Orthopedic Surgery@http://orthoinfo.aaos.org/topic.cfm?topic=A00347

   A screen shot of the first page of Google images of swaddling methods demonstrates several potentially harmful methods of swaddling that are promoted by producers of commercial products that are probably unaware of this potential for harm. The following products are promoted with the intention of wrapping the legs straight in full extension and together (adducted). [REDACTED] 2. Knit Lullawrap by Baby Bug and Me: http://www.babybugandme.com/catalog_i5972254.html [REDACTED] 4. Many others

   Swaddling in North America has become increasingly popular during the past decade. According to a 2010 survey of over 500 parents of a child born from 2008-2010, 82% report that they swaddle their infants for sleep. The survey, focusing on parents’ concerns about SIDS, was conducted by Ipsos Public Affairs: [http://www.ipsos-na.com/news-polls/pressrelease.aspx?id=4941].

   There are some benefits of swaddling as noted in this abstract of an article published in Pediatrics. This article calls attention to the risk of developmental hip dysplasia but that part of the message may not be widely appreciated by parents, nurses, and pediatricians. Pediatrics 120:e1097, 2007 [1] Swaddling: A Systematic Review Bregje E. van Sleuwen, MSca, Ade` le C. Engelberts, MD, PhDb, Magda M. Boere-Boonekamp, MD, PhDc, Wietse Kuis, MDd, Tom W. J. Schulpen, MDe, Monique P. L’Hoir, MSc, PhDa Departments of aMedical Psychology and dImmunology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands; bDepartment of Pediatrics, Maaslandziekenhuis, Sittard, Netherlands; cDepartment of Science, Technology, Health, and Policy Studies (STeHPS), School of Management and Governance, Twente University, Enschede, Netherlands; ePaediatric Association of the Netherlands, Utrecht, Netherlands The authors have indicated they have no financial relationships relevant to this article to disclose. ABSTRACT [REDACTED]

   There is ample evidence that tight swaddling with the legs in full extension is major risk factor for hip dislocation and hip dysplasia. Kutlu, et.al. identified this association in Turkey almost twenty years ago, and the practice of tight swaddling was changed through public health efforts.[2] Kutlu, et.al. JPO 12:598-602, 1992

   Although public health efforts were initiated in Turkey following that report, the association between swaddling and hip dislocation has not been completely eliminated. A prospective study of neonatal diagnosis in Turkey was published in 2007.[3] The authors reviewed 3,541 infants who had neonatal examination followed by routine Ultrasound screening at 4-6 weeks of age. Hip dysplasia was identified at the time of ultrasound study in 21% of the 151 infants that had been swaddled. This was a greater risk factor than any other factor including breech delivery, gender, or family history. H. Dogruel, et.al. Intl. Orthop. (2008) 32:415–419

   Similar findings were noted in Japan more than thirty years ago.[4] A national campaign to eliminate swaddling with the legs in extension reduced the incidence of DDH to 0.2% from an incidence of 1.1%-3.5% prior to the national campaign. Clin. Orthop. Rel. Res. 184:34-40, 1984

   Even prior to these reports, Robert B. Salter had called attention to the association between swaddling and developmental dislocation of the hips.[5] RB Salter, Gibson Memorial Lecture: “Etiology, Pathogenesis and Possible Prevention of Congenital Dislocation of the Hip.” Canadian Medical Assoc. J. 98:933-45, 1968.

   The International Hip Dysplasia Institute, a not-for-profit entity, has released the following Position Statement on Swaddling Summary Statement: Swaddling infants with the hips and knees in an extended position increases the risk of hip dysplasia and dislocation. It is the recommendation of the International Hip Dysplasia Institute that infant hips should be positioned in slight flexion and abduction during swaddling. The knees should also be maintained in slight flexion. Additional free movement in the direction of hip flexion and abduction may have some benefit. Avoidance of forced or sustained passive hip extension and adduction in the first few months of life is essential for proper hip development. The full opinion, complimentary brochures and a video about proper swaddling can be found at www.hipdysplasia.org and specifically at the following page of that website: http://www.hipdysplasia.org/For-Parents/Living-with-Hip-Dysplasia/Hip-Healthy/default.aspx 1.van Sleuwen, B.E., et.al., Swaddling: A Systematic Review, Pediatrics 120:e1097-e1106, 2007 2.Kutlu, A., et.al. Congenital dislocation of the hip and its relation to swaddling used in Turkey, JPO 12:598-602, 1992 3.Dogruel, H., et.al. Clinical examination versus ultrasonography in detecting developmental dysplasia of the hip. Intl. Orthop. 32:415-19, 2008 4.Yamamuro, T. and Ishida K, Recent advances in the prevention, early diagnosis, and treatment of congenital dislocation of the hip in Japan, Clin. Orthop. Rel. Res. 184:34-40, 1984 5.RB Salter, Gibson Memorial Lecture: “Etiology, Pathogenesis and Possible Prevention of Congenital Dislocation of the Hip.” Canadian Medical Assoc. J. 98:933-45, 1968.

   Summary Tight swaddling with the legs adducted and in extension is widely recognized by pediatric orthopedic surgeons as a risk factor for hip dislocation and hip dysplasia. Twenty of more years ago the lessons of correct swaddling were learned and implemented in countries that practiced incorrect swaddling methods. However, swaddling has recently gained popularity among parents in North America, most likely without knowledge of the risk of DDH. The benefits and risks of swaddling have recently been studied by pediatricians, and these benefits and risks are becoming more widely understood. However, there appears to be a need for greater awareness regarding the risk of hip dysplasia from incorrect swaddling so the lessons of the past will not be forgotten.

   Please feel free to contact me any time. I can provide two patient examples of infant hip dislocations attributed to tight swaddling. The frequency of hip dislocations has increased in Australia correlating with increased swaddling of infants. Data about increased prevalence in the USA is not known but the evidence is clearly established from Turkey, Japan, North American Indians and other similar reports.

   [REDACTED] The address is my business address

   Model

   Knit Lullawrap

   Where

   Orlando, Florida: Other

   Who was involved

   Unspecified

   The reporter’s relation to them

   Unspecified

   As this report names them

   Brand Baby Bug and Me, made or sold by Cloud B

   How badly, in CPSC’s words

   No Incident, No Injury

CPSC’s disclaimer

Sources