Hip dysplasia is an abnormal development of the joint in which the alignment of the head of the femur relative to the acetabulum (the depression in the pelvic bone) is disrupted. This leads to defects in the supporting function of the limbs.
The causes of dysplasia, as a rule, are heredity, hormonal disorders in a woman during pregnancy, breech presentation of the fetus, oligohydramnios, large fetal size, and gynecological diseases. As a result, the child has a reduced range of motion in the hip joints, which prevents their normal development. Dysplasia is detected in late pregnancy or within 6 months after the birth of the baby using the necessary examinations. If a deviation is suspected or detected, wide swaddling is prescribed.
What is wide swaddling
Wide swaddling is a method of swaddling infants, which is used for the prevention and therapeutic treatment of dysplasia. Using a special technique, the baby’s legs are positioned similarly to the intrauterine position, as a result of which the hip joint is formed anatomically correctly.
There are several ways to swaddle a baby this way. This is done using a regular diaper, special panties for wide swaddling, covers or orthopedic devices.
Pros of wide swaddling:
- excellent for physical prevention;
- use in infancy eliminates the need for more serious methods and techniques of treatment in the future;
- eliminates the need for surgical intervention.
Minuses:
- using technology for a long time;
- consistency of use;
- in some cases it is inconvenient without special accessories.
Important ! According to statistics, the need for wide swaddling is about 20% of all newborn children, most of them are girls. Unfortunately, not all mothers understand the need for such care for their child, believing that with age the problem of dysplasia will disappear or will not cause serious problems. In the absence of therapeutic measures in infancy, dysplasia is fraught with various forms of arthrosis for an adult, and in some cases, disability.
Types of swaddling
There are three main types of swaddling, which differ significantly from each other:
- Tight. The classic traditional method, in which the newborn is tightly wrapped in a diaper, even the head can be fixed. In this position, the baby cannot move his arms and legs.
- Free. The newborn is wrapped in a diaper in such a way that he is able to make small movements. Sometimes only the baby’s legs are fixed, and the arms remain free.
- Wide. The main task of this type of swaddling is to spread the legs into an M-shaped position for the correct formation of the hip joint. It is recommended primarily for children with dysplasia and immaturity of the hip joint, but can also be used to prevent these diseases.
Indications and contraindications
Wide swaddling is indicated for babies who have hip dysplasia immediately after birth or before 6 months. The method is also widely used for prevention. It is prescribed by an orthopedic doctor after a physical examination or examination using ultrasound or x-ray.
Contraindications for use:
- pronounced forms of dysplasia;
- late diagnosis, several months after birth;
- development of dysplastic coxarthrosis due to interruption of correction.
In such cases, dysplasia can only be eliminated through surgery.
Devices for wide swaddling
Depending on the method of wide swaddling, various devices are used.
These include:
- diapers made from natural materials of different sizes;
- ready-made or homemade covers;
- special panties;
- Freyka pillow;
- orthopedic splints and more.
Devices are used on the recommendation of a doctor. The choice depends on the nature of dysplasia and the age of the child. You will also need a changing table or other flat surface, diapers, diaper cream and other available items.
How to properly swaddle
There are many techniques for wide swaddling a baby. The simplest and most accessible techniques are those using one, two or three diapers. Let's look at how to do this swaddling correctly below.
One diaper
Despite the fact that this method is recognized as insufficiently fixative, it is actively used by mothers of calm babies or at night.
Procedure:
- Lay the diaper vertically on the surface, fold it in half.
- Spread the top layer so that a triangle-shaped pocket is formed.
- Turn the resulting product over to the reverse side on the table.
- Fold the right corner in half to form a tight rectangular strip in the center.
- Place the baby in the center of the resulting product.
- Wrap the legs with the remaining corners of the fabric.
- Place the bottom of the thick strip between the legs and secure the position by putting on the sliders.
Two diapers
Wide swaddling of a newborn with hip dysplasia with two diapers is considered the most optimal and resembles a reusable diaper.
For this method of swaddling you need two diapers measuring 80×120 cm and 80×90 cm:
- Fold a larger diaper in half to form a triangle.
- Place the resulting product on the table.
- Place the second diaper, folded 2-3 times in the shape of a tight rectangular roll, in the center.
- Place the baby in the center and pass the end of a rectangular roller between the legs.
- Wrap the legs with the corners of the first diaper and secure by putting on the sliders.
Three diapers
For this method, you need to prepare three canvases: one 80x120 cm in size and two 80x90 cm in size. Technique:
- Lay out a larger canvas on the table.
- Fold the second fabric into a scarf and place it on the first one with the main angle down.
- Place the third canvas on the second, folding it into a 20 cm rectangle.
- Place the baby on the top edge of the canvas just above waist level.
- Place the third sheet between your legs.
- Wrap the corners of the second fabric around the hips.
- Wrap the first fabric around the tummy and fold the bottom edge, while making sure that the child’s posture is natural and the legs are well fixed.
Using a case
A fabric cover for wide swaddling is sold in pharmacies, and it is also easy to make it yourself using a special pattern.
The cover is worn for the most stable fixation over panties, diapers or orthopedic products. They are secured on the sides with Velcro or ropes, and on top of the baby’s shoulders with harnesses or buttons.
On a diaper
The technique of swaddling with a diaper is similar to the above-described methods of swaddling using one or three diapers, but in this case the central roller is not used. With this technique, it is necessary to wrap the diapers looser, and lubricate the places of contact with the diaper with a special baby cream.
Using Freyka's pillow
There are orthopedic devices for wide swaddling, for example, Freyka pillows. This ready-made device is used for minor dysplasia. It looks like a solid bandage that goes between the child’s thighs and is attached to a belt or hanger.
Depending on the baby's anatomy and the doctor's recommendations, pillows of different sizes are used, with firm backs or raised edges. They are used from a month to a year old baby.
How to properly swaddle a baby in this way?
To do this, you can use one diaper, two, or three. It is also possible to swaddle your baby using a diaper. This is how babies are swaddled to prevent diaper rash, developmental disorders of the hip joints, etc.
First way
It is suitable for a calm baby. You can also swaddle him while he sleeps.
To do this, a rectangular diaper needs to be spread on a hard surface. Then fold it in half. Open one pocket to form a triangle. Then the middle part of the diaper is bent and folded into a rectangle. This creates a diaper. It is used for swaddling the baby.
It's done like this. The baby needs to be placed in a diaper. Move the legs apart to form a 90-degree angle. Wrap both legs of the baby in a diaper, place the middle part between them and bend it up so that the folded rectangle is between them.
To prevent such a diaper from immediately unraveling due to the child’s movement, you need to put sliders on it, or swaddle it on top. To better master this technique, you can watch a special video about wide swaddling with a diaper.
Second way
It will require two diapers. One of them needs to be taken more, the second - less. The first, large diaper should be spread on a flat surface. Roll the second one into a rectangular roller.
The baby lies down on the spread diaper. Between the legs, bending them slightly, place a cushion from a smaller diaper. Wrap the baby's body on both sides. Having grabbed the lower part of the diaper, also place it between the legs and secure the ends around the waist.
It is imperative to remember that you should use only high-quality diapers, preferably cotton, soft, non-irritating to the baby’s skin and absorbing liquid well.
Using this method, it is possible to both correct deformities of the hip joints and prevent irritation and diaper rash. Much fewer disposable diapers will be required, which naturally reduces costs significantly. It’s easier and faster to teach a child to ask to go to the potty.
Third way
You need to use three diapers for it.
The essence of the technology itself is this. The first diaper should be folded into a triangle. Then place the child on it so that the middle (right) angle is under the legs.
Fold the second diaper into a rectangle (its width is approximately 20 cm). After this, pass between the legs. Then the corner of the first one is grabbed and also threaded between the legs, and the ends are wrapped around the hips, after which they are secured to the belt.
After this, a third diaper will be required. With its help, the baby’s body is wrapped, and the first two diapers are securely fastened. Then its lower edge is attached to the belt near the navel.
In cases where a diaper is used, a diaper folded into a rectangle is not needed. The diaper itself will play its role.
How to sew a wide swaddling blanket
To save money, you can make a wide swaddling diaper yourself. To do this, you will need cotton or flannel fabric of such a size that the result is a dense rectangle measuring 40x20 cm.
Fold the fabric in several layers, giving the product the desired size, tuck it in and trim the edges. From the remaining pieces of material, make six strips that will serve as suspenders and ties. Sew four strips on the sides of the product so that you get ties on each side at the level of the tummy.
Sew the remaining two strips on the back side, and attach buttons or Velcro to the front to secure it to the front of the product. As the child grows, the buttons can simply be altered or additional slits can be made in the straps.
How long can wide swaddling be used?
As a rule, the wide swaddling method is used for prevention for an average of two months, 2-4 hours every day.
Treatment takes longer - at least several months. Moreover, the duration and frequency of use depend on the degree of dysplasia and how early the disorder was detected.
These factors guide the pediatrician, orthopedist or osteopath when prescribing therapy. Wide swaddling is used as prescribed by a doctor from the birth of the baby to 6-12 months of age.
Wide swaddling of a newborn with hip dysplasia
The concept of hip dysplasia in newborns includes a problem associated with the pathology of the hip joint. Dysplasia develops more often in girls than in boys. The disease can be detected using ultrasound in late pregnancy. Three causes of dysplasia have been identified: a large fetus, oligohydramnios, and breech presentation of the child . All these factors can affect the position of the fetus in the intrauterine state.
Detection of the disease at an early stage is carried out in the maternity hospital by spreading the legs to the side by 180 degrees. If the legs lie freely on the surface in a bent state, then the disease is absent. A mother can also detect dysplasia when examining her baby after returning from the maternity hospital.
Dysplasia can cause the development of dislocation and subluxation of the hip in a newborn , so it is necessary to use the wide swaddling method from the first days of birth. This method can be used up to 6-12 months of age as prescribed by a doctor.
It is very important to follow your doctor's warnings regarding choosing the most effective treatment method. If you treat the child yourself, visually only determining the possible occurrence of the disease, then you can use an ineffective method.
Swaddling a baby in a wide manner is a way to achieve intrauterine position. The main essence of this method of swaddling is that the legs are in a freely bent, spread-out position. The baby should be comfortable in this position, since this is a natural position and cannot cause discomfort to the baby.
The use of diapers or other special items designed for this method of swaddling is a targeted treatment for hip dysplasia in newborns.
