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The Benefits of Baby Carrying - Swaddling and Hip Dysplasia

Written by Elizabeth Antunovic   
Wednesday, 01 December 2010 00:00
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The Benefits of Baby Carrying
Swaddling and Hip Dysplasia
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Swaddling and Hip Dysplasia

Although there are myriad psychological, emotional and physiological benefits from the swaddling style of the Navajos, there is clear evidence that swaddling the legs so that they are bound together and not allowed to flex at the knee or hip has led to hip abnormalities. By not allowing the head of the femur to sit in the socket, the socket often does not develop properly, causing developmental dysplasia of the hip (DDH).

Carrying a young infant in the horizontal position with legs together in a baby carrier (like a sling or a wrap) provides adequate spinal support, but it is not the optimal position for hip development or prolonged carrying. This is especially true if there is congenital dysplasia present in the infant.

The American Academy of Pediatrics released a review of swaddling under Van Slewen in 2007, which reaffirmed that infants’ legs should not be tightly swaddled. In 1965, the incidence of DDH was high in Japan when a swathing diaper was used widely by the population. Eight years later in 1973, Japanese doctors advised mothers to avoid “prolonged extension of the hip and knee of infants during early postnatal life.” Soon afterward, experts reported a marked decrease in infants with DDH.


Supporting the Legs

Upright baby carriers that support the legs, carrying a baby as a mother naturally would in arms, do not compromise a baby’s spine or hips. When an infant’s legs are flexed and straddled, the instinctive position that his little body assumes when picked up, the head of his femur (bone of the thigh) fills out the hip socket (acetabulum). The hip socket is filled most evenly when the legs are pulled up to roughly 100 degrees and spread roughly 40 degrees at the same time. DDH does not occur when an infant’s legs are supported. Actually, this is the position that doctors advocate as treatment for babies with hip dysplasia.

Interestingly enough, babywearing is customary among the Netsilik Inuit people. Netsilik mothers don’t use papooses, but instead carry their infants in their amautis of their parkas. The babies assume a seated straddling position on their mother’s back inside their coats. No studies indicate prevalence of either DDH or spondylolisthesis in this northern Inuit babywearing group. Their hips and spines develop normally.

A mother, using either her arms or a simple piece of cloth, supports her baby’s legs in a f0lexed (knees bent), abducted (away from midline) position, supporting the hips and the spine. Instead of fabric at the crotch, which contributes no leg support, or swaddling the legs, which is too restrictive, ergonomic carriers put the baby in the position that supports the legs just as a mother’s arms would. The flexed abducted position is what infants are hardwired to assume when picked up. It is what nature intended: legs spread around the mother’s hip, back or torso, with knees bent in a seated position.


Improving Respiration

Proponents of horizontal positioning in early infancy may be concerned with whether the infant actually receives adequate levels of oxygen while being carried. According to Dr. Maria Blois, premature infants placed in an upright position on their mother’s chests had improved respiratory patterns, more regular than in an incubator.

Blois’s study also showed “reduced episodes of sleep apnea [temporary cessation of breathing] and bradycardia [slowing of the heart rate]. Transcutaneous oxygen levels do not decrease, indicating that oxygen saturation is not compromised.” These studies were done on premature infants, some weighing as little as 3 pounds, placed upright on their mothers’ chests. The preferred position for these tiny babies is upright, usually secured by a piece of cloth. If the upright position is safe for a 3-pound preemie, it doesn’t make sense that it could be harmful to a fullterm newborn.


Preventing Ear Infections

Lying horizontally is not only a poor option for your baby’s spine, hips and cranium, it can also contribute to inner ear infections in infants. Gastric reflux of contents into the middle ear causes ear infections. Gastroesophageal reflux disease, or GERD, can be pretty prevalent in infants, as sphincters tend to take a while to fully close.

Parents of infants diagnosed with GERD are advised to carry them upright to ease the symptoms. When infants are placed lying in the horizontal position, not only are the symptoms exacerbated, but gastric juices can enter the immature eustachian tubes, making reflux from the throat into the middle ear more probable. The same may occur when bottle-fed infants are fed while flat on their backs. A slight upright tilt prevents milk from entering the middle ear.

The buildup in the eustachian tube can cause inflammation and a buildup of bacteria, and subsequently an infection. Wearing your baby upright can actually be a preventative measure against ear infections, and can help ease the symptoms of GERD.


Tuning Balance

Another benefit of carrying your baby is that carried babies receive a lot of vestibular stimulation, whereas lying babies do not. Our vestibular system helps us out with our sense of balance and our security in space. When a mother holds her baby, the baby moves back and forth with mom’s walking, and side to side from her swaying or rocking. Mom may stop and turn and reach to grab something, or she may move gently and smoothly. These varied movements force her baby to respond appropriately to keep himself balanced. All of these movements tune her baby’s vestibular system.

A stroller moves either forward or backward, offering movement on a single plane, and not very varied. When changed from the upright position and the containment of his mother’s arms to the horizontal position laying down uncontained, a baby may produce random movements and suddenly flail his arms and legs, as if to save himself from falling. This is called a baby’s Moro reflex. It acts as a baby’s primitive fight/flight reaction, and is replaced later in life by an adult’s startle reflex.

Carrying, rocking and swaying stimulate an infant’s vestibular apparatus and help them to feel secure in space. Most babies today spend most of their day apart from their mothers in a container or in a stroller, leaving them prone to vertigo, and a feeling of physical insecurity in space in general. Native Americans are typically very secure in space; they are actually known for their comfort with heights and apparently tend to have little problem working tall construction projects. Most traditionally raised Native American babies are swaddled or spend most of their infancy either in cradleboards or on their mothers’ hips, leading to enhanced vestibular development. Interestingly enough, the fear of flying and the fear of heights which plagues many of today’s adults can often be traced back to not being carried as an infant. Carried babies feel secure, and are less apt to develop space-related phobias.


Constantly Learning

Babies have reason to feel secure. They physically need to be in close contact with their mothers. They giggle and coo and drink in all of our expressions. Upright on mother, they are able to view the world unobstructed from a safe place and can learn about everything around them. Not only are babies better off physically when upright, but they are happier and calmer. In her book, The Vital Touch, Dr. Sharon Heller writes, “The more time that babies spend vertical, the more time that they are alert and calm. Even newborns that spend most of their time sleeping, stop crying and perk up when picked up and placed on our shoulder. Interestingly, how alert a newborn is relates to where he is. Upright in an infant seat, he is less alert than when upright in arms.… Vertical positioning as optimal in infants makes perfect sense. Think of how much time our infants spend horizontal—flat on their back in a crib or a buggy. Might this affect their alertness? There’s a good chance.… Researchers found that infants too young to sit independently learn more when placed in a vertical position.”