Swaddle Safety Tips - Ask the Expert

June is Child Safety Awareness Month and also Hip Dysplasia Awareness Month.

Karen Barski is a mom of five, RN, and inventor of the Woombie baby swaddle, the best baby swaddle that is safe.

QUESTION: What is hip dysplasia?

ANSWER: The National Hip Dysplasia Institute explains it best: Improper swaddling may lead to hip dysplasia. 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. After birth, it takes several months for the joints to stretch out naturally. So until this time, it's important parents do everything they can to prevent hip dysplasia and keep baby's healthy hips. After 6 months it's rare a baby will develop hip dysplasia since their joints are stretched out by then.

QUESTION: What are the signs of hip dysplasia in a baby?

ANSWER: It's important to follow preventative measures to make sure your baby has healthy hips as they develop. I'll share what these are in a bit. It's hard to detect hip dysplasia because it is known as a “silent” condition according to the International Hip Dysplasia Institute. It does not cause pain in babies and doesn’t normally prevent them from learning how to walk at a normal age. So when parents actually noticed it, it can be when their child is a toddler - at which point surgery is needed to correct it.

Here are some symptoms that parents MAY be able to notice in their babies (pulled from the International Hip Dysplasia Institute):


Asymmetrical buttock creases can suggest hip dysplasia in infants but, like a hip click, an ultrasound or x-ray study will need to be done to determine whether the hips are normal or not.

Hip Click

Hip clicks or pops can sometimes suggest hip dysplasia but a snapping sound can occur in normal hips from developing ligaments in and around the hip joint.

Limited Range of Motion

Parents may have difficulty diapering because the hips can’t fully spread.


Pain is normally not present in infants and young children with hip dysplasia, but pain is the most common symptom of hip dysplasia during adolescence or as a young adult.


A painless but exaggerated waddling limp or leg length discrepancy are the most common findings after learning to walk. If both hips are dislocated, then limping with marked swayback may become noticeable after the child starts walking.

QUESTION: How can parents prevent hip dysplasia?

ANSWER: Some babies are born with hip dysplasia, but many develop it from incorrect swaddling techniques. Although it cannot be prevented 100{3eef1f002d1e0193b4b964844dbc64e3636761dc336ac7205011e67901c7a764} there are some things parents can do to reduce the risk greatly. Whether swaddling, in a baby swing (for a prolonged period of time), or in a baby carrier, parents must have baby's legs in the right position to support healthy hips.

"The unhealthiest position for the hips during infancy is the opposite of the fetal position when the legs are held straight in extension with the hips and knees stretched out and the legs brought together. The risk to the hips is greater when this unhealthy position is maintained for a long time. Healthy hip positioning avoids positions that may cause or contribute to development of hip dysplasia or dislocation. The healthiest position for the hips is for the hips to fall or spread (naturally) apart to the side, with the thighs supported and the hips and knees bent." (International Hip Dysplasia Institute).

We call it the Froggy Position - legs up and out like this:

QUESTION: How should parents swaddle a baby safely to keep hips healthy?

ANSWER: The Woombie baby swaddle is the original peanut-shaped swaddle that offers a full 9 inches of EXTRA hip space on the bottom peanut of the swaddle compared to the top peanut. Babies are able to position their legs up and out without being restricted.

According to a recent research study, infant swaddling with any restriction of leg movement may harm unstable hips increasing the risk of hip dysplasia or dislocation. The Woombie baby swaddle is the ONLY swaddle that gives an EXTRA 9 inches of room for baby's hips. In fact, it was quite alarming to see many of the Woombie knock-offs which have become popular swaddles on the market today, do not promote the healthy hips positioning babies need to safely be swaddled.

Babies love the hips-out-froggy position and any swaddle baby uses should support this position and any other position baby wants to move their legs naturally.

QUESTION: Tell us more about this new study.

ANSWER: It's best to quote the actual study: “Physicians at A.I. duPont Hospital for Children in Wilmington, Delaware used dynamic ultrasound to examine infant hips while being swaddled using different methods. These methods included (1) tight traditional swaddling with the legs straight and together, (2) hip-healthy swaddling with plenty of room for full hip movement, and (3) commercial sleep sacks with upper body swaddle that might limit hip movement when the sack size was too small or the upper body wrap extended down over the hips.

“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.” (SOURCE)

QUESTION: What are the five key features a baby swaddle should have in order to keep baby safe not only from hip dysplasia but to reduce the risk of overheating and suffocation which are both factors of SIDS?

ANSWER: When inventing the Woombie swaddle 13 years ago as an RN and mom of three at the time, we knew how important it was to create a swaddle that mimicked the womb environment, snug enough to feel safe and secure like baby is being held, but stretchy enough so baby can move naturally just like they did in mama’s belly. Hip health has been one of the most important features from day one and with our unique ergonomic design we have the safest swaddle for babies on the market.

The five must-have features a baby swaddle should have are:

  1. Plenty of extra room on the bottom of the swaddle so baby can comfortably be in the hips open froggy position. Legs should not be extended down with hips locked.
  2. Ability to move naturally. A swaddle should gently cocoon baby, yet allow baby to move naturally in any position.
  3. Babies should be swaddled in the hands-over-heart position which is he preferred sleeping position of babies and helps them learn the crucial skill of self-soothing (meaning they learn to fall asleep on their own).
  4. Choose a swaddle that requires NO wrapping. The traditional wrapping of a blanket to swaddle baby poses a suffocation risk since swaddle blankets often come unraveled and can cover baby’s face. (Not to mention the origami skills that are difficult for parents to learn causing swaddle anxiety.)
  5. Breathable fabrics such as cotton/nylon blend, bamboo, merino wool, and other moisture-wicking materials should be used in a baby swaddle.

QUESTION: Since it's also Child Safety Awareness Month, what are other safe sleep tips you have to share?

ANSWER: Yes, there are very important safe sleep guidelines that parents need to know and follow.

Always place baby on his back to sleep.

Many studies have found that there is a higher incidence of SIDS among babies who are placed to sleep on their stomachs. It is thought that sleeping on the stomach narrows the baby’s airway and causes difficulty breathing. There is also a possibility that an infant sleeping on his stomach is “rebreathing” his own exhaled carbon dioxide. Baby must be put to sleep on his back throughout the first year of life. Swaddling helps baby sleep on their backs and helps prevent sleep-deprived parents from placing baby on their stomach to sleep.

Keep baby’s crib clear of blankets and toys.

The crib should only have a swaddled baby and a tight-fitted sheet and that's it! And if you are using the SafeSleep Breathe-Through crib mattress this requires no sheet at all (more on this below). You never want to put blankets, comforters, bumpers, stuffed toys or pillows anywhere near the baby while she is sleeping. Baby’s head and face must remain free of any blankets or coverings. By keeping the crib clear it can prevent rebreathing and suffocation.

Practice safe swaddling.

A Pediatrics study suggests that babies who are swaddled experience a more restful sleep than unswaddled babies and can awaken more easily in response to noise, potentially decreasing the risk of SIDS.

For safe swaddling parents should always:

  • Use a swaddle where baby can have good hip range of motion; swaddling too tightly and in the wrong position can cause hip dysplasia as we already covered.
  • The preferred sleeping position for babies is the “hands over heart” position; use a swaddle that does not pin baby’s arms to the side. Babies (and especially babies with colic) can self-sooth and settle by using their hands and fingers in the natural “hands to heart” position just like babies do in the womb.
  • Use a swaddle that will not unravel- this prevents blankets from becoming lose and covering baby’s face. Choosing a no-wrap style swaddle is safest.
  • Don’t over-swaddle baby or double swaddle- overheating baby is linked to SIDS. All Woombie swaddles are made with breathable cotton or bamboo. Plus we have swaddles designed to allow excess heat to escape - great for warmer months or climates.

The Woombie Air

Summer Woombie - True Air

Venti Flo Mod'Swad

  • When baby begins to roll, it’s no longer safe to swaddle with arms over heart. To transition baby to arms-free sleep, take one arm out of the swaddle at nap time and then when baby is used to it, try it at night time. Take out the other arm and remove the swaddle completely or switch to an arms-free sleep sac such as the Convertible Woombie.

Convertible Woombie

Keep baby at a comfortable temperature.

You don’t want baby to get too warm while sleeping. It has been suggested that babies who get too warm go into a deeper sleep making it more difficult for them to awaken. KidsHealth.org suggests keep the room at a temperature that feels comfortable for an adult in a short-sleeve shirt.

Many experts recommend that the temperature in the room where a baby's sleeps be kept between 68–72°F (20–22.2°C). Always check baby by touching the back of their neck - if sweaty, then baby is too hot. Never check a baby's temperature through the hands or feet because these will always be cooler than baby's core temperature (heat dissapates through the extremities).

First Candle, a national nonprofit health organization uniting parents, caregivers and researchers nationwide with government, business and community service groups to advance infant health and survival, says, “When a healthy baby becomes overheated their brain recognizes the problem and attempts to correct it. When a baby predisposed to SIDS overheats, nothing happens to correct the situation.”

Place baby on a firm sleep surface.

It’s important to use a safety-approved, firm mattress covered with a fitted sheet and avoid placing baby on a pillow, waterbed, couch, chair or other soft surface. This can help prevent smothering or suffocation.

The safest crib mattress for baby is from SafeSleep - if baby is sleeping face-down (or rolls over in the middle of the night and becomes face down), baby can breathe right through the mattress normally. It's an incredible invention that Woombie recommends to be the best baby crib mattress on the market. Very sadly, the two sisters who invented this product lost a baby simply because they rolled over in the middle of the night and could not roll back over.

QUESTION: Where can moms follow Woombie and learn more.

ANSWER: We would love to connect with moms on Instagram @woombieusa and our Facebook page.

Also, visit our website at www.woombie.com - here's an exclusive deal code to use all the month of JUNE 2020. Get 15{3eef1f002d1e0193b4b964844dbc64e3636761dc336ac7205011e67901c7a764} site-wide with code TLMC.


Karen is an experienced media expert, RN BSN of over 25 years, wife and high energy mom of 5 (including twins!). She is an Infant Care Specialist, business coach, inventor, and author.


The Woombie baby swaddle has dominated the swaddle market for over a decade being the first to invent the peanut-shaped, NO WRAP swaddle. From what started as a mom being creative to help her baby sleep, has now grown to a multi-million dollar global brand helping over a million babies and counting. The Woombie’s signature one-step swaddle takes the guesswork out of swaddling and helps to eliminate risks associated with SIDS such as overswaddling/overheating and swaddle coming unraveled and covering baby’s face.

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