Congenital Dislocation of the Hip and Its Relation to Swaddling Used in Turkey

Kutlu, Abdurrahman; Memik, Recep; Mutlu, Mahmut; Kutlu, Ruhuşen; Arslan, Ahmet

doi:10.1097/01241398-199212050-00006

Cited by 30 publications

(43 citation statements)

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“…Prospective trials have linked tight swaddling with the legs in extension and adduction with increased incidence of congenital hip dysplasia. 14 Therefore, a swaddling technique that allows hip flexion and abduction is important. Other reports have linked tight chest swaddling with increased risk for pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Arousals in Supine Infants While Swaddled and Unswaddled During Rapid Eye Movement and Quiet Sleep

2002

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ABSTRACT. Objective. Supine sleep is recommended for infants to decrease the risk of sudden infant death syndrome, but many parents report that their infants seem uncomfortable supine. Many cultures swaddle infants for sleep in the supine position. Swaddled infants are said to "sleep better"; presumably they sleep longer or with fewer arousals. However, there have been no studies of the effect of swaddling on spontaneous arousals during sleep. Arousal is initiated in brainstem centers and manifests as a sequence of reflexes: from sighs to startles and then to thrashing movements. Such "brainstem arousals" may progress to full arousal, but most do not.Methods. Twenty-six healthy infants, aged 80 ؎ 7 days, were studied during normal nap times. Swaddled (cotton spandex swaddle) and unswaddled trials were alternated for each infant. Sleep state (rapid eye move- ment [REM] or quiet sleep [QS]) was determined by behavioral criteria (breathing pattern, eye movements) and electroencephalogram/electrooculogram (10 infants).Respitrace, submental and biceps electromyogram, and video recording were used to detect startles and sighs (augmented breaths). Full arousals were classified by eye opening and/or crying. Frequencies of sighs, startles, and full arousals per hour were calculated. Progression of events was calculated as percentages in each sleep state, as was duration of sleep state.Results. Swaddling decreased startles in QS and REM, full arousal in QS, and progression of startle to arousal in QS. It resulted in shorter arousal duration during REM sleep and more REM sleep.Conclusions. Swaddling has a significant inhibitory effect on progression of arousals from brainstem to full arousals involving the cortex in QS. Swaddling decreases spontaneous arousals in QS and increases the duration of REM sleep, perhaps by helping infants return to sleep spontaneously, which may limit parental intervention. For these reasons, a safe form of swaddling that allows hip flexion/abduction and chest wall excursion may help parents keep their infants in the supine sleep position and thereby prevent the sudden infant death syndrome risks associated with the prone sleep position. Pediatrics 2002;110(6). URL: http://www.pediatrics.org/cgi/content/ full/110/6/e70; sudden infant death syndrome, sighs, startles.ABBREVIATIONS. SIDS, sudden infant death syndrome; REM, rapid eye movement; QS, quiet sleep; EMG, electromyogram; EEG, electroencephalogram; EOG, electrooculogram. S upine sleeping decreases the risk for sudden infant death syndrome (SIDS). 1 However, some parents place their infants in the prone sleep position despite these recommendations. [2][3][4] Many of these parents state that their infants seem more comfortable when prone and sleep better. 4 Studies confirm that the prone position decreases frequency of arousals. [5][6][7][8][9] Swaddled infants placed on their backs are said to "sleep better," presumably meaning that they sleep longer or with fewer arousals. Parents commonly report that infants who are back sleepers "startle ...

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Section: Discussionmentioning

confidence: 99%

Spontaneous Arousals in Supine Infants While Swaddled and Unswaddled During Rapid Eye Movement and Quiet Sleep

2002

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“…It is more common in cultures that use swaddling of babies, a manoeuvre that forces the hips into extension and adduction. 9 There is a 9:1 female predominance. Apparently the baby's own female hormones aggravate and contribute to the abnormal looseness of the hip ligaments.…”

Section: Risk Factorsmentioning

confidence: 99%

Risk factors and diagnosis of developmental dysplasia of hip in children

Agarwal

Gupta

2012

Journal of Clinical Orthopaedics and Trauma

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“…Swaddling of babies has been associated with rickets 23, 24 . Swaddling is practiced in the colder regions of Central Kenya, where the average temperature for the coldest month in some locations, such as Nyeri town, is 10°C.…”

Section: Discussionmentioning

confidence: 99%

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

Karuri¹,

Murithi²,

Irimu³

et al. 2017

Wellcome Open Res

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Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences.

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Congenital Dislocation of the Hip and Its Relation to Swaddling Used in Turkey

Cited by 30 publications

References 0 publications

Spontaneous Arousals in Supine Infants While Swaddled and Unswaddled During Rapid Eye Movement and Quiet Sleep

Spontaneous Arousals in Supine Infants While Swaddled and Unswaddled During Rapid Eye Movement and Quiet Sleep

Risk factors and diagnosis of developmental dysplasia of hip in children

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

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