Between grandmothers’ wisdom and doctors’ warnings

For generations, mothers in Oman and around the world have passed down the same trick for soothing a crying newborn: wrapping the baby snugly in cloth to recreate the comfort of the womb. Long regarded as a respected custom and a piece of folk wisdom, swaddling is now drawing closer medical scrutiny, as studies reveal its less comfortable side.
For parents, the appeal is understandable: a calmer baby and the prospect of a quieter night. But during those early months, when an infant’s joints are still developing, how the cloth is wrapped matters.
Deeper Sleep, Less Crying
There is a reason the technique has endured. Newborns have what is called the Moro reflex, an involuntary startle response that makes them fling out their arms at a sudden noise or movement, as if they are falling. It can jolt them awake in tears.
Swaddling limits this movement, recreating something of the snug containment of the womb. That combination helps explain its reputation as a near-magical calming tool.
Paediatrician Harvey Karp advocates swaddling as a way to soothe fussy babies. The American Academy of Pediatrics (AAP) also acknowledges that, when done correctly, it can help calm infants and improve their sleep.
The reassurance, however, comes with a condition: a snug wrap must still leave room for a growing baby to move.

Risks to Growing Hips
While parents focus on settling their newborn, the baby’s hip joints are still taking shape. Traditional swaddling straightens the legs and presses them tightly together, holding the hips in a position they are not built for.
At Azadi Teaching Hospital in Duhok, Iraq, researchers followed 110 newborns whose families continued traditional swaddling despite warnings against it shortly after birth. During the study, conducted between October 2022 and October 2024, the babies had ultrasound examinations at three months and X-rays at six months.
The checks found developmental dysplasia of the hip in 6.4 per cent of the infants. The condition was significantly associated with being female, being born breech, being a first-born child and having a family history of hip dysplasia. The left hip was most commonly affected.
Such concerns have prompted clinicians to look more closely at how babies are wrapped. Can swaddling offer comfort while leaving the hips free to develop?
A study at the A.I. duPont Hospital for Children explored how different swaddling techniques affect hip stability, including in babies whose hips were already unstable. Its findings suggested that wrapping that allows the legs to move freely is unlikely to cause hip problems, whether a baby has normal hips or is receiving treatment with a Pavlik harness.
The findings were more troubling when swaddling held the legs straight and restricted movement. In one case, tight swaddling caused an unstable hip to dislocate. Even some products marketed as only mildly restrictive interfered with treatment in three babies wearing a Pavlik harness for hip dysplasia.
More research is needed to understand the long-term effects on hip development. For parents and caregivers, these early findings underline the need for caution with techniques that keep a baby’s legs tightly bound.
Keeping Comfort Safe
Medical advice leaves room for the tradition to continue, but with some adjustments. Major medical bodies have not called for an outright ban on swaddling, recognising that it can be beneficial when done correctly.
Caregivers should leave enough room for the hips and knees to bend and move freely, rather than forcing the legs straight. Babies should always be placed on their backs to sleep, and swaddling should stop at the first signs of trying to roll over, usually between two and four months.
For families who have passed the practice down through generations, the familiar aim remains the same: helping a newborn feel secure. Part of that comfort is knowing when to loosen the folds — and when to put the swaddling cloth aside.