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PEDIATRICS Vol. 110 No. 6 December 2002, pp. e78

ELECTRONIC ARTICLE

Risks of Ancient Practices in Modern Times

Josephus Petrus Johannes van Gestel, MD*, Monique Pauline L’Hoir, PhD{ddagger}, Maartje ten Berge, MD§, Nicolaas Johannes Georgius Jansen, MD, PhD* and Frans Berend Plötz, MD, PhD||

* Pediatric Intensive Care Unit
{ddagger} Departments of Medical Psychology
§ Pediatrics, University Medical Center, Utrecht, the Netherlands
|| Department of Pediatrics, St Antonius Hospital, Nieuwegein, the Netherlands

--> Swaddling, ie, wrapping the child to restrict movement, is an ancient practice. In the Netherlands, it is becoming increasingly popular as an intervention for excessive crying in infants. However, one must be well aware of the potential risks. We present the case reports of a twin boy and girl who had been swaddled and kept in a heated room for several days. On admission to the hospital, both infants suffered from severe hypovolemic shock, hyperthermia, and secondary respiratory insufficiency. The girl developed multiple organ dysfunction syndrome and died, whereas the boy had an uneventful recovery. When swaddling is being considered as an intervention for excessive crying in infants, parents have to be well-informed about the possible side effects and about additional measures that they may have to take to make it a safe intervention.

Key Words: swaddling • hyperthermia • complication • risk • excessive crying

Abbreviations: bpm, beats per minute • PICU, pediatric intensive care unit

Received for publication May 13, 2002; Accepted Aug 9, 2002.