As a breeder of Labradors for over 20 years, I have encountered what we refer to as "swimmers" occasionally.  It is a puppy that cannot get up on his feet and start walking at the appropriate age, usually around 2 weeks.  I'm not going to go into all the possible reasons for this (as there's a lot of information and speculation on the internet), but in almost all cases is due to a newborn puppy lying flat on his belly, with arms and legs sprawled out, rather than on his side.  Some think there's a correlation to the puppy position in the uterus.  I, personally, think it's simply the result of a newborn puppy choosing to lay on his belly in the first couple days of life.  In many cases the chest will become flattened very quickly; sometimes it affects only the front, sometimes only the rear, sometimes both.  I had a puppy years ago that became flat on the chest by 3 days of age.  Once that happens, the puppy is not comfortable on his side ... he tends to roll over on his belly again, or even onto his back.  If the chest cavity flattens, it is of real concern, as it compresses and heart and lungs; this sometimes results in a puppy who is not thriving like the rest of the litter.  If left too long, it can possibly result in some permanent damage.  Thus, many vets recommend that a "swimmer puppy" be euthanized.

The quite common practice of euthanizing swimmmers is outrageous to me, as it is to most of the good dedicated, established breeders I know.  I put this information together primarily to help novice people who have a swimmer puppy and have no idea of what to do.  If it saves only one puppy from being euthanized, it's well worth the effort.  I have had puppies with chests as flat as a pancake, some affected in both front and rear legs, and I have saved every one of them.  But it took a lot of work, time and trying many different techniques.  And, to save a swimmer, one needs to intervene at a very early stage ... as soon as you see the beginning of flattening of the chest, or a puppy who's always laying on his belly.  And, I mean watching for this problem from day one.

Preventive measures include carefully monitoring the newborns in the first couple days.  Keep turning puppies onto their sides, even when nursing.  That's about all you can do at that age.

If you encounter a puppy who's always on his belly, and/or is starting to go flat on his chest (or his hips are spreading out), you can start propping the puppy on a pillow or fluffy blanket; or roll up soft towels or big stuffed animals around him.  The purpose is to position him comfortably on his side,  get him back to sleep, and hope that he isn't readily able to roll onto his belly again. 

The big concern comes when the puppies approach 2 weeks, the time they should be trying to get up onto their feet.  A swimmer puppy simply can't.  And the bigger and heavier they get, the more challenging it becomes.  Again, I'm not going to go into details of some techniques to try at this stage, as they can be found on the internet.  But, here are a few that have been tried with various levels of success:

1. Make the bedding soft so a flat chest isn't resting on a hard surface when you're not watching.  Put pillows, big stuffed toys and fluffy blankets in the whelping box so the puppy can climb up on them and pad his body.  Then, whenever you can, continue the efforts to get the puppy to sleep on his side.  Lay him on a pillow or fluffed up blanket, pad him on both sides so he's not likely to roll over.  (Note that the temperature in the room may be significant.  In the first two weeks, you need to keep the whelping area quite warm, as newborns cannot maintain their own body temperature.  If it's too hot, the puppies don't pile up; they spread out, often sleeping flat.  Ideally, you want to see the puppies comfortably warm, but piling up on each other for additional warmth.  This helps them from going flat.)

2. Bind the puppies affected legs with a first aid tape.  You need to try to pull the legs together at the right point, making a figure-8 in-between the legs.  The goal is to make it impossible for the puppy to lay on his belly with his legs sprawled out to the sides;  and to hold them in, under him, as he starts trying to get up and walk.  I've done this numerous times with various degrees of success.  It's difficult to get the bindings precisely at the right place, and they tend to come loose, etc.  But definitely worth the effort.

3. Try the "sock" technique, cutting holes for the legs in an old sock, padding the sock with soft stuffing under the flattened chest.  I have tried this and found it virtually impossible to fit the sock to the point that it accomplishes anything, but there are examples/pictures on the internet.

4. Put a big piece of egg-carton foam in the whelping box.  Goal is to give good footing.  But, I found the puppy just tripped over the lumps ... and, of course, it got saturated with urine, etc.

5. Physical therapy.  Yes, definitely worth the effort!  I have no experience in therapy but it's just common sense if you evaluate precisely what is wrong ... what is in the wrong position or shape, what is not moving in the right direction, etc.  I have held puppies on my lap and done therapy exercises 2 or 3 times a day.  If the chest is flat, I gently squeeze in from the shoulders; at the same time, I pull one front leg straight out (as it should be if he were standing), then back in, then back out.  Then do the other front leg.  If the hips are spread out and rear legs affected, I gently squeeze the hips inward; then pull a hind leg straight forward and back in a bicycle motion, making sure to allow a bending at the hock (as would happen if taking a step forward).  I normally hold the leg near the hock, but if a foot is twisted in or out, you need to correct that positioning at the same time.  You do need to be careful, make sure you're not manually stretching something too far for the condition of the puppy's muscles and tendons.  If a puppy seems to have had enough of the exercises, I often have simply massaged the shoulders inward, and massaged the hips inward.  Occasionally a puppy starts to "fight" the rear leg exercise; then, with his rear pads in my hand, I let him push a few moments in his struggle; I think that's beneficial as he's really using those muscles in a positive, correct manner.  I firmly believe that these daily exercises have given my swimmer puppies a tremendous advantage in overcoming the problem. 

6. Swimming.  Although I haven't tried this technique, I believe it would be a very constructive exercise.  You can use a towel as a sling under the puppy's belly and carefully lower him into water.  He instinctively should start to do a dog-paddle, thus using those muscles in a correct manner.  I think this could help, but it's not putting any weight on the muscles ... may not give results as fast as if you could get him walking on his feet.  Lukewarm water in the bathtub or big sink should work.

7. Give the puppy good traction under his feet.  This is essential for allowing the puppy to build the muscles that will let him start to walk properly.  We have used all sorts of things.  I've spent days searching for carpet scraps that might provide good footing, others have used rubber-backed carpets or rugs turned rubber side-up ... which must result in a mess of pee and poop in the whelping box!  But this essential need is the inspiration for my new idea (below) to give a puppy the traction he needs to develop his muscles and basically correct himself.

Depending on the circumstances and the age, I would try doing #1, #2, #5, #6 and #7 ... all techniques at the same time. 

My New Idea For Good Traction - my "Traction Mat"

I came up with this idea just 8 days ago when I had a big puppy, one of only two, who couldn't get up on his feet by 3 weeks of age.  The front hadn't gone flat, but his rear legs were twisted, one knee stuck out; all he could do was push his rear.  I had been constantly turning him on his side, propping him up on a blanket, and doing some physical therapy already.  I tried binding his rear legs but it just didn't accomplish anything.  And, it was really time that he got on his feet and built up those rear muscles.  I had a scrap of the rubber mesh material used for lining kitchen and tool box drawers; I laid it on the floor, put him on his feet on it and his traction was amazing!  Of course, it moved around, wrinkled and he tripped over the wrinkles.  But I knew I was on to something and that could be remedied.

I looked in the garage and found a piece of pressed board about 3' x 5'.  (Smooth plywood would be better but the pressed board was all I could find quickly.)  I spray painted it with a waterproof paint on the top side, left it to dry.  I wanted it waterproof so I could clean it, particularly if I needed to leave it inside the whelping box.

I ran to the Dollar General store and bought a couple rolls of the rubber drawer lining, 18" wide was the widest.  I stretched the material across the board, stapled on the back side, then stapled down the seam on the front.  I hammered the staples down so they'd be completely flush with the board. 

If I hadn't been in a hurry, I would have spray painted the back side also, as I want to have it re-usable.  But, I can spray paint the back side later, after I've hosed and sterilized the mat in the sun.

I put the mat down on the whelping room floor and set the puppy down, positioning his feet as best I could.  It was immediately amazing!  This puppy really wanted to walk, and he started trying ... with more success than I expected.  He had such good traction, and it was so solid and unmoving under him.  I'd call him to the opposite end of the mat, then praise him like crazy.  He seemed so proud of himself!

I worked with the puppy on the mat two or three times a day.  Within 2 days, the improvement was dramatic.  Within 4 days, his body was correcting itself ... his twisted foot rarely twisted on him and the knee didn't stick out nearly as much.

I have some video below that shows how he walked on the mat, then what happened when he moved off of it and fell to pieces.  He was smart enough to know that, if he wanted to walk, run, etc, he'd have to get back on the mat.

Within a week, this puppy is walking, running, and hopping around almost normal!  Even on the whelping box bedding, even on the slippery tile floor.  It's been an amazing experience to watch.  I did continue doing physical therapy with his legs for about the first 3-4 days, then realized that he didn't need that anymore.

Here's a couple pictures of when we started.

Advantages of this idea are:  (1) it provides outstanding, stable traction, (2) it can be cleaned/sterilized and saved and re-used for a future puppy, and (3) it's inexpensive and easy to make.  As long as you paint both sides and edges of the board, you can spray it with disinfectant, hose it off and dry it in the sun.  It even could be put inside the whelping box if you don't think you can spend enough time with the puppy on the mat outside the box.  (In that case, you may want to make two mats, so you can clean and rotate them.)

Here's a couple pics of another puppy that I worked with some years back; he was flat on the chest and had issues with both front and rear legs.  He turned out completely normal ... and beautiful.

4 weeks

8 weeks