Swaddling has been part of caring for babies for centuries — millennia. It makes a baby feel like he’s back inside the womb — or like he is being snuggled close.
It has been shown to help many babies sleep better. In addition, it can be beneficial for babies with neurologic problems or colic or babies born addicted to drugs.
It can also help some parents get their babies to fall and stay asleep on their backs, which we recommend to help prevent sudden infant death syndrome or SIDS.
Some babies have trouble sleeping on their backs because they startle themselves awake; that’s less likely to happen when they are swaddled.
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What Is Swaddling?
Yes, if you follow safe sleeping and safe and hip friendly swaddling guidance for babies.
Current baby sleeping advice is to always lay your little one down to sleep on their back and avoid front or side positions for rest, especially if your baby is swaddled.
In addition, you should stop swaddling your baby when they show the first signs of rolling over.
Swaddling is a way to make your baby feel safe and comfortable by wrapping the baby in a blanket.
The technique is helpful when babies fuss and fidget, especially when going to sleep.
If you are going to swaddle your baby, there are a few safety recommendations you need to be aware of.
Swaddling has not been shown to protect against SIDS or other infant sleep-related deaths. Remember these few safety tips to prevent the risk of injury.
Ensure the swaddling is snugly wrapped around the baby so the blanket does not loosen during the night.
Remember, no loose blankets or bedding are ever allowed in the crib with your baby. If the swaddling becomes unwrapped, this puts your baby at risk of suffocation.
However, the swaddle should not be so tight that the baby cannot breathe or move its hips.
Make sure you are placing your baby on their back, in a crib, after being swaddled. Studies have shown wrapping your baby and placing them on their side or stomach will double their risk of SIDS.
Remember: Babies do not need to be swaddled all day, just when fussy and sleep time.
But there are downsides to swaddling. Because it keeps the legs together and straight, it can increase the risk of hip problems.
And if the fabric used to swaddle a baby comes loose, it can increase the risk of suffocation.
Another warning about swaddling comes from a study published in the journal Pediatrics, which found that when swaddled babies were put on their sides or bellies, their risk of SIDS went up a lot.
For those put on their bellies, especially babies more than six months old, the risk doubled.
Although the study can’t tell us exactly why the risk doubled, one can imagine that a tightly swaddled baby might not be able to get her head up if she started having trouble breathing — and if that swaddling blanket came loose. She was face-down; it also might make smothering more likely.
This is what we meant before about common sense. Just because something works sometimes doesn’t mean it’s right for everyone or every situation — and it doesn’t mean you shouldn’t think before you do it.
Here’s what parents should consider when they think about swaddling:
- Babies don’t have to be wrapped. If your baby is happy without wrapping, don’t bother.
- Always put your baby to sleep on his back. This is true no matter what but is especially true if he is wrapped.
- Make sure that whatever you are using to wrap can’t come loose. Loose fabric and babies is a dangerous combination.
For the healthy development of the hips, babies’ legs need to bend up and out at the hips.
Swaddling for short periods is likely fine, but if your baby spends a significant amount of the day and night swaddled, consider using a swaddling sleep sack that lets the legs move.
Swaddling is the practice of wrapping an infant snugly in a square of light fabric, with his head exposed, to calm him.
The practise is widespread and longstanding; societies worldwide have swaddled their babies for centuries, using various methods.
Swaddling has been touted as a helpful tool for calming infants during the first few weeks of life, providing a reassuring closeness when the baby is adjusting to his new environment outside his mother’s snug womb.
For premature infants, additional benefits have been found, including:
- improved neuromuscular development
- less physiological distress
- better motor organisation (muscle control)
- more self-regulatory ability
- pain relief
- better temperature regulation
However, swaddling also has some risks for babies, both premature and healthy, including:
- overheating, which can increase the infant’s risk of sudden infant death syndrome (SIDS)
- suffocation, if the baby rolls over during sleep or the swaddling fabric unravels during sleep
- hip dysplasia (a problem with the formation of the hip joint) or dislocation, if an infant’s legs are positioned incorrectly
- delayed weight gain due to less frequent arousal and less frequent feedings, since babies who sleep more may eat less
- Despite these risks, parents are often taught to swaddle their babies while at the hospital and continue the practice once they are at home. Babies who are wrapped during sleep startle less, arouse less and sleep more.
If you choose to swaddle your baby, you should be aware of the risks so that you can mitigate them.
To reduce the risk of hip dysplasia and dislocation, make sure that your baby’s legs can bend outward and upward.
Do not swaddle your baby with his hips and knees extended. Instead, to reduce your child’s risk of suffocation, place your swaddled child on his back for sleep, and make sure that the swaddling is wrapped correctly and will not dislodge.
To reduce the risk of overheating, use a light blanket, a breathable muslin fabric, or a blanket designed for swaddling. Also, dress your baby lightly underneath, either in just a diaper or a onesie.
Do not use an ordinary full-size blanket. To reduce the risk of slow weight gain, make sure to follow feeding recommendations for your baby; to ensure adequate calorie intake, newborns need to feed at least 8–12 times every 24 hours.
Above all, remember that while it is safe to swaddle infants during the first few weeks of life, you should stop swaddling your baby once he has shown interest in rolling over, which can occur as early as two months of age.
Swaddled infants who roll over are at an increased risk of SIDS or suffocation due to entrapment.
Just in case your baby does roll, be sure to keep your baby’s a sleeping area free from pillows, blankets, crib bumpers, or other “breathing blockers” (and remember that a swaddle wrap that becomes dislodged can become a “breathing blocker” too).
Once your baby has shown an interest in or an ability to roll over—even if he hasn’t mastered the skill yet—retire the swaddling wraps and review other safe sleep practices.
Keep in mind that every baby is different, and some won’t respond well to swaddling at all.
For helping your child to transition to life outside of the womb, many parents find that skin-to-skin care (also called “kangaroo care”) is a better alternative to swaddling. Plus, kangaroo care can continue as your baby grows.
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Does Swaddling Cause SIDS?
Swaddling reduces two everyday parent stressors: Persistent crying and poor infant sleep. Because of this benefit, swaddling is recommended in the American Academy of Pediatrics (AAP) parenting books and educational websites.
Reducing crying and mom exhaustion are key goals because these problems often trigger a terrible cascade of dysfunction and death, including postpartum depression (which can lead to life-long depression, suicide and even infanticide); child abuse/neglect; breastfeeding failure (which can increase SIDS); dangerous sleeping practices (which can increase SIDS and suffocation); marital stress; cigarette smoking (which can increase SIDS); car accidents; overtreatment with medication; and perhaps even maternal and infant obesity
These problems are not rare. The burden of hundreds of thousands of families costs our nation billions of dollars in health care and related expenses.
For example, the AAP promotes swaddling to reduce shaken baby syndrome (which peaks at 3-5 months of age and is usually triggered by a baby’s persistent screaming).
And although there were 22 deaths of swaddled babies reported to the CPSC from 2004-2012, during the same period, 1,024 infant deaths were reported to the CPSC from sofa sleeping (most under three months of age).
Babies are usually brought to the sofa when crying, and then their poor exhausted moms fall asleep while soothing/feeding them.
Is it Dangerous to Swaddle a Baby?
A study of 2,000 moms found that 44 per cent of women reported falling asleep while nursing on a sofa or recliner.
Many of these sleep-deprived moms might not have been tempted to head to the sofa in the middle of the night had their babies been swaddled, calm and sleeping better.
Unfortunately, the study authors chose to completely ignore the possibility that swaddling may prevent SIDS and suffocation by:
Reducing infant rolling: Correct swaddling may make it harder for babies to flip to the more dangerous stomach position.
In a scientific review of swaddling, the Dutch scientist, van Leeuwen, noted, “The physical restraint of swaddling presumably prevents infants from turning prone during sleep before they have gained experience in turning prone and back again when awake.”
That’s important because several studies show that unswaddled babies—who accidentally rollover—are 8 to 38 times more at risk of SIDS.
Reducing unsafe sleeping: Infant death from accidental suffocation in sleep has quadrupled over the past 20 years.
By improving sleep and calming crying, swaddling may reduce a mom’s temptation to put her baby to sleep on the stomach, bring the baby into her bed or fall asleep on a sofa.
Reducing cigarette smoking: Researchers at George Mason University have shown that infant crying can push a mom to restart smoking, clearly tied to SIDS.
Boosting breastfeeding: Crying and exhaustion leads some women to abandon nursing because they’re depressed or doubtful of the adequacy of their milk.
Swaddling can reduce the crying and help mothers get the sleep they need to make more milk. This is important because nursing can reduce SIDS by up to 50 per cent.
No wonder a review of swaddling concluded that back sleeping, while swaddled, was best,
The evidence clearly shows that being supine and swaddled decreases the SIDS risk more than being supine without wrapping.
All in all, it would appear that the advantages of swaddling supine-sleeping infants outweigh the risks if any.
What Are the Benefits of Swaddling My Little One?
Often people say swaddling seems to help calm their little one, helping them settle more easily and sleep for longer. Yet, there is little research to support these theories.
It’s also thought that swaddling prevents unnecessary wake-ups caused by a baby’s startle reflex.
This is because a swaddled baby’s arms and legs will be contained as they’re wrapped gently in a blanket.
That means they will be less likely to startle themselves awake with their flailing limbs.
A growing parenting trend considers the first three months of your baby’s life a transitional fourth trimester.
The idea is that the first three months of your baby’s life is a difficult transition period for them after they emerge from the womb to the outside world.
Considering this, it makes sense that babies would enjoy being wrapped gently (not too tightly) so they feel secure like they did in the womb.
Medical opinion on whether swaddling is a good practice or not is divided. So, if you’re considering swaddling your baby, make sure you always follow safe swaddling guidelines to protect your little one.
What Are the Risks of Swaddling My Baby?
Swaddling your baby carries some risks. It’s potentially unsafe if your baby is not swaddled correctly.
There’s also a risk of your baby overheating if they are wrapped in too many blankets, in covers that are too heavy or thick, or if they’re wrapped too tightly.
It’s not a good idea to wrap your baby while breastfeeding as breastfeeding causes them to get hot quickly, and they might overheat.
Your baby will also have a more natural positioning and latch well on the breast if they are not restricted by swaddling.
Another consideration is that routine swaddling might suppress the baby’s voice, which might delay the baby’s response.
Research has shown that swaddled babies feed less frequently, suckle less effectively and that their inhibited arm movement affects their arousal pathways.
Some evidence suggests that tightly swaddling a baby could increase their chance of developing hip dysplasia (a developmental problem with a baby’s hip joint).
You can help lower this risk by making sure you don’t swaddle your baby too tightly. You can also use hip-healthy swaddling techniques to reduce your baby’s risk of hip dysplasia.
Make sure your baby can move their hips and knees freely to kick. A newborn baby’s legs should be able to fall into a natural position in a frog style.
Sudden Infant Death Syndrome Risk and Swaddling
The effects of swaddling on sudden infant death syndrome (SIDS) is unclear. However, recent decades have seen a general decline in deaths due to SIDS.
This is thought to be because of clear recommendations that it’s safer for babies to sleep on their backs rather than on their front or side.
Swaddling may prevent babies from turning from their back to a face-down position, potentially protecting them from SIDS.
Yet once a baby can roll over, they could be at increased risk of SIDS if they’re swaddled.
This is because head lifting and turning are crucial to avoid suffocation, and that is impeded when a baby’s arms are restrained by its sides when they’re swaddled.
How Do I Swaddle My Baby Safely?
Follow these seven safe and hip friendly swaddling tips:
- Swaddle your baby using thin, breathable materials. Suitable cloth includes cotton receiving blankets, cotton muslin wraps, or specialised cotton-winged baby swaddles. Don’t overlayer them.
- Don’t swaddle your baby above their shoulders – their neck and head should never be wrapped.
- Wrap your baby firmly but gently (not too tightly). Tight swaddling that stops your baby’s hips and knees from moving freely is not recommended. Swaddling your baby too tightly might cause hip dysplasia, which is where the hip does not form correctly.
- Use hip-healthy swaddling techniques to reduce the risk of hip dysplasia. Make sure your baby can move their hips and knees freely to kick. Your baby’s legs should be able to fall into a natural position (like frog legs).
- Always put your baby to sleep on their back. Never place a swaddled baby to sleep on their front or side.
- Check your baby’s temperature regularly to make sure they don’t get too hot or overheat. Check they’re wearing suitable clothes for the weather too.
If someone else looks after your baby, make sure they know about safe sleeping advice and how to swaddle safely.
Take your time to show them and explain safe swaddling and make sure they always know to put your baby to sleep on their back.
When to Stop Swaddling a Baby
It is critical that swaddling is discontinued once an infant approaches the time in development to roll onto the side.
The standard recommendation is to stop swaddling at two months of age. However, if your baby shows signs of early development and can roll to the side earlier, the swaddling must be stopped even sooner.
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