Swaddling has been in practice by many cultures throughout the centuries and has become increasingly popular in North America in the past ten years. In general, swaddling is tightly wrapping your baby in a blanket to restrict the movement of his limbs.
As simple as it may seem, swaddling comes with risks and benefits. There are some major safety concerns that every parent should be aware of if you are swaddling your baby. These risks include SIDS, hip dysplasia, pneumonia, and over-heating. However, if swaddling is done properly and safely many of those risks can be avoided.
Plase keep in mind the following information and research is based upon swaddling babies at night. It is not recommended that you swaddle your baby during her wakeful hours, as she needs time to move and explore her world and environment. If you decide that swaddling is not for you there are alternative techniques to help get your baby to sleep at night.
A Safe Way to Swaddle
The first step is to learn how to safely swaddle your baby.
- Her legs and hips should not be wrapped so tightly as to restrict movement.
- Legs should be free to move up and out. Consider using a roomy swaddle sack.
- Her arms are bound firmly but not too tightly. Avoid too much pressure on her chest.
- When swaddling your baby for sleep, NEVER lay her down on his stomach. There is a high correlation between SIDS and babies who are swaddled and laid on their tummy to sleep.
- Be aware of her temperature. Sometimes just a diaper underneath is appropriate.
- Only swaddle to calm your baby or for sleeping. Ensure she is unwrapped during wakeful periods for movement and activity, as well as during feedings.
- Make sure breastfeeding is established before you begin swaddling. If your baby is sleeping longer intervals be sure that you wake her up to feed regularly.
- Swaddling should be discontinued if your baby is rolling or close to rolling.
This video shows the triangle technique that may be helpful to swaddle your baby without any compression issues with the hips or chest:
Benefits of Swaddling
Please be aware that the following list of benefits assumes that your baby is swaddled safely.
- Your baby may sleep longer and deeper (this is also a risk factor)
- Can be used as a calming technique to reduce crying
- Young babies, when swaddled, cannot wiggle into compromising positions in their cribs
- Reduces the risk of your baby rolling on to stomach
- Reduces flailing arms which could startle and wake your baby
- Can help your baby feel as though she is still in utero
Swaddling and SIDS
The most common prevention of SIDS is to lay babies on their backs to sleep. While swaddling can help young babies (usually 4 months or younger) remain in this position, older babies who can roll over (or even younger ones who accidently manage this maneuver) actually increase their risk of SIDS by becoming stuck on their stomach. The added risks of overheating, difficulty in rousing or ending up with a blanket over their face are all other SIDS risk factors.
Risks Associated With Swaddling
- Swaddling may impede breastfeeding.Since swaddled babies can sleep longer and deeper she may feed less frequently. This can also affect weight gain in the early days after birth.
- Can reduce the ability to self-sootheYour baby may naturally soothe and comfort herself when tired and drowsy. This can include thumping her legs, sucking on her hands, a blanket or lovey, and rubbing her face with her hands.
- Over heatingWhen your baby is swaddled and her environment is too warm, she can easily overheat. If she is damp from sweat, this means that she is on the verge of overheating.
- HypothermiaSurprisingly, swaddled babies are not necessarily warm and cozy. Studies have shown that swaddled babies can have a lower body temperature then non-swaddled babies.
- Hip dysplasiaThis joint disease can be the result of tight swaddling which immobilizes the hips and legs and forces them in a straight position for pro-longed periods of time.
- Respiratory compression leading to infection and pneumoniaWhen your baby is swaddled tightly it can compress her chest, not allowing the lungs to fully expand. Trapped air in the lungs can lead to respiratory infections and may cause pneumonia.
Alternatives to Swaddling
There are other methods you can use instead of swaddling that will ultimately have the same calming effect and can help your baby fall asleep. Also see How To Sooth a Fussy Baby.
- RockingGently rocking your baby either in a rocking chair or standing up and doing the “figure 8” with your hips creates a soothing motion that will help her fall asleep.
- Skin to skin contactSkin-to-skin contact is always a good way to help comfort your baby. Skin-to-skin also regulates her body temperature, heart rate and breathing, stimulates digestion, and helps both both you and your baby relax.
- WalkingJust like rocking, walking with your baby can create a calming motion that will help your baby to fall asleep.
- Breastfeeding your baby
- Babywearing
Resources:
O’Mara, Peggy. “The Question of Routine Swaddling”
Bregje E. van Sleuwen, Adèle C. Engelberts, Magda M. Boere-Boonekamp, Wietse Kuis, Tom W.J. Schulpen and Monique P. L’Hoir. “A Systematic Review of Swaddling” Pediatrics 2007;120;e1097 DOI: 10.1542/peds.2006-2083
Ksenia Bystrova*1,2, Ann-Marie Widström*1, Ann-Sofi Matthiesen1, Anna- Berit Ransjö-Arvidson1, Barbara Welles-Nyström1, Igor Vorontsov2 and Kerstin Uvnäs-Moberg. “Early lactation performance in primiparous and multiparous women in relation to different maternity home practices. A randomised trial in St. Petersburg” International Breastfeeding Journal 2007.
Ksenia Bystrova*1,2, Ann-Marie Widström*1, Ann-Sofi Matthiesen1, Anna- Berit Ransjö-Arvidson1, Barbara Welles-Nyström1, Igor Vorontsov2 and Kerstin Uvnäs-Moberg. “Early lactation performance in primiparous and multiparous women in relation to different maternity home practices. A randomised trial in St. Petersburg” International Breastfeeding Journal 2007.
Bregje E. van Sleuwen, Adèle C. Engelberts, Magda M. Boere-Boonekamp, Wietse Kuis, Tom W.J. Schulpen and Monique P. L’Hoir. “A Systematic Review of Swaddling” Pediatrics 2007;120;e1097 DOI: 10.1542/peds.2006-2083
Mahan ST, Kasser JR (2008). Does swaddling influence development of dysplasia of the hip? Pediatrics, 121 (1), 177-8
Sahin F, Akturk A, Beyazova U. et al (2004). Screening for developmental dysplasia of the hip: results of a 7-year follow-up study. Pediatrics International, 46(2):162
Yurdakok K, Yavuz T, Taylor CE. (1990) Swaddling and acute respiratory infections. American Journal of Public Health, 80:873-875