Swaddling

 

Swaddling, or wrapping a baby’s body in a thin blanket or sheet, has been practiced for centuries. Many modern parents love it and say it promotes both sleep and security for the baby, but some fear that it may not be safe and could even lead to suffocation, sudden infant death syndrome (SIDS), or some other form of sudden unexpected infant death (SUID).

Competing Opinions

Perspective #1: Swaddling calms infants when they’re upset, and it promotes sleep by re-creating the security and snugness of the womb. Swaddled babies spontaneously wake up less often and cry less than those who aren’t swaddled.

Perspective #2: The risks associated with swaddling outweigh any benefits. SIDS isn’t the only danger. Swaddling can also lead to overheating, and it can affect a baby’s physical development and even cause hip dysplasia.

What the Science Says

WHILE THERE’S NOT a conclusive body of research, the science seems to point to the fact that swaddling presents minimal risk if precautions are taken and it’s done the right way. Certain hazards do exist. For example, swaddling too tightly around the hips seems correlated with the possibility of hip dysplasia, though it’s not clear whether such swaddling actually causes the dysplasia or simply worsens the condition in infants already predisposed to it. But this problem appears to be avoided when you use a safe, “hip-healthy” technique, where the swaddling is loose around the hips.

As for SIDS, a 2016 meta-analysis and a 2017 integrative review both found that, while consistent and conclusive research studies were limited, there didn’t appear to be a clear association between swaddling and SIDS. Instead, the link existed more clearly between SIDS and unsafe swaddling techniques, like using thick sheets or blankets that could lead to overheating, or placing a baby on his front or side rather than laying him on his back.

Research does support the claims of swaddling proponents, finding that babies wrapped securely have greater “sleep efficiency.” They are less likely to wake themselves as a result of hypnagogic startles, the involuntary reflex that results in a sudden body jerk. Swaddling has been found to be soothing when an infant is overstimulated, and it can help him cry less often.

The Bottom Line

THIS IS ONE of those decisions that’s entirely up to you. If you decide to swaddle, having understood the risks and benefits, be sure to read guidelines for safe and effective swaddling. These will likely involve placing your baby on his back, watching out for overheating, wrapping him securely so he can’t unwrap himself (but not so tight that his legs and feet can’t move freely), and making sure to stop swaddling as soon as he shows signs of rolling over on his own. A quick online search will lead you to more specifics about the dos and don’ts of swaddling.