Swaddling is an ancient practice of wrapping up a baby to help them sleep. It's been gaining popularity over recent years, with an estimated 90% of babies in North America being swaddled in their first few months.
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Swaddling recreates the cozy feeling of the womb and can help soothe an infant. Safety, however, is a concern with swaddling because of hip problems or suffocation that can happen when swaddling is not done correctly. So it's important to learn how to do it properly, as well as to know the benefits and risks of swaddling.
Swaddling your newborn can calm them down and help them sleep better and in the right position, on their back. Doctors recommend this sleeping position in babies to lower their risk of sudden infant death syndrome (SIDS). Eventually, your baby will outgrow the swaddle. Here's what you need to know.
Is swaddling safe?
Swaddling can be safe when done correctly. It can help babies sleep better and may be especially helpful with babies born with brain conditions, colic, or an alcohol addiction. It's important to remember that babies don't have to be swaddled, but if they are, loose blankets should be avoided. And if the baby is swaddled for longer times during the day or night, a sleep sack that lets their legs move should be used vs. a fitted blanket.
You can buy swaddling cloths from most baby stores. There are different types of swaddling cloths. Some of them are simple square or rectangular blankets. Others are sack-like and allow you to zip your baby inside. Some have additional flaps on the side that wrap across your baby's body and are secured with sticky strips.
What is a swaddling bag?
A swaddling bag is like a wearable blanket or sleeping bag that can be worn by your baby once they are able to roll over and have grown out of the swaddling stage. Swaddling bags allow your baby to have their arms free and more control of movements. They are worn over clothing or pajamas and can provide comfort without the suffocation risk of loose blankets.
You'll most often swaddle your baby before they sleep and to help calm them when they're fussy. It's important to stop swaddling once your baby starts trying to roll over. This can be as early as 2 months of age. Sleep sacks or wearable blankets that don't compress your baby's arms and chest can be worn up to about the age of 2 or about 30 lbs. Once your baby outgrows a sleeping sack, they should be able to use a blanket.
Follow these simple steps to swaddle your baby safely:
&#;You should stop swaddling your baby when they start to roll over. That's typically between 2 and 4 months. During this time, your baby might be able to roll onto their tummy but not be able to roll back over. This can raise their risk of SIDS.
When it's time to stop swaddling your baby and change their sleep routine, you'll need to transition them. Some babies may be used to sleeping in a swaddle. Taking them out of it might upset them and cause them to cry more during bedtime.
Create a brief transition to help them adjust to their new sleeping method. When they're showing signs of rolling over, you should take the swaddle away. You can replace the full swaddle with a wrap that meets your baby's developmental stage. Be sure to keep their arms free while they're sleeping.
You can still wrap your child with the same method you used for swaddling. Just keep their arms out. You can also use a sleep sack as a helpful tool during the transition.
In a sleep sack, your baby can move around a little. This is different from no mobility with their swaddle. Getting to move around and build their strength is good for their growth. But if they roll over in the night, place them back on their back. Using a sleep sack is also helpful for getting your baby ready to sleep with a blanket when it's safe.
Once your child is done with the sleep sack, you can transition them to a wearable blanket. This will get them closer to sleeping with a blanket when they're older. A wearable blanket lets them move their arms and legs freely without hazards.
Swaddling can help a baby sleep but has both pros and cons. The advantages of swaddling your baby include:
Disadvantages include:
There has been much debate around the positives and negatives of swaddling. Ultimately, it is up to you and your family if you choose to swaddle your newborn.
Ignoring the signs of your baby trying to roll over can be dangerous if you continue to swaddle them. If your baby is fussy and moving more, they can overheat while swaddled. Signs of being overheated include:
After 2 months, you should reevaluate your baby&#;s sleeping situation. Stop swaddling if someone is watching your child for you or they're moving around. Swaddling can be dangerous for babies at any month if it's not done the right way. Because of this, some child care centers refuse to swaddle babies. Some doctors suggest it could be dangerous for children to be swaddled after 2 months.
Another danger of continued swaddling is the increased risk of SIDS. Following safe swaddle practices can reduce these risks.
If you have any questions about whether or how to safely swaddle your baby or transition them out of their swaddle, your doctor can help. Together, you'll decide the best course of action.
By: Rachel Y. Moon, MD, FAAP & Danette Glassy, MD, FAAP
New parents often learn how to swaddle their infant from the nurses in the hospital. A thin blanket wrapped snuggly around your baby's body can resemble the womb and help soothe your newborn. When done correctly, swaddling can be an effective technique to help calm infants and promote sleep.
But if you plan to swaddle your infant at home, you need to follow a few guidelines to make sure you are doing it safely.
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To reduce the risk of Sudden Infant Death Syndrome, or SIDS, it's important to place your baby to sleep on their back&#;every time you put them to sleep. This may be even more important if your baby is swaddled. Some studies have shown an increased risk of SIDS and unintentional suffocation when babies are swaddled if they are placed on their stomach to sleep, or if they roll onto their stomach. If babies are swaddled, they should be placed only on their back and monitored so they don't roll over.
Stop swaddling as soon as your baby shows any signs of trying to roll over. Some babies start working on rolling as early as 2 months of age, but every baby is different. There is no evidence with regard to SIDS risk related to the arms swaddled in or out.
Parents should know that there are some risks to swaddling. Swaddling may decrease a baby's arousal, so that it's harder for them to wake up. That is why swaddling can seem so attractive to new, sleep-deprived parents&#;the baby sleeps longer and doesn't wake up as easily. But we know that decreased arousal can be a problem and may be one of the main reasons that babies die of SIDS.
The AAP recommends parents follow the safe sleep recommendations every time they place their baby to sleep for naps or at nighttime:
Place your baby on their back to sleep on a firm, flat surface and monitor them to be sure they don't roll over while swaddled.
Do not have any loose blankets in your baby's crib. A loose blanket, including a swaddling blanket that comes unwrapped, could cover your baby's face and increase the risk of suffocation.
Do not use weighted swaddles or weighted blankets, which can place too much pressure on a baby's chest and lungs.
Use caution when buying products that claim to reduce the risk of SIDS. Wedges, positioners, special mattresses and specialized sleep surfaces have not been shown to reduce the risk of SIDS.
Your baby is safest in their own crib or bassinet, not in your bed.
Swaddling can increase the chance your baby will overheat, so avoid letting your baby get too hot. The baby could be too hot if you notice sweating, damp hair, flushed cheeks, heat rash and rapid breathing.
Consider using a pacifier for naps and bedtime.
Place the crib in an area that is always smoke-free.
See How to Keep Your Sleeping Baby Safe: AAP Policy Explained for more information and tips.
Babies who are swaddled too tightly may develop a problem with their hips. Studies have found that straightening and tightly wrapping a baby's legs can lead to hip dislocation or hip dysplasia. This is an abnormal formation of the hip joint where the top of the thigh bone is not held firmly in the socket of the hip.
The Pediatric Orthopaedic Society of North America, with the AAP Section on Orthopaedics, promotes "hip-healthy swaddling" that allows the baby's legs to bend up and out.
Use only a thin blanket for swaddling.
To swaddle, spread the blanket out flat, with one corner folded down.
Lay the baby face-up on the blanket, with their head above the folded corner.
Straighten their left arm and wrap the left corner of the blanket over your baby's body, tucking it between their right arm and the right side of their body.
Then tuck the right arm down, and fold the right corner of the blanket over her body and under their left side.
Fold or twist the bottom of the blanket loosely and tuck it under one side of the baby.
Make sure their hips can move and that the blanket is not too tight. You want to be able to get at least two or three fingers between the baby's chest and the swaddle
Some child care centers may have a policy against swaddling infants in their care. This is because of the increased risks of SIDS or suffocation if the baby rolls over while swaddled, in addition to the other risks of overheating and hip dysplasia.
Compared to a private home, where one or two people are caring for an infant, a child care center usually has a number of caregivers who may have variations in their swaddling technique. This raises a concern because studies show babies who are not usually swaddled react differently when swaddled for the first time at this older age. They may have a harder time waking up, which increases their risk of SIDS.
The difference in the advice for swaddling at home or the hospital nursery, versus in a child care center, really comes down to the age of the child and the setting. A newborn can be swaddled correctly and placed on their back in his crib at home, and it can help comfort and soothe them to sleep. When the child is older, in a new environment, with a different caregiver, if they are learning to roll or perhaps haven't been swaddled before, swaddling becomes more challenging and risky.
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