Breastfeed or bottle feed, vaccinate or not, crib vs. family bed, there is another controversy surrounding parenthood – swaddling.
What is swaddling?
Swaddling is an age-old practice of wrapping infants in cloth with the intention to restrict the movement of infants’ limbs.
The arms and legs are secured within the swaddle, and only the head is exposed.
For one thing, babies can’t regulate their temperature very well and swaddling helps keep them warm.
Proponents of swaddling also conclude that babies are calmer and fuss less when swaddled. When you wrap a newborn snug in a blanket, you’re sort of recreating the feeling of being back in the womb which can help infants relax as they adjust to the new world around them. Hence, they may cry less.
Overall, swaddling has been shown to be a beneficial tool in promoting infant sleep. Keeping baby’s arms tucked in inhibits the Moro reflex (also known as the startle reflex) that babies are naturally born with.
The Moro reflex causes babies’ arms to reach up and outward suddenly in a reaction to a quick movement, loud noise, and other non-obvious reasons. Their flailing arms upset them and wake them up from an otherwise peaceful sleep, often causing them to cry.
But something so seemingly innocent that has been done for literally centuries has come under scrutiny in the past few years. Why?
While it’s true that swaddling can help babies sleep better, there are also a few risks associated with swaddling that all parents should be aware of.
Yet, according to this paper that was published recently in the Academic Journal of Pediatrics and Neonatology, less than half of pediatricians educate parents of newborns about the pros and cons of swaddling.
The study further points out that over half of the surveyed pediatricians were NOT educated about swaddling at any point of their training or career.
In case your pediatrician is keeping mute on the topic of swaddle-related risks, this is what you should be aware of if you’re swaddling or planning to swaddle your baby:
#1 Swaddling can increase the risk of hip problems and dislocation
In utero, baby’s legs are bent and crossed and can move freely.
In addition, the bones and joints of babies are intentionally loosened at birth by maternal hormones. Given how tight the birth canal is, soft bones are one of nature’s ways to ease the childbirth process for both the mom and the baby.
When infants are swaddled, their legs can be forced into an unnatural position which can loosen hip joints, force the hips out of sockets, and damage the soft cartilage of the socket.
While most kids that are showing signs of hip dysplasia eventually recover without needing a treatment, it can cause lifelong hip problems for some.
Never swaddle your baby tightly around the legs or forcefully keep baby’s hips and knees in an extended (straight) position.
For a healthy hip development, the legs of a swaddled baby should be able to freely bend up and out at the hips. In other words, your baby should be able to kick around while being swaddled.
Experts recommend that baby’s legs are allowed to be in a frog-like position (legs apart, hips and knees bent) as much as possible, including when they’re swaddled.
This recommendation extends to baby carriers and other products. It is recommended that parents avoid using baby carriers that let babies dangle by the crotch, as well as exersaucers, walkers, and jumpers.
For more information regarding hip-healthy swaddling, visit the Hip Dysplasia Institute.
#2 Swaddling can increase the risk of suffocation
Improper swaddling techniques can lead to suffocation.
Don’t use a loose blanket to swaddle your baby without close supervision. Baby’s hands eventually do break out of the fabric cocoon one day and can bring the blanket over the face which can lead to suffocation.
NEVER put a swaddled baby to sleep on her front or side. There is a high correlation between SIDS (sudden infant death syndrome) and swaddled babies laid to sleep on their stomachs or sides.
Always monitor a swaddled baby. Make sure there are no signs of trouble.
Stop swaddling when your baby shows signs of wanting to roll over (back to front, or front to back). All bets are off even with safe swaddling practices when your baby starts to roll over in any direction.
Babies typically start rolling over between 4 and 7 months, but sometimes as early as 2 months. For this reason, it is not recommended to swaddle babies past 2 months of age.
#3 Swaddling too loose or too tight
Babies love being safe, warm, and cozy. But swaddling your baby too tight or even too lose poses risks.
Make sure not to swaddle your baby too tight. Not only can this cut off baby’s circulation, it can also compress the chest wall and impede breathing.
Not being able to take full breaths can cause respiratory problems or worsen existing respiratory infections.
Likewise, don’t swaddle your baby too loose if using a blanket. Parts of the blanket can come undone which can potentially cause suffocation.
Babies should be wrapped snug, but no pressure should be put on baby’s chest.
To make sure that your baby isn’t wrapped too tightly, examine the space between the swaddle and baby’s chest. Make sure you can easily put two fingers between your baby’s chest and the swaddle.
#4 Babies can become overheated
Swaddled infants can become overheated because they’re unable to cool themselves off, having legs and arms contained within the swaddle.
Also, overheating can cause abnormal breathing which is one of many factors associated with SIDS.
Don’t overdress your swaddled baby.
Never swaddle in a hot environment.
Use the type of fabric for swaddling that is naturally breathable, like cotton or cotton muslin.
Dress baby accordingly. A thin layer of cotton with socks is enough in a comfortable room temperature.
#5 Swaddling can lead to too much deep sleep
Having swaddled infants sleep better and longer might be a score for parents and caregivers, but it may not necessarily be in the best interest of babies.
While it has been observed that swaddling leads to longer sleep, this can interfere with frequent feedings early on – especially with the initiation of breastfeeding. Evidence shows that some exclusively breastfed swaddled infants gain less weight than exclusively breastfed infants that aren’t swaddled.
When infants are purposely made to spend more time sleeping, it can result in reduced milk supply, slow weight gain, premature formula supplementation, or an increased risk of dehydration.
Also, when newborns spend considerable amounts of time being swaddled, their natural instinct to rouse may be diminished. Even though infants frequently startle themselves awake which often causes them to cry (hence the use of a swaddle), it is possible that this may be a natural protective mechanism that shouldn’t be suppressed.
Don’t let your nursing newborn sleep in a swaddle for long stretches of time.
Newborns should be nursed about every two to three hours (or more frequently – anytime they cue hunger). That’s usually around 8-12 feedings a day, give or take.
It’s OK to rouse a newborn to feed.
Wake a sleeping swaddled infant to nurse if you feel like she’s not getting enough milk when feeding on her own terms. This will help you produce more milk.
#6 Lack of movement associated with swaddling
No matter how gentle, swaddling is a form of restraint. Swaddled babies can’t freely wiggle and feel with their fingers and/or toes (and put them in their mouth) which are all part of the healthy developmental process.
We’ve already talked about how to keep legs and hips safe in a swaddle. But what about baby’s arms?
You have the option to swaddle your baby with her arms in, out, or one of her arms in and the other one out. When swaddling with arms in, you can gently lay arms down along baby’s sides, or swaddle with arms folded across the chest and elbows bent.
Swaddling a baby with ARMS IN inhibits the startle-inducing Moro reflex, which is the main reason for swaddling. But it also means that a parent is much more likely to miss early feeding cues.
Babies show us they’re ready to eat by pulling their fists close to their mouths and/or sucking on their fists. When infants cry out of hunger, it’s a sign of them being over-hungry.
It’s up to you to decide which way is the best way to swaddle your baby, because NO one way works for all babies. Pay attention to what your baby prefers.
Do NOT swaddle your baby tight, and never with legs and arms uncomfortably straight.
Don’t feed your baby in a way that restricts baby’s natural movements and prevents skin-to-skin bonding, especially during daytime.
Do expect your baby to be frustrated when she is hungry and can’t find her fist, or when she is fussy despite of being swaddled and unable to self-soothe.
Consider using a swaddle that allows free arm movement. This will help you spot early hunger cues. In all fairness, hands-free means your baby will be more likely to startle herself awake from sleep.
Unswaddle your baby for feeding as often as you can. Then, reswaddle for sleeping.
There you have it.
These are the PROS and CONS of swaddling, as well as the swaddling DOS and DON’TS according to the latest scientific research.
It’s up to you to weigh the benefits and risks of swaddling and make an informed decision that’s best for your child.
If you do end up swaddling your baby, use quality breathable products and follow safe swaddling practices.
NOTE: This information is based on swaddling babies FOR SLEEP. You should NEVER swaddle your baby during AWAKE time – babies need to be able to explore their bodies and the environment around them. Also, swaddles should NEVER be used when bed-sharing – swaddled babies may not be able to get out of an unsafe position in a family bed.