Key Evidence Summary Points
- Being wrapped and placed on the tummy is associated with a greatly increased risk of SUDI and should be avoided 1,5-7.
- The advantages of swaddling back sleeping infants outweigh the risks 3,23 and swaddling is acknowledged as an important and appropriate tool in the care of the newborn 3.
- There are benefits associated with wrapping premature babies during their hospitalisation. Premature and sick babies who were not wrapped in the early weeks of life due to their medical needs are able to commence wrapping as soon as the baby is medically well and sleeping on their back this is recommended prior to discharge.
- Infant wrapping must be correctly applied to avoid the possible hazards. Wrapping the baby does not reduce the need to follow safe sleep recommendations 1,5.
- Wrapping should be discontinued as soon as the baby shows signs of being able to roll 1,5.
In Australia, between 1990 and 2015 approximately 5,000 babies died suddenly and unexpectedly. Baby deaths attributed to SUDI have fallen by 85% and it is estimated that 9,967 infant lives have been saved as a result of the infant safe sleeping campaigns.
The Safe Sleeping program is based on strong scientific evidence, has been developed in consultation with major health authorities, SUDI researchers and paediatric experts in Australia and overseas, and meets the National Health & Medical Research Council rules for strong evidence.
View the references for this article here.
Every Baby Is Different
Some touchy or sensitive babies may appreciate the cozy feeling but not every baby needs it at bedtime. In fact, Ive come to see firsthand that many babies sleep just as well without it.
If you feel your baby needs to be swaddled, its important that a swaddled baby be placed on his back every time he goes to bed. Also, you should stop swaddling by 2 months of age before your baby rolls over. Be careful not to allow your swaddled baby to overheat.
Child Psychologist Reveals Baby Sleep Secret
Baby sleep issues arent just about finding short-term fixes to a long-term problem. Difficulties such as sheer inexperience, mounting sleep debt, unavoidable mental breakdowns or lack of a solid strategy can severely affect the wellbeing of mothers who are desperate to find an effective, practical solution to this delicate problem.Lets face it, ignoring the problem and waiting for it to go on its own isnt a choice, says Mary-Ann Schuler, creator of babysleepmiracle.com. Your approach determines not only the emotional environment your baby will sleep and live in, but also his present and future mental development.Fact: Tens of millions of American mothers are in a desperate need of a solution for their babies sleep problems, with millions more already having invested valuable resources in time-consuming band-aids. Do Babies Sleep Better When Swaddled
This is why Baby Sleep Miracle was created. Author Mary-Ann Schuler says, we want moms who struggle with this kind of problem to be aware that there is a solution to this. The product contains specific strategies on how to establish healthy sleeping habits for any child, with special sleep guidelines for newborn babies and general sleep rules for children up to age 5, complemented by psychologically-backed tips and tricks.
How Does It Help
Swaddling mimics the feeling babies get when theyre in the womb. They feel snug and secure wrapped in a comfy blanket.
Dr. Kimberly Edwards, pediatrician at Austin Regional Clinic, says she doesnt recommend swaddling for all babies, but for some it can be helpful. She says some babies sleep just fine and that swaddling is more of a technique to use if the baby is fussy.
When done correctly, it can calm and soothe the baby, explains Dr. Edwards.
The idea is that if an infants arms stay snuggly wrapped in the swaddle, the baby wont wake up suddenly from the startle reflex. Babies and parents may be able to snag some extra sleep.
Should Infants In Child Care Centers Be Swaddled
The AAP recommends that infants not be placed in child care centers until they are about three months old. By then, infants are no longer being swaddled, so the risks associated with swaddling arent a concern.
Swaddling is not recommended for infants younger than two months who are placed in childcare. Variations in swaddling techniques by the different caregivers and the inability of caregivers to monitor the infant adequately if it accidentally rolls over while swaddled are among the main reasons.
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Special Note About Sick And Low Birth Weight Babies
Babies who are born preterm and wrapped during the period of hospitalisation have been shown to have improved neuromuscular development 2,41, less physiologic distress 16,18, better motor organisation and more self-regulatory ability 19. Swaddling has been shown to reduce behavioural distress after heel lancing in preterm infants older than 31 weeks but not in more immature babies 18. More recently a study conducted by Shu and colleagues 22 showed that both swaddling and heel warming reduced pain responses to the heelstick procedure in neonates born at 31-41 weeks gestation 22.
A study of preterm infants born less than 32 weeks gestation investigated the developmental benefits of positioning in the neonatal intensive care unit 42. Using a randomised controlled trial design, babies were randomised to be positioned in an alternative positioning device or to traditional positioning methods for their length of stay. Infants in the alternative positioning arm of the study demonstrated less asymmetry of reflex and motor responses than those positioned using traditional positioning methods 42.
In the early weeks of life however infant wrapping should not interfere with skin to skin contact of the low birth weight infant with a caregiver. Kangaroo mother care, or skin to skin, has been shown to reduce risk of mortality and morbidity and improve growth, breastfeeding and maternal-infant attachment outcomes for low birth weight babies 43.
Material And Thickness Of The Swaddle
Most popular swaddles are made out of a 100 percent cotton blanket, lightweight cotton muslin, or microfleece.
Swaddles should come with a TOG rating when you purchase them, which provides a score for the best use of the fabric. A rating of 0.5 TOG for example is ideal for warmer seasons while a rating of 3 TOG is best for keeping them warm enough in colder temperatures.
We used a 0.5 TOG for our daughter in summer, and she wore only a diaper underneath . In winter, we switched to a sleep sack due to her age. We used a 2.5 TOG sack, with light pajamas and a diaper underneath.
There are many swaddling blanket options with natural fibers in addition to cottons such as cashmere, silk, wool, and hemp. Natural fiber is best for absorbing moisture or sweat when its hot and provide more insulation when its cold. These fabrics also differ in weight. A cotton blanket, for example, may feel lighter than a microfleece.
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How To Use Swaddle Blankets
The swaddling procedure can seem intimidating, but its not hard to perfect your baby burrito-wrapping technique.
Follow along with this five-step process, and you could be a swaddling pro in no time!
Make sure that your babys hips can move and that the blanket isnt too tight. Ideally, you want to be able to place two to three fingers between babys chest and the blanket.
*Swaddling can also be done with the arms straight by the side instead of bent.
What Are The Risks
If baby isnt swaddled correctly or rolls onto their stomach while swaddled, this can be very dangerous even deadly.
Sudden infant death syndrome is the term used to describe when an otherwise healthy baby under 12 months dies suddenly without a known cause.
According to the Centers for Disease Control and Prevention , there are about 3,600 sudden unexpected infant deaths in the United States each year, and 38 percent of those are classified as SIDS.
SIDS often happens during sleep. Babies who are swaddled can suffocate in their sleep if placed on their stomach, or if they roll onto their stomach.
A swaddle thats too loose can also be risky because the babys arms can get free, leaving loose blanket that could end up covering their mouth and nose. Babies should never be put to sleep with loose blankets because this also puts them in danger of SIDS.
Another risk that comes with poor swaddling is hip dysplasia. In the womb, a babys legs are bent up and across each other. If legs are straightened or too tightly wrapped together, the joints can be dislocated and the cartilage damaged. Its important to allow the babys hips to move around and spread apart.
Dr. Edwards says in a safe swaddle, Hips can move and its not too tight, but arms are kept in. You should be able to fit your hand between the blanket and the babys chest.
- are sweating
- get heat rash or red cheeks
- seem to be breathing heavily
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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.
Its also thought that swaddling prevents unnecessary wake-ups caused a babys startle reflex . This is because a swaddled babys arms and legs will be contained as theyre 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 babys life to be a transitional fourth trimester. The idea is that the first three months of your babys life is a complex 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 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 youre considering swaddling your baby, make sure you always follow safe swaddling guidelines to protect your little one.
What Should Baby Sleep In After Swaddle
Now I know that parents need only a very short list of things to be ready to bring home baby . For most babies, diapers, wipes, clothes, and a safe place for sleep are more than sufficient. However, one thing I recommend all families have on hand for their newborn is a swaddling blanket. For lots of reasons, newborns sleep best when they are swaddled. But what should baby sleep in after the swaddle? And on a related note, when should they stop being swaddled?
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Your Baby Doesnt Sleep As Well As He Used To
If a babystarts waking up in the middle of the night for no apparent reason, it might bea sign that the swaddling has become bothersome.
Also, if ababy who has developed a good sleeping pattern suddenly can only sleep forshort intervals at a time, it can be a sign that the swaddling is notcontributing to a good sleep anymore.
Swaddling Also Helps To Calm Babies
Use a swaddle made of a 100% cotton interlock as the stretchy fabric mimics the elastic feel of the womb. As your babys little jerks push against the fabric the elastic quality pushes the arms back, providing the resistance that is so calming. The tight wrap of swaddling provides deep pressure, the most calming of the touch inputs. This is the reason that babies who are swaddled for significant periods of the day are calmer babies. Baby Sense has designed the Cuddlewrap, a swaddle that is perfect for a new baby, in shape and fabric.
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Swaddling & Safe Sleep
What is swaddling?
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.
- Make sure 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 his or her hips.
- Make sure you are placing your baby on their back, in a crib, after being swaddled. Studies have shown swaddling 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.
When to Stop Swaddling a Baby
To read more about what Dr. Tyrala has to say about swaddling and all things infant safe sleep, visit our Ask the Pediatrician Frequently Asked Questions section!
How to Swaddle a Baby
When swaddling a baby always make sure you do it properly, follow the steps below:
What Is The Alternative To Swaddling
The question is more like what is an effective alternative to swaddling? Because there are now many sleeping products that can be used as an alternative to the swaddle wrap/swaddling.
The key things to look for when choosing an alternative are:
- looser fitting sleep suits, one’s that don’t restrict your baby’s arms.
The SLEEPY HUGS sleep suit is the perfect solution for tummy rollers as the free arm movement allows baby to use their arms naturally to allow themselves to roll-back and resettle into a safe sleeping position. The SLEEPY HUGS sleep suit gives them the feeling of security and comfort and can help them self settle back to sleep.
Article by: Malou Villarreal, Founder Baby Loves Sleep
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Signs Its Time To Stop Swaddling Your Baby
If I could give new parents just one piece of advice, it would be to swaddle their newborn.
Swaddling is an effective technique to help soothe newborns as they adjust to life outside the womb. I swaddled my girls right from the get-go and it was truly a lifesaver during the first couple of months. By wrapping them up tightly, youre helping them soothe through startle reflex and mimicking the womb environment which can help them sleep better and for longer stretches.
But as much as swaddling helps, it cant last forever. Swaddling, when done properly, is completely safe and recommended for newborns. But as they grow and become more mobile, swaddling can become unsafe if you dont transition your baby out of it at the right time.
When To Stop Swaddling
The AAP recommends that parents stop swaddling their baby after they turn two months old. This is because swaddling becomes unsafe if:
You can continue to keep your baby in their swaddle with one or both arms out beyond 8 weeks old, but its important to look out for the signs that its time to make the transition out of swaddling altogether.
5 Signs Its Time To Stop Swaddling
How To Transition Out Of A Swaddle
Use white noise: Learn more about how white noise helps babies sleep soundly here.
Signs That You Should Wean From This Practice
If your tyke is showing increased mobility and fewer signs of the Moro reflex, these are common indications you can start weaning your child off swaddling. You can do this gradually so that your kiddo isnt suddenly wiggling around in their newfound freedom or scared by this sudden feeling of insecurity.
You can swaddle them partway with their dominant arm out this way, they can still push themselves around a bit. See how your newborn reacts when put down for a nap, if they still wake up multiple times or struggle with a strong Moro reflex at times, it may not be time to transition.
If this is the case, it may be best to keep them half bundled with one arm out and see how they do from there. Every child is unique and will progress at their own pace.
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How To Safely Swaddle Your Baby
Swaddling can comfort babies when they are upset and help them fall and stay asleep. To keep your baby comfortable and safe while swaddled:
- Do not swaddle the legs: Studies have shown that babies whose legs were tightly swaddled may develop hip problems. Make sure your baby can move their legs up and down at the hips.
- Stop at the shoulder: This is especially important if youre putting your baby to sleep for the night or for a nap. If you are holding and observing your baby, you can pull the blanket up around the head like a hood, but dont do this if you are not watching them.
- Leave the arms free or the hands by the face: Some babies prefer to have their arms free, while others find it calming to have their hands near their faces.
- Make sure baby is not too warm: Swaddling should be done to help your infant feel secure, not to keep them warm. Use a thin, breathable blanket, and check periodically to make sure your baby is not overheating.
- Stop swaddling when baby begins trying to roll over: This can vary from baby to baby, but by three months, you should stop swaddling.