Is Swaddling Safe for Your Baby?

Swaddling safe

© Katrina Elena Photography / Dollar Photo Club

Swaddling a baby is the technique of snugly wrapping your baby in a cloth or light blanket, resembling the mother’s womb. It is believed to help soothe the newborn baby who then cries less and sleeps better.

Basic technique to swaddle your baby

Lay out a lightweight blanket on your bed or the floor in a diamond shape. Picture a clock face. Fold the top corner (12 o’clock) down about 6 inches. Put your baby here, with her head just above the fold and her feet pointing toward 6 o’clock. Pick up the right-hand corner of the blanket (3 o’clock) and wrap it firmly over her right arm and chest, then behind her back (under her left arm). Next take the 6 o’clock corner of the blanket and pull it up over her feet, tucking it under her chin. Finally, pull the remaining corner (9 o’clock) across her body and around and under her back. Done!

For a few dollars you can purchase a swaddler or sleep sack that zips. These may be more practical than using a regular blanket because they allow your baby to be swaddled with his/her arms close to the body thanks to the velcro flaps sewn in to the sack.

Remember: never swaddle and put your baby to sleep on his or her stomach!

American Academy of Pediatrics safe sleep recommendations

The American Academy of Pediatrics recommends parents follow the safe sleep recommendations every time they place their baby to sleep for naps or at nighttime:

  • Place your baby on her back to sleep, and monitor her to be sure she doesn’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.
  • Keep your baby’s crib free of bumper pads, soft bedding, wedges, toys, pillows and positioners.
  • Your baby is safest in her 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.

Swaddling a baby and risk of Sudden Infant Death Syndrome (SIDS)

In the United States, SIDS is the leading cause of death for infants 1 month to 1 year old, with most occurring when the child is 2 to 4 months old. Placing infants on their backs to sleep is considered a key element in preventing SIDS deaths. Medical experts do not know what causes SIDS. One prominent theory is that a combination of three factors — an undetected genetic abnormality, the development phase the infant is in, and environmental stressors such as stomach sleeping, exposure to cigarette smoke, and overheating — makes SIDS far more likely

Several studies have been conducted to assess whether swaddling increases the risk of SIDS. One British study found that swaddling increases the risk of SIDS but the researchers did not distinguish between swaddled babies who were left to sleep on their backs versus their stomachs. In a 2011 study of 103 inner-city U.S. parents, none reported putting their babies to sleep on their stomachs when they swaddled, whereas 9 percent of parents left unswaddled babies on their stomachs. (A few parents did leave their swaddled babies on their sides, though, which isn’t good because they could accidentally roll onto their stomachs.) When a 1994 New Zealand study tried to separate out all possible bedding-related factors that contribute to SIDS, it concluded that tight swaddling significantly decreases the risk of death.

A recent analysis of 4 studies found that swaddled babies placed on their side or stomach were twice as likely to have died from SIDS as were babies in those sleep positions who had not been swaddled. Risk was greater among babies 6 months or older, who the researchers noted had a “greater likelihood of rolling to a prone [stomach] position.” Risk of a SIDS death was somewhat less for all babies sleeping on their backs, but it was still greater among swaddled babies, compared with those who were not swaddled. The study authors wrote that “the current advice to avoid placing infants on their front or side to sleep may especially apply to infants who are swaddled.”

As the well-known phrase goes, “the jury is still out.”

Diego Wyszynski
Dr. Diego Wyszynski is the Founder and CEO of Pregistry. He is an expert on the effects of medications and vaccines in pregnancy and lactation and an accomplished writer, having published 3 books with Oxford University Press and more than 70 articles in medical journals. In 2017, he was selected a TEDMED Research Scholar. Diego attended the University of Buenos Aires School of Medicine and Johns Hopkins School of Public Health.

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