Swaddling is the practice of wrapping an infant snugly in a square of light fabric, with his head exposed, to calm him. The practice is widespread and longstanding; societies around the world have swaddled their babies for centuries, using a variety of methods.
Swaddling has been touted as a useful tool for calming infants during the first few weeks of life, providing a reassuring closeness during the time when the baby is adjusting to his new environment outside his mother’s snug womb.
For premature infants, additional benefits have been found, including:
- improved neuromuscular development
- less physiological distress
- better motor organization (muscle control)
- more self-regulatory ability
- pain relief
- better temperature regulation
However, swaddling also has some risks for babies, both premature and healthy, including:
- overheating, which can increase the infant’s risk of sudden infant death syndrome (SIDS)
- suffocation, if the baby rolls over during sleep or the swaddling fabric unravels during sleep
- hip dysplasia (a problem with the formation of the hip joint) or dislocation, if an infant's legs are positioned incorrectly
- delayed weight gain due to less frequent arousal and less frequent feedings, since babies who sleep more may eat less
In spite of these risks, parents are often taught to swaddle their babies while at the hospital and continue the practice once they are at home. Babies who are wrapped during sleep startle less, arouse less, and sleep more.
If you choose to swaddle your baby, you should be aware of the risks so that you can mitigate them. To reduce the risk of hip dysplasia and dislocation, make sure that your baby’s legs are able to bend outward and upward. Do not swaddle your baby with his hips and knees extended. To reduce your child’s risk of suffocation, place your swaddled child on his back for sleep, and make sure that the swaddling is wrapped correctly and will not dislodge. To reduce the risk of overheating, use a light blanket, a breathable muslin fabric, or a blanket designed for swaddling. Also, dress your baby lightly underneath, either in just a diaper, or a onesie. Do not use an ordinary full-size blanket. To reduce the risk of slow weight gain, make sure to follow feeding recommendations for your baby; to ensure adequate calorie intake, newborns need to feed at least 8–12 times every 24 hours.
Above all, remember that while it is safe to swaddle infants during the first few weeks of life, you should stop swaddling your baby once he has shown interest in rolling over, which can occur as early as 2 months of age. Swaddled infants who roll over are at an increased risk of SIDS or suffocation due to entrapment. Just in case your baby does roll, be sure to keep your baby’s sleeping area free from pillows, blankets, crib bumpers, or other “breathing blockers” (and remember that a swaddle wrap that becomes dislodged can become a “breathing blocker” too). Once your baby has shown an interest in or an ability to roll over—even if he hasn’t mastered the skill yet—retire the swaddling wraps and review other safe sleep practices.
Keep in mind that every baby is different, and some won’t respond well to swaddling at all. For helping your child to transition to life outside of the womb, many parents find that skin-to-skin care (also called "kangaroo care") is a better alternative to swaddling. Plus, kangaroo care can continue as your baby grows.
Click here for a step-by-step guide on swaddling your baby.
