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Swaddling 101 (Part 1): How to Swaddle and Safety Considerations



At Baby Sleep Science we consider swaddling your newborn baby to be an almost essential component to sleep!

The Science: Newborns have an immature startle reflex. They also twitch and move a lot during sleep. Both of these types of movements can be disruptive to sleep. Studies have demonstrated that swaddles can help prevent waking – not to mention the cozy snuggle factor for your baby!

The Sleep: Naturally, we’ve heard all the common dilemmas and excuses (“she hated it”, “it was too hard”, “he wanted his fingers”, “my daycare wouldn’t allow it”, etc) and we love to help families work through these roadblocks and find safe, effective ways to swaddle their newborns. Sometimes the issue isn't that a baby doesn't like being swaddled, but rather that a baby doesn't like a particular type of swaddle. We've created this brief overview on swaddling and safety and listed some of our favorite swaddling products so that you can find the right option for your baby.


Swaddling and Safety:

Although a very effective sleep cue and sleep protector, swaddling can carry risks if done improperly. First and foremost, always put your baby down on her back when swaddled. Review the following tips on swaddling and always be sure to use your swaddle product in the way the manufacturer suggests.

Tightness:

The key is to have your baby’s swaddle snugly securing her arms so she won’t be able to wiggle free and pull loose fabric up around her face – which is definitely unsafe! You want the blanket or wrap tight enough to be effective, but not so tight it’s constricting breathing or chest movements. You should be able to easily slide your flat fingers between the swaddle and your baby. It is dangerous to have loos blankets in your baby's crib, so if your baby can break out of the swaddle, it's time to transition to a sleep sack.

Temperature:

Ideal sleep temperature ranges from the mid-sixties to about 72 degrees F, but that’s only half the story because what your baby is wearing matters too! A swaddle will contain some of your baby’s body heat so be careful of over-bundling and overheating your newborn, which can increase the risk of SIDS. Assess your baby’s core temperature by putting a couple of fingers down her clothes to her bare chest or back when she sleeps. She should feel warm and dry at the core, not hot and clammy or sweaty and not cold. Her nose, ears, and fingers may feel cool due to more immature circulation but that doesn’t necessarily mean she’s cold.

Hips:

Swaddling gets a bad rap when it comes to hip dysplasia and many parents express concerns to us about this topic. When you swaddle your baby, use a blanket or product that allows for hip movements. You want your baby to be able to happily thump those legs up and down against the mattress all she wants, and be able to “frog” her legs up to the side if that’s comfy too. Avoid swaddling legs tightly together and do give plenty of supervised floor and tummy time during the day as well!

Technique:

Techniques vary! What you see Meg doing in our video clips might be slightly different from what you do and might be slightly different from how Meg does it the next time! The basics are the same though: arms down at the sides but not pinned under your baby’s sides, snug but not too tight, wrap around chest, not neck, no bumpy wrinkles under your baby’s back or bum, and a loose enough pocket for the legs to move and thump!

How Long to Swaddle?

Currently, the AAP hasn’t made an official statement but the lead author of the SIDS task force suggests in an online statement not swaddling past 2 months because some babies can roll that early. We always like to bring you current information and encourage you to make an informed decision about your parenting choices. Most parents we work with do decide to swaddle for longer than 2 months, especially if the startle reflex is still pronounced, but do be sure to stop swaddling when your baby is showing signs of learning to roll. A swaddled baby who rolls onto her side or tummy is in an unsafe situation and has a much higher risk of SIDS.

What type of Swaddle?


Our Favorite Swaddle Products (We don't receive anything from these companies, we just love their products. Always use products as recommended by the manufacturer):

  • Miracle Blanket – best for babies about 6-8 weeks and up who are not rolling. Although it seems cumbersome at first, the Miracle Blanket is very effective, especially for strong babies who are known to break out of Velcro-style swaddles.

  • Aden and Anais Muslin Blankets – big, soft, and stretchy – worth the price! Try the A and A “Issie” for older babies as a great first lovey too!

  • Aden and Anais Easy Swaddle – muslin swaddle bag with arm flaps

  • Halo Sleep Sack Swaddle – Very easy to use. The downside is that strong babies may be able to break through the Velcro after a few washings

  • Woombie and Zipadee-zip – allow for more movement, but very easy to use during the day for naps.

Remember, just like adults prefer different pillows and bedding, babies have preferences too. If your baby doesn't like one type of swaddle, then consider trying something different before giving up.


Check out our blog on how to transition out of the swaddle if your baby is ready to transition to a sleep sack. Some parents will opt to transition their babies out of the swaddle in conjunction with sleep training. For comprehensive information on how to do that, check out our sleep class.


References


Pease, A.S., Fleming, P.J., Hauck, F.R., Moon, R.Y., Horne, R.S., L’Hoir, M.P., Ponsonby, A.L. and Blair, P.S., 2016. Swaddling and the risk of sudden infant death syndrome: a meta-analysis. Pediatrics, 137(6).


Franco, P., Seret, N., Van Hees, J.N., Scaillet, S., Groswasser, J. and Kahn, A., 2005. Influence of swaddling on sleep and arousal characteristics of healthy infants. Pediatrics, 115(5), pp.1307-1311.


Van Sleuwen, B.E., Engelberts, A.C., Boere-Boonekamp, M.M., Kuis, W., Schulpen, T.W. and L'Hoir, M.P., 2007. Swaddling: a systematic review. Pediatrics, 120(4), pp.e1097-e1106.


Gerard, C.M., Harris, K.A. and Thach, B.T., 2002. Spontaneous arousals in supine infants while swaddled and unswaddled during rapid eye movement and quiet sleep. Pediatrics, 110(6), pp.e70-e70.


Kleitman, N. and Engelmann, T.G., 1953. Sleep characteristics of infants. Journal of applied physiology, 6(5), pp.269-282.