Swaddling for Sleep
Swaddling (firm wrapping in a cloth or blanket) is an ancient and widely used baby-care tool.
Some research studiesFor an overview of research addressing both potential benefits and harms of swaddling see: Swaddling: A Systematic Review. Van Sleuwen et al., 2007 have found that swaddling can help calm and soothe babies, and help them sleep. Researchers have suggested that swaddling can help babies settle on their backs, and prevent them turning on to their front or getting their heads covered by bedding. Parents in Western countries are increasingly turning to swaddling to help calm their babies for sleep.
Recently, however, some research has suggested that swaddling might not always be safe:
- Babies that are swaddled may sleep more deeply. While this may at first appear to be a good thing it may in fact put them at higher risk of SIDS. The ability to arouse (begin to wake) from sleep is key to a baby’s ability to cope with things in their environment that might otherwise put them at risk of SIDS.
- ResearchInfluence of swaddling experience on spontaneous arousal patterns and autonomic control in sleeping infants. Richardson et al., 2010 shows that swaddling reduces this ability much more among babies for whom swaddling is a new experience - i.e. have NOT been swaddled since birth.
- A recent review paperSwaddling: A Systematic Review. Van Sleuwen et al., 2007 found that swaddling increased SIDS risk if the baby was on its front, and decreased it for babies sleeping on their back. However a recent UK study Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. Blair et al., 2009 found an increased risk of SIDS for all swaddled babies - including those sleeping on their back. The current evidence is therefore contradictory.
Swaddling can also put babies at higher risk of bone-development problems, chest infections and overheating. It is also not considered to be a good idea to swaddle a baby when bed-sharing. Babies need to be able to use their arms and legs to alert adults who get too close, and to move covers from their faces. Swaddling prevents a bed-sharing baby from doing this.
If you decide to swaddle...
- Wrap firmly but not too tightly.
- Baby's legs and feet should be able to move freely, and bend at the hip.
- Leave arms free for babies over 3 months, to allow self-soothing.
- Leave baby's head uncovered, and don't let baby get too hot.
- If you bring baby into your bed, remove swaddling to prevent overheating.
- Always place baby to sleep on his or her back.
If you are going to swaddle, evidence suggests it is safest to do it from birth. Don't suddenly start when SIDS risk is highest (at 2-3 months).