There are many reasons why parents may swaddle their babies including:
- Regulate babies temperature
- Reduce the likelihood that the startle reflex will wake baby up
- Help baby to feel more secure and safe especially in the “fourth trimester” the first 3-4 months after baby is born
- Reduce excessive crying in young babies, especially babies with colic/reflux
- Help babies to get the sleep they need for optimum infant development
While swaddling has been documented for hundred’s of years, it became much more popular in the early 1990’s after the promotion of back sleeping for all babies. Prior to the early 1990’s, it was common practice to put babies to sleep on their tummies. With better research showing that there was a relationship between SIDS, or Sudden Infant Death Syndrome, and tummy sleeping, the Back to Sleep campaign was launched in 1994. Parents were cautioned against putting their babies to sleep on tummy and were encouraged to put baby to sleep on back. Naturally, parents began to explore options for helping babies to sleep safely, especially as parents found that their baby woke more and “startled more” in the back to sleep position. The first-generation swaddling blankets, sleep bags, swaddle sacks, and any number of baby-sleep products developed out of a very real need for parents and babies to get the sleep they need. The second-generation of baby sleep products expand upon a better understanding of infant development, especially safe versus unsafe swaddling practices such as keeping swaddling garments loose around babies hips and mid-line hand/arm position for better settling supportive of infant development.
As second-generation swaddling and baby sleep products become available to parents, the issue of safe swaddling becomes even more important. Always be sure that when using any infant sleep garment, swaddle, blanket, or sleep bag, that the garment is properly positioned on babies body so as to avoid the garment coming up over babies nose and face. Always make sure that your baby is not over-dressed and avoid over-heating by only using breathable baby sleep garments, blankets, or sleep bags, preferably 100% cotton products. If baby begins to roll to side or roll to tummy, it is no longer safe to swaddle your baby for sleeping. Be sure to pay attention to the rolling to side or rolling to tummy movements that your baby makes during floor play or tummy time. If your baby is already beginning to roll to side or tummy during floor time or tummy time, it is a good idea to no longer swaddle your baby for sleeping since babies will very often roll to side or roll to tummy while sleeping. During the day and when not sleeping, it is advised that parents don’t swaddle their baby, that their baby has time during the day to move freely about, especially during daytime feeds, during tummy time or floor play, and while in parents arms and cuddling.
SIDS, or Sudden Infant Death Syndrome, is the sudden, unexplained death of an infant under 1 year of age. According to the American Academy of Pediatrics 2005 guidelines, “the occurrence of SIDS is rare during the first month of life, increases to a peak between 2 and 3 months of age, and then decreases.”
The AAP’s 2005 Guidelines include:
- Place infant to sleep on back, never on side or tummy.
- Remove all soft objects, blankets, pillows, comforters, sheepskins from area where baby sleeps.
- It is recommended that crib bumpers are thin and well-secured.
- A firm mattress with fitted sheet is the recommended sleep surface.
- The use of sleep bags are recommended rather than using a blanket or quilt to cover a sleeping baby.
- Avoid smoking, it has been shown to increase the risk of SIDS.
- Recommended room-sharing with baby for the first 6 months.
- Offer a pacifier at the beginning of nap or at bedtime. Don’t force your baby to take a pacifier if baby won’t take it.
- Nursery temp 68-70 degrees. You can use a fan to keep the air cool in the room where your baby sleeps.
The AAP recommends against bed-sharing although research shows that up to 50% of American families may bed-share with their infants, especially as breastfeeding rates have increased.
Breastfeeding advocates recommend that if parents are bed-sharing with babies that they also follow additional safe-sleeping guidelines:
- Avoid bed-sharing with your baby if you or your spouse/partner have had more than one alcoholic beverage, have taken medicine that makes you or your spouse/partner sleepy, have taken illegal drugs, or smoke.
- Avoid bed-sharing if you or your spouse/partner are overly tired
- Avoid bed-sharing if you have other children or pets in your bed.
- Never place an infant to sleep on a sofa, recliner, or armchair.
Whatever sleep location a family chooses for their infant, always check with your babies pediatrician regarding the most current recommendations for safe sleeping practices for your baby.