Swaddling? Not if you want to sleep.

October 15, 2017

The latest swaddling recommendations say caregivers should stop swaddling their baby by 8 weeks of age.  That means that if a caregiver does swaddle for sleep for the first 7 weeks, they will have to change the sleep routine right when baby is (finally) starting to sleep for longer periods.  This is the most practical argument against swaddling, in my opinion, but not the scariest one. 


According to the most recent guidelines (1)  released by the American Academy of Pediatrics, swaddling can increase the risk of injury or death to healthy, term infants in the following ways:


  • Swaddling can increase the risk of respiratory infections, pneumonia, hip dysplasia, and overheating which is a risk factor for Sudden Infant Death Syndrome (SIDS) (2)

  • Swaddling after 8 weeks of age increases the risk of suffocation and SIDS because infants may be able to roll over on their side or stomach (3).  

  • Swaddling with regular blankets or wearable blankets can increase the risk of suffocation if the material becomes loose and covers an infants mouth and nose (3). 


It is for these reasons and others that swaddling is "not necessary or recommended" in early child care settings, according to the National Resource Center for Health and Safety in Child Care and Early Education.   


Additionally, some breastfeeding experts believe swaddling can interfere with successful initiation of breastfeeding.


The bottom line is that swaddling increases the risk of harm without offering any clear benefit for baby, and could delay a good night sleep for an exhausted caregiver when they need it most.  


Dyann Daley, MD is a board certified pediatric anesthesiologist, physician innovator, and experienced child maltreatment prevention executive.  Learn more at DyannDaleyMD.com and Predict-Align-Prevent.org


(1) Moon RY. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment, TASK FORCE ON SUDDEN INFANT DEATH SYNDROME Pediatrics Oct 2016, e20162940; DOI: 10.1542/peds.2016-2940


(2) Pease A, Et al.  Swaddling and the Risk of Sudden Infant Death Syndrome: A Meta-analysis Pediatrics May 2016, e20153275; DOI: 10.1542/peds.2015-3275


(3) McDonnell E, Moon RY, Et al.  Infant Deaths and Injuries Associated with Wearable Blankets, Swaddle Wraps, and Swaddling. The Journal of pediatrics. 2014;164(5):1152-1156. doi:10.1016/j.jpeds.2013.12.045. 


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