I get so many questions about swaddling! Why swaddle? Does swaddling make babies safer? How do you swaddle properly? Can swaddling delay important developments? When should I start or stop swaddling? Is swaddling the right choice for my baby?
I would love to answer these questions not only from my experience but also from evidence-based research so that you can make the best decision about swaddling for YOUR family.
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In the womb, babies grow and develop in a snug, tight space. That snug place feels secure and comforting to babies in the womb, and swaddling recreates that environment outside of the womb for newborns. The snugness of a swaddle also helps calm the Moro reflex while babies try to sleep.
Swaddling truly does provide that comfortable, secure feeling. For preterm infants, swaddling results in: “improved neuromuscular development, less physiologic distress, better motor organization, and more self-regulatory ability.” It also says that full-term infants cry less when swaddled compared to other soothing techniques, and that “swaddling can soothe pain in infants.”(1)
Do you see this? Swaddling can be amazing for babies! If your baby hates the swaddle, don't stop reading now! My newborn class can help you.
What is the Moro reflex?anchor
Have you ever seen a newborn throw both of their arms back and start crying as you place their head down or when they hear a loud noise? That is the Moro reflex. Imagine how disruptive that reflex must feel when babies are trying to sleep!
Swaddling helps calm that Moro reflex and keeps those sweet little arms from flailing when babies are trying to sleep.(2,3) That’s what makes swaddling such a powerful tool, specifically for newborns.
The Moro reflex typically fades and disappears between 3 and 6 months. Keep in mind that a reflex is an involuntary response, which means that it doesn’t stay longer or disappear more quickly based on swaddling or not swaddling.
Is swaddling safe?anchor
Yes, it is! Swaddling is safe when you follow the recommended guidelines from the American Academy of Pediatrics (AAP).(4,5)
According to the AAP(4), “when done correctly, swaddling can be an effective technique to help calm infants and promote sleep.” The Canadian Paediatric Society(6) agrees and says that “swaddling is safe if done properly.”
Babies who are safely swaddled:
- are NOT at risk for having their mouth or noses covered by the swaddle.
- have space for proper hip movement.
- are securely swaddled, yet can easily take deep breaths. They are snug around the chest, but still allow for your hand to slide inside.
- are not sweating, flushed, or showing signs of overheating.
- are safely on their backs. Discontinue swaddling when your baby shows signs of rolling.
Does swaddling reduce the risk of sudden infant death syndrome (SIDS)?anchor
It can! There is evidence that swaddling can decrease the risk of SIDS. Parents, I know: SIDS is scary. I’m not here to add to your stress. But, if I can give you tools to make things a little bit easier and less scary, I want you to have them.
We know that “back is best” for sleep because it decreases the risk for SIDS(7). Researchers found that swaddling helps keep babies safely on their backs. There is wonderful research (8) about the history of both swaddling and SIDS concerns if you want to read more.
Some parents are tempted to place newborns on their belly even knowing these recommendations. These parents wonder if their babies might sleep better that way. Studies(7) actually confirm that babies sleeping on their tummy do experience fewer wakings. BUT, it’s simply not safe.
Swaddling helps babies sleep well while sleeping safely. If you feel your baby hates the swaddle or will only sleep on their tummy, you are not alone: my newborn class can help you.
Will swaddling make my baby sleep so soundly that it will be dangerous?anchor
Parents, I know that there is so much information out there. I know that you are doing your best for your sweet baby. Perhaps you’ve heard someone saying that swaddling is dangerous because swaddled babies sleep so deeply.
Can I walk you through the research?
Some will use this study(7) when talking about swaddling and the startle reflex. You may have read this:
“Swaddling has a significant inhibitory effect on progression of arousals from brainstem to full arousals involving the cortex in QS. Swaddling decreases spontaneous arousals in QS and increases the duration of REM sleep, perhaps by helping infants return to sleep spontaneously, which may limit parental intervention.”(7)
In simple terms, this means that if your baby is swaddled, he may be able to sleep so soundly that he won’t even wake you. This great sleep may seem appealing to you, or maybe it sounds scary because you fear that this deep sleep might not be good for your baby.
BUT, we have to keep reading: this conclusion (the very next sentence) is left off the study when shared on some social media sites:
“For these reasons, a safe form of swaddling that allows hip flexion/abduction and chest wall excursion may help parents keep their infants in the supine [on the back] sleep position and thereby prevent the sudden infant death syndrome risks associated with the prone [on the belly] sleep position.”(7)
Did you see that? Don’t miss it! The study concludes that BECAUSE your baby will sleep so soundly, swaddling is GOOD. It says, right there for you, that swaddling can actually help prevent SIDS.
Now, just in case you want a little more, I have it for you. The research(1) shows that babies who are swaddled still respond to sounds. It says that for swaddled babies “there was no decrease in the capacity to respond to stimulation; there was only a decrease in frequency of response to stimulation.”(1) The swaddled babies in this study were still responsive in exactly the way they needed to be.
Can swaddling ever be dangerous?anchor
In this study(1), the dangers ONLY occur when swaddling is not done safely OR when parents continue to swaddle after babies are rolling onto their bellies. This is why safe swaddling is so very important! The study addresses the many possible risks of swaddling incorrectly, but it never once mentions any concerns about developmental delays or neurological consequences to swaddling.
Can swaddling keep my baby from developing properly?anchor
Research does NOT show that swaddling harms a baby’s development!
This study(1) directly states that there has been “no evidence that swaddling has short-term or long-term effects on the attainment of motor milestones.”
This study(9) that looked at babies with prolonged swaddling (beyond 7 months) shows that babies swaddled or unswaddled have no significant differences with a child’s early mental or psychomotor development. Now, because of safety factors, I DO NOT recommend swaddling beyond the stage where babies can independently roll, but even in cultures where swaddling is conducted with infants beyond 7 months, studies show no developmental concerns for swaddling.
Please hear me again, I do NOT recommend swaddling infants past the time when they are showing signs of rolling as instructed by the AAP(5), but I want you to see the research that shows that there were no negative developmental effects.
Is swaddling a brand new thing?anchor
That is a great question! In short, no! Swaddling has been around for centuries.
I’ve heard some claims that swaddling was started and/or popularized through social media, but I want to share that swaddling is a long-standing practice in many cultures(1) that has existed for centuries both in and out of medical practice. Swaddling has recently become popular in Western cultures because of the “back is best” recommendations that started in the 1990s; however, that doesn’t mean swaddling originated in the last 30 years.
This study(1) actually calls swaddling “an almost universal child-care practice before the 18th century.” Swaddling has been a long-term strategy for calming infants.
Even knowing all of this, for me, the history(8) is not enough. It’s the research about the benefits of swaddling that makes me feel confident that swaddling, when done following the safety guidelines, is not only safe, but beneficial for your baby!
When do I transition out of the swaddle?anchor
For safety, you must transition out of the swaddle when your baby shows signs of rolling. If you have questions about the transition, I’ve got a blog for you on transitioning out of the swaddle.
After your baby has transitioned out of the swaddle, tummy sleep can be safe when your baby rolls independently onto their tummy. However, for the first 12 months, you’ll always want to place your baby on his back and let him roll onto his belly if he chooses.
So Cara, would you ever change your stance on swaddling?anchor
If there was ever evidence-based research demonstrating concerns, of course! We are always adapting as we learn more, and I am always open to new research and make recommendations based on what evidence-based science tells us is true.
Do I have to swaddle to use your classes?anchor
We know that science shows us that swaddling, done correctly, is safe. For that reason, I do encourage swaddling in my newborn class. (Please know that in Navigating Months 3 & 4 and 5-24 Month Collection, I talk about coming out of the swaddle. Swaddling is only appropriate for babies who are not yet rolling.)
However, if swaddling doesn’t serve you or your baby well for whatever reason, I would never encourage you to swaddle outside of your comfort. I merely want to hand you tools that can help you and your family to thrive.
Please know that my classes teach you so much beyond swaddling. They cover wake windows, setting up the environment, having a routine throughout the day, how to get longer stretches throughout the night, understanding naps and setting them up for success, and so much more.
I’m on your team. I want you to thrive and enjoy that sweet baby!
Van Sleuwen et al. (2007). Swaddling: A Systematic Review
Lauren Vinopal. (2022). The Moro Reflex: Why your Sleep Baby Suddenly Freaks Out
Futagi, Y., Toribe, Y., & Suzuki, Y. (2012). The Grasp Reflex and Moro Reflex in Infants: Hierarchy of Primitive Reflex Responses
Healthy Children, American Academy of Pediatrics. (2022). Swaddling: Is it safe your your baby?
American Academy of Pediatrics. (2016). SIDS and Other Sleep-Related Infant Deaths: Recommendations for a Safe Infant Sleeping Environment
Canadian Paediatric Society. (2018). Swaddling.
Gerard, Harris, and Thach. (2002). Spontaneous Arousals in Supine Infants While Swaddled and Unswaddled During Rapid Eye Movement and Quiet Sleep
Brittany Clair. (2017.) It’s a Wrap: The Science on Swaddling
Manaseki-Holland et al. (2010). Effects of Traditional Swaddling on Development: A Randomized Controlled Trial