When Should I Stop Swaddling My Baby?
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When Should I Stop Swaddling My Baby?

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October 6, 2014

By LOUISE CARR, Contributing Columnist

Swaddling has been practiced throughout history across the world. A safely swaddled baby, sleeping peacefully, is a beautiful thing.

Many moms find swaddling their newborn helps him feel safe, secure, and warm - and this contributes to the Holy Grail of infant care: better sleep.

A 2011 study from Academic Teaching Hospital of the Charité - Universitätsmedizin Berlin showed that swaddling promotes a quieter sleep in babies with better sleep efficiency and fewer nighttime wakenings.

But babies soon outgrow the swaddling stage - and research also shows that it can be dangerous to swaddle babies. So when should you stop swaddling your baby? How does swaddling help - or hinder - her development?
Consider the Breastfeeding Needs of Your Baby - Don't Start Swaddling?

Research has shown that swaddled babies wake up less and sleep longer (University Children's Hospital, Belgium, 2005) - great news for the exhausted parents but fewer wakenings can have a negative effect on breastfeeding patterns.

In a 2007 study from Vanderbilt University School of Nursing, NashvilleVanderbilt University School of Nursing, Nashville researchers compared two groups of babies after birth - one group had skin-to-skin contact with the mother and the second group was swaddled before being held by the mother.

The group that was swaddled displayed delayed feeding behaviors and established effective breastfeeding later than the other group.

If your baby is not putting on weight as she should, or you are having difficulties establishing a breastfeeding practice, consider not swaddling your baby. Alternatives to swaddling while breastfeeding is being established include plenty of skin-to-skin contact to keep baby's temperature up - blankets can be placed over mother and baby.

Swaddling Associated with Health Problems and SIDS

A 1990 study from Ministry of Health, Kuloglu Sokak, Ankara, Turkey reported that babies who are routinely swaddled during the first three months have a four-times greater risk of developing pneumonia and other respiratory infections when compared to non-swaddled babies.

Babies who were swaddled also had a greater risk of hip dysplasia, according to a 2012 study by Shengjing Hospital, China Medical University, Shenyang, China.

Babies who are swaddled are at greater risk of overheating if the room is also warm, which can be fatal in rare cases, according to a 2002 study by Wilhelmina Children's Hospital, Utrecht, The Netherlands.

And a 1993 study from the University of Tasmania, Australia found that swaddled babies laid face down were at 12-times greater risk of sudden infant death syndrome (SIDS)  than those laid face up - the risk was only three-times greater when infants were not swaddled.

However, reports such as a 2014 study from the Children's National Medical Center, Washington, DC remind parents that "reports of sudden unexpected death in swaddled infants are rare."

Benefits of Swaddling

So why swaddle in the first place? Some babies tend to start or jerk themselves awake when they are falling asleep and swaddling prevents these wakings.

Swaddling prevents babies scratching their skin - great for babies with eczema.

Swaddling also gives some babies a sense of security that is akin to being held and cuddled.

Stop Swaddling as Soon as Baby Begins to Roll

The safest way to swaddle is from birth rather than introducing the practice later on at an age when there is a higher risk of SIDS (three months old.) Researchers from the Children's National Medical Center, Washington (2014) say that the risks of death and injury can be reduced by stopping swaddling when your baby is beginning to roll - about three or four months old.

As he is learning to roll, stopping swaddling reduces the risk of the infant getting into a facedown position or being suffocated by the swaddle or other bedding from moving about too much in the crib. The researchers add that "risks can be further reduced by removing soft bedding and bumper pads from the sleep environment.

When using commercial swaddle wraps, fasteners must be securely attached."
According to the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital in Providence, Rhode Island, at two months your baby is moving around more in his sleep so swaddling could actually result in him waking more as he is uncomfortable and restricted.

National Resource Center Advice About Swaddling - And When You Should Stop
The American Academy of Pediatrics and American Public Health Association, in its third edition of "Caring For Our Children", advises against swaddling especially in childcare settings.

The group says "Benefits of swaddling may include decreased crying, increased sleep periods, and improved temperature control. However, temperature can be maintained with appropriate infant clothing and/or an infant sleeping bag. Although swaddling may decrease crying, there are other, more serious health concerns to consider, including SIDS and hip disease.

If swaddling is used, it should be used less and less over the course of the first few weeks and months of an infant's life."

How to Swaddle Safely

If you swaddle your newborn, make sure she is not kept swaddled all day long - swaddling for sleep is OK but your baby also needs time to move without restriction. Try not to swaddle during awake time.

Use a safe swaddle technique - try swaddling with your baby's hands by her face which can help her to self-soothe and also may be less dangerous that swaddling with arms by the sides. Don't swaddle too tight - you don't want to restrict breathing and you want to allow your baby to be able to bend her legs. Don't swaddle your baby while breastfeeding - skin-to-skin contact has been found to benefit baby and mom during this time.

An alternative to swaddling for babies that move around a lot can be the baby sleep sack - keeps baby warm and cozy while also removing the risk of loose blankets and suffocation dangers.


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