Babies have been swaddled or wrapped for thousands of years and it is enmeshed in many cultures around the world. It is designed to provide containment and mimic being in the womb. More recently in New Zealand swaddling was promoted with the introduction of the back-to-sleep campaign. Back sleeping is not an instinctive position for babies, but this combined approach helped them go to sleep and made an incredible difference to sudden infant death syndrome rates. However recently in some regions in New Zealand, there has been a move away from teaching new mothers how to swaddle. This intrigued me, so I went on a search to find the scientific evidence for the change in practice.

What does the research say?

Key findings: Tight, full-body, heavy fabric swaddling can cause significant issues

• Swaddling that is tight with arms bound to their side (elbows straight) has been found to increase chest (respiratory) infections compared to non-swaddled babies
• Tight swaddling around the hips and legs has been linked to hip development problems (hip dysplasia)
• Heavy synthetic fabrics have been found to raise an infant’s body temperatures beyond the normally accepted temperature.

However there is nothing about how it might be beneficial for infants or parents if done correctly (hands up near their faces, loose around their hips, or not include their hips with a breathable light cotton fabric).

1. If you recall your antenatal ultrasound scans, you may have seen your baby’s hands up by their face or busily sucking on their thumb or fingers. Developmental swaddling which encourages their hands up by their face can help maintain this familiar and comforting position.
2. In neonatal units, supportive positioning is common practice as they are born with low muscle tone. Containment swaddling or nesting helps prevent over-stretching of chest muscles from the effects of gravity, provides good alignment of shoulder blades, and improves the baby’s energy expenditure. As a developmental therapist, there are noticeable differences in arm and body posture in non-swaddled term babies too. They tend to have tighter shoulder blade muscles and longer chest muscles making bringing their hands together and reaching up harder. It is visible when they are learning to roll and in sitting
3. Containment can help babies learn self-regulation, their ability to self-settle in the first few months after birth. If you are a new parent, you would be familiar with this period called the fourth trimester. During this time, parents are encouraged to support their babies to learn this skill which helps them go to sleep and return to sleep if woken after a sleep cycle.
4. I have heard the rumor babies who have not been swaddled lose their startle reflexes faster. In my experience, this is not the result of swaddling but the baby’s ability to control their arms. This voluntary control of their arms and legs is learned at around the age of two to three months.  If we are comparing babies who are swaddled all the time during their awake periods then yes but I am recommending developmental swaddling for sleep only.
5. Good sleep is important to both parents and babies. For infants, good quality REM sleep is when they lay down their new learning for the day (motor learning) and this will help them learn the voluntary control discussed earlier as well as promote weight gain, growth, and stabilization of hormones compared to overtired upset babies.

When should I stop swaddling?

When your child starts showing signs of rolling from their back to their tummy is a good time to stop. For most babies, they learn to roll consistently at 4 to 5 months of age. Some babies roll earlier than this. If they have accidentally rolled over they might have demonstrated this skill once or twice then stop for a few weeks this is normal at 2 to 3 months of age.

I would recommend weaning the swaddling off. Start with no swaddling for day sleeps then progress to no swaddling for night sleeps after a few days of practice. The Love to dream range has a progression suit that allows you to zip off the arm covers to help them slowly get used to the change in sleep support.

Steps to Developmentally Swaddle

• Hands up by their shoulders
• keep it loose around hips and legs
• use lightweight fabrics and do not overdress your baby

1. lay wrap with a point at one end – like a diamond
2. fold the top corner down around 1/3 of the wrap
3. lay baby on the wrap with fold line at the level of their ear lobes
4. tuck one hand into the “pocket” created from folding down the corner, pull the end across to the opposite side of their body, and tuck under
5. repeat with their other hand as in step 5
6. fold up the bottom of the wrap loosely fitting around their waist.

Watch the video to learn how to developmentally swaddle your baby. Check out the link here https://youtu.be/_BAikYKQylk

I don’t want to developmentally swaddle my baby.

I would recommend providing opportunities to counter the muscle imbalance changes through play if you do decide to not use developmental swaddling. Encouraging more side-lying play, using body slings, and supporting their arms together during cuddles and feeds will help.

Thank you for taking the time to learn more about developmental swaddling.

Hopefully, this has answered a few of your questions and also allowed you to work out what is best for you and your baby when it comes to swaddling. If you stick to the developmental method of swaddling with breathable light fabrics it can be a great way to ensure a successful night’s sleep. But if you find it stressful or challenging then swaddling may not be for you.

References:

1. Patricia Franco, Nicole Seret, Jean-Noël Van Hees, Sonia Scaillet, José Groswasser, André Kahn. Influence of Swaddling on Sleep and Arousal Characteristics of Healthy Infants, Pediatrics May 2005, 115 (5) 1307-1311; DOI: 10.1542/peds.2004-1460
2.  Bregje E. van Sleuwen, Adèle C. Engelberts, Magda M. Boere-Boonekamp, Wietse Kuis, Tom W.J. Schulpen and Monique P. L’Hoir. Swaddling: A Systematic Review, Pediatrics October 2007, 120 (4) e1097-e1106; DOI: https://doi.org/10.1542/peds.2006-2083
3. Nelson, Antonia M. RNC-MNN, PhD, CNE, IBCLC Risks and Benefits of Swaddling Healthy Infants, MCN, The American Journal of Maternal/Child Nursing: July/August 2017 – Volume 42 – Issue 4 – p 216-225 doi: 10.1097/NMC.0000000000000344