To Swaddle or Not?

Swaddling is one of the oldest baby-calming techniques and is popular across many different cultures.  As it has regained popularity in North America however, some questioned its actual benefits and safety.  The debate exists because there has not been enough studies looking at the risks and benefits of swaddling.
A fairly recent meta-analysis (a report which brings together the evidence from smaller high quality studies) found that swaddling has some benefits including…
  1. BETTER SLEEP!  This is what many parents know intuitively and why they swaddle their babies in the first place.  Swaddled infants startle less, arouse less often and sleep longer.
  2. Benefits for PRETERM infants: Swaddling is thought to help with a preterm infant’s brain and motor development.  It is also found to be more effective than a pacifier for pain control.
Those against swaddling wonder if it is a healthy thing to do – do babies really want to be restrained?  Can tucking the baby in firmly be just as effective? There are also a few studies that question the following adverse effects.
  1. Overheating:  There is a hypothetical risk of hyperthermia if an infant is swaddled too tightly and left in a hot room
  2. SIDS if swaddled baby is PRONE:  If the baby turns over into his or her tummy and is unable to move because the arms are swaddled
  3. Vitamin D deficiency:  If the baby is swaddled, only the face is exposed to sunlight, a source of Vitamin D.
  4. Acute respiratory Infections:  Some studies have correlated respiratory infections to swaddling
  5. And lastly development dysplasia of the hip (DDH)

Developmental Dysplasia of the hip happens when the bones of the hip joint don’t line up properly.  The hip joint or socket is still developing when a baby is born and needs the head of the hip bone to help it do this properly.  When a baby is swaddled too tightly the hip bone may not sit correctly in the hip joint leading to DDH.  The best way to prevent this is to swaddle the baby in a way that allows the hips and legs to move freely –  as demonstrated in this video from the International Hip Dysplasia Institute.

For more information, please see this  Hip Safe Swaddling handout- Courtesy of Dr. Sharon Yong from King Edward Pediatrics.

Categories: Ask A Pediatrician, Handouts, Parenting, Sleep

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