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That’s a wrap Baby Care

That’s a wrap

Done safely, swaddling can be an effective way to calm your restless newbie and help him clock some shuteye.

As timeless as a lullaby and nearly as soothing as being rocked in mama’s arms, swaddling has been recommended across generations— and cultures—as a trusted way to settle fussy babes. But although swaddling may be time-tested, it isn’t without risk. Wrap too tightly, and your baby can overheat. Wrap too loosely, and that cozy blanket can become a strangulation hazard. Wrap too long, and your older infant might roll over without any way to lift his head.

“Swaddling is definitely something you can do to help calm a fussy baby,” says Amanda Lea, RN, a pediatric nurse with the Monroe Carrell Jr. Children’s Hospital at Vanderbilt University Medical Center in Nashville, Tennessee. “I completely understand how it feels when you put your baby down for a nap, and the dog barks— or the mailman knocks on the door. As a parent, you don’t want your baby to be woken up. The downside about swaddling is it decreases spontaneous awakening, which can be dangerous. There is definitely a balance.”

Snug and secure
Studies have shown that infants who are swaddled tend to sleep for longer stretches —and tend to wake less easily—than those who aren’t. “There are some theories that swaddling mimics the tightly packed environment of the womb,” notes Jennifer Sonney, PhD, a pediatric nurse practitioner and assistant professor at the University of Washington School of Nursing in Seattle.

But what’s more likely, according to Sonney and other medical professionals, is that swaddling dulls a newborn’s startle, or moro, reflex. That’s the hardwired reflex that causes your little one to fling out his arms and grasp at the air (often waking himself up in the process) when there’s a sudden change in sensation: a loud noise, a bright light or even just a change in position, such as when you’re moving him from your arms to his crib.

By restricting arm movement, swaddling helps prevent your baby from startling himself awake. “Swaddling is helpful,” Lea advises. “But you have to be careful how and when you do it.”

Bundling basics
Infants, especially preemies, aren’t always able to regulate their body temperature effectively—after all, they’ve spent the past nine or so months in a temperature- controlled environment. That makes your little one especially sensitive to overheating when you swaddle, Lea says. If your newborn’s cheeks seem flushed, or if he’s starting to sweat, you’re probably bundling too snugly, or with a blanket that’s too bulky.

Tight swaddling can also make it difficult for your baby to breathe, Sonney notes. “Make sure the wrap is secure, but not so tight that it restricts the baby’s ability to expand his chest.”

On the other hand, loose swaddling, like loose bedding, can become a strangulation or suffocation risk if your little one gets tangled up in it.

“You don’t want the top of the blanket to slip over the baby’s shoulders and cover the mouth or nose,” explains Sonney. “They can begin breathing in their own carbon dioxide.”

As a rule of thumb, keep the top of the blanket level with your newborn’s shoulders when you swaddle, and make sure you can slide two of your fingers between the swaddling and your little one’s chest.

Rollover risk
Doctors recommend that parents stop swaddling their newbies at about the 2-month mark. Seem too soon? Consider this: Many babies begin rolling over, or at least attempting to, when they’re around 2 months old—and they often do it when you’re not looking. Even the most attentive parents can be surprised to find out their wee one has mastered this milestone.

“The babies who get into trouble are the ones who are on their stomachs,” notes Rachel Moon, MD, a pediatrics professor at the University of Virginia School of Medicine in Charlottesville, Virginia. As chair of the American Academy of Pediatrics’ Task Force on Sudden Infant Death Syndrome (SIDS), Moon also led a recent study that examined potential connections between swaddling and infant death.

All babies should be placed on their backs to sleep, according to AAP recommendations. Still, a 2- or 3- month-old infant can roll onto his stomach overnight or during naptime. “If they’re swaddled, they have no defense mechanism,” Moon says. “It’s a very hazardous situation.”

As you transition away from swaddling, take the opportunity to firm up your bedtime routine and begin building good sleep habits, Sonney suggests. Gradually wind down activities, reduce stimulation and dim lights as the evening progresses. Then, after a bath, a feeding and a cuddle, put your baby down in his crib at a predictable hour each night. “Sleep is very habit- based,” Sonney explains. “If you follow the same routine every night, the body will come to expect sleep.

Sleeping like a baby
Moon also hopes to change the conversation on infant sleep in general. We often think of a “good sleeper” as a baby who sleeps through the night. But for newborns, that’s not a realistic expectation.

“A 2-month-old baby is not going to sleep seven hours straight,” she says. “They’re designed to wake up every few hours. This is normal, and it’s a phase that won’t last forever.”

To Moon, a good sleeper is one who wakes up in the night to feed, then falls easily back to sleep afterward. Lea agrees. “If you have a baby who’s sleeping for three- or four-hour stretches, I think you’re definitely winning,” she says. “You have a good sleeper.”