To Swaddle or not to Swaddle?
Is any issue more emotive in the babycare world at the moment?
Emotive in general, but also a point that I am asked to comment on at least once per week in response to questions from, mostly, potential BabyCalm teachers – concerned that BabyCalm “advocate swaddling”. My answer is always “BabyCalm don’t advocate anything! That’s not what we do – we’re all about empowering parents and in order to truly empower we must allow the parent to make his or her own informed choice – and sometimes that choice may be something that makes our heart sing, othertimes it may be something that makes us uncomfortable – BUT – and it’s a big but! – we have to learn that our feelings must stay that – OUR feelings.”
So, what’s the deal with swaddling and BabyCalm?
In short we present the idea of swaddling to parents as one of many, many ways that they can soothe their baby (and those of you who have attended a BabyCalm class will know how little of it is taken up with soothing techniques – in short it’s the smallest part of what we do!) and it is just that “presented”. As with any other method we present we always disccuss the pros and cons of the technique and we help parents to know how to do it safely, with the minimal amount of risks as possible – be that dummy use, bedsharing, babywearing or swaddling. I am always concerned when somebody says “That’s dangerous – never do it” (FSIDs and bedsharing anyone?) or “That interrrupts feeding – never do it” because things are NEVER that cut and dried………..sure most things in life have risks, but most have benefits too and ways to reduce those risks.
What would you suggest in this scenario? A mum with a 6 week old baby who confesses to you she’s not coping, her baby is very fretful and sleeps fitfully. She is at the end of her tether, she admits that the exhaustion and lack of sleep she’s experiencing is now affecting her bonding with her baby, she’s desperate. She also tells you that she is happily formula feeding, baby is in her own cot (and she wants it to stay that way) and babywearing isn’t for her. She’s tried swaddling and it really seems to help, she’s using a fleece blanket and pulling it really tight all around the baby. This scenario is precisely when swaddling can be a God send – this scenario is the norm in the UK, outside of the AP bubble of breastfeeding, bedsharing and babywearing………..but, this scenario is when swaddling can be dangerous and why we still teach swaddling in BabyCalm, we teach how to reduce those risks as much as possible.
Think of another scenario – Mum of a 6wk old baby who confesses to you she’s not coping, her baby is very fretful and sleeps fitfully. She is at the end of her tether, she admits that the exhaustion and lack of sleep she’s experiencing is now affecting her bonding with her baby, she’s desperate. She is breastfeeding and open to suggestions of babywearing, bedsharing and co-bathing…..what would you suggest here? would it be different to the above? Of course it would! but……..what if this mum’s informed choice was *still* to swaddle rather than bedshare/babywear/cobath/skin to skin? is that your position to tell her what NOT to do? even though she’s thoroughly considered the pros and cons and made her decision – most definitely NOT!
In my opinion telling somebody NOT to swaddle – ever, is just as bad as telling them to ALWAYS swaddle, as certain baby experts might! Frankly it is none of our business what parents do and I’m always shocked that some in this profession think that it is by passing on their own strong feelings (often backed by hunches and opinion, not evidence) to vulnerable new parents. This is NOT letting the parent make an informed choice!
So what are the pros and cons of swaddling? What does current research and our own anecdotal opinion tell us?
PROS
- Swaddling can help promote new sleep cycles/less waking.
- Swaddling can help prevent prolonged crying. (but see 8 below!)
- Swaddling can help breastfeeding when a baby has flailing hands making latch difficult (but see 2 below!)
- Swaddling can help a baby to not accidentally scratch his face
- Swaddling can stop loose blankets going on top of the babies face
- Swaddling can prevent a baby from rolling onto his tummy during sleep.
- Swaddling Can give parents a technique to calm their baby and thus time to calm themselves, this is heightened for parents who make the choice to formula feed and not bedshare/babywear etc..
- Swaddling can help a baby feel ‘held’ and perhaps as if still in utero.
CONS
- Swaddling can lead parents to miss baby’s early hunger cues
- Swaddling can inhibit breastfeeding, particularly in the early days
- Swaddled babies cannot suckle on their own hands as they may have done in utero
- There is an increased risk of SIDs shown in studies when babies placed to sleep on stomach swaddled
- Swaddling can cause hip dysplasia if babies are swaddled too tightly over hips
- Swaddling can cause respiratory compression if babies are swaddled too tightly over chest
- Swaddling has been linked to less arousability, if the swaddling was not started until 3months of age.
- Swaddling prevents a baby’s freedom of movement and expression.
If a parent would still like to swaddle their baby after considering the above, how best to do so as safely as possible?
When Swaddling Always Remember:
- Never swaddle over a baby’s head or near their face
- Never swaddle a baby who is ill/has a fever
- Ensure the baby does not overheat – only swaddle with a breathable/thin fabric
- Only swaddle until a baby can roll **
- Always place a swaddled baby to sleep on their back
- Do not swaddle tightly across the chest
- Do not swaddle tightly around the hips/legs. Legs should be free to “froggy up”
- Begin swaddling well before 3 months of age, if breastfeeding only once feeding established and never in the first few hours postpartum (in the hospital!) when skin to skin is necessary!
** The American Academy of Paediatrics recommends swaddling for babies 0-14weeks only.
I’m being a bit lazy here as it’s the first day of school summer holidays and I want to take my kids out on a picnic – so here’s a great summary of up to date swaddling evidence.
So what’s BabyCalm’s position on swaddling? To be honest we don’t really have one! other than we are committed to letting parents make their own choices and helping them to have the information they need to do so. For some swaddling is an amazing tool, for others it’s quite the reverse! There is no “one size fits all approach” when it comes to new parents and babies and *THAT* is our position!
Sarah Ockwell-Smith – Mum to Four, Parenting Author and Founder of BabyCalm Ltd
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I never knew that swaddling was a contentious issue :)) Here in Australia everyone gets shown in hospital how to do it as a matter of course and is is often done for just the first few weeks till they wiggle so much it is of no use anyway :)) For me personally we co slept in the end, so my little one wasn’t swaddled at night – but if napping during the day in his bassinet he liked to be wrapped, he was happier wrapped than not when in the bassinet.
I would add in that safety list though that if bed sharing don’t swaddle – baby needs arms and legs free at all times if co-sleeping :)
We swaddled our baby and it worked well, but almost too well. He relied on it far longer than the age limit you mentioned, and made it difficult for him to understand why he couldn’t sleep so well anymore.
If I were to do this again, I would lightly swaddle. I wouldn’t make it so tight that he couldn’t free himself if he wanted to. I also don’t want him to rely on it too much and instead use it as a comforting measure.
I understand though your sentiment that *any* advice is never one size fits all. We do what we have to do; I swaddled because I was going crazy with a newborn, and I’m sure that breath of sanity helped me, even if down the line we had to wean him off of it.
But next time around, I would most likely try not to use it again, if only so that we don’t have to subject him to weaning.