The Case Against Swaddling

My very content un-swaddled newborn baby

When my son was born just over 2 years ago now, I remember being rather annoyed that every time the nurses brought my son back to me after tests and treatments (We were hospitalized for 5 days due to a placental infection not diagnosed until the birth) he was bound tightly in hospital issue receiving blankets. At the time I didn’t know why I was annoyed, it just seemed wrong that each time I would have to rescue my tiny grunting struggling son from his flannel burrito and spend the next 5-10 minutes calming him down enough to breastfeed.

‘Don’t un-wrap him’ one nurse told me. ‘They like it, it feels like the womb, he’ll settle.’

I looked down at my grunting, grimacing, rooting baby and then back up at her with disbelief. My son HATED the swaddle. In fact, my son hated anything that didn’t involve being skin to skin with a boob in his mouth. Yet each and every nurse would tell me how much babies like to be swaddled, about how it was comforting and would help him adjust to being on the outside. All of these praises made me feel kind of dumb, made me feel like there might be something wrong with my baby because he so obviously didn’t like their magical blankets one tiny bit. As I said before it was just kind of annoying.

When we finally got home and settled in I promptly forgot about the whole thing. Needless to say we never swaddled him again. Life went on.

More recently I found myself thinking about this again when I was watching a friend struggle to wrap her flailing infant as tightly as she could because ‘the nurses said it would help him settle’. I thought about how much my own baby hated it, and about how the more newborns I see swaddled the less I believe that any of them like it half as much as everyone says they do, and I started wondering where health care provider’s knowledge of it's wonderful benefits were coming from since every actual parent I’ve heard talk about it reports that their baby wasn’t really all that impressed by it.

So I did a little research. As it turns out there are, as far as I can see, far more reasons NOT to swaddle a newborn then there are reasons TOO do it.

Reasons to swaddle: Tightness is “womb-like” making baby feel content and keeping them from startling resulting in longer periods of sleep.

Reasons not to swaddle:

1) Keeps baby from startling – When we remember that the startle reflex is a survival mechanism which help infants to wake up and alert their parents if something is wrong. (Like falling out of a tree or forgetting to breath) Then logically it seems like a bad idea to intentionally subdue that reflex. As a parent the idea of it makes me really uncomfortable. Sure babies do sometimes startle when there is nothing wrong, but I will take a few false startles as a comfort that my baby will wake up if something is actually wrong. I should mention, however, that the scientific jury is still out on this one.

I have found two similar studies done on the effects of swaddling on the startle reflex here and here that come to two different conclusions. One recognizes the inhibition of startle reflex but asserts that this poses no risk for SIDS (This study used a swaddle method that did not limit mobility of the infant’s legs, which is interesting.), while the other shows a big difference in arousal responses of infants who are routinely swaddled vs those who are not and suggests that further study is needed on what this means for SIDS risk.

2) Not entirely all that womb-like – Aside from the snug fit, a swaddling blanket is nothing like the womb, it isn’t always the perfect temperature (see next point), it doesn’t have a heartbeat or comforting voice, it has no means of providing nutrients.

3) Possibility of overheating – Human infants are born quite helpless, we all know this. They cannot walk, feed themselves, or do their own (never ending) laundry. They also aren’t very good at regulating their own body temperature. When an infant becomes too hot, which could happen in a tight swaddle in thick blankets, they are at risk for apnea. The most natural way for an infant to maintain a proper temperature is through direct contact with a parent or caregiver. (see link in point 5)

4) Hip Dysplasia – The standard super tight burrito swaddle that the nurses at our hospital raved about can often result in an infant spending a lot of time with their legs incorrectly positioned causing problems in the hip joints not unlike the effects of improper babywearing. While no extensive large scale studies have been carried out on the effects of swaddling on hip joint development there is still evidence to show the correlation. http://pediatrics.aappublications.org/content/121/1/177.full

5) Limits tactile stimulation – Since an infant in a swaddle is so tightly wrapped in so many layers of fabric it limits the stimulation of a caregivers touch. Since physical contact is so important for bonding, breastfeeding, and for an infant to self regulate body heat, heart rate, and other biological systems, it may not be such a good idea for an infant to spend too much time wrapped up in this way. http://www.naturalchild.org/guest/jack_newman2.html

6) Could potentially interfere with breastfeeding – In the early days a swaddled baby who enjoys being swaddled may rouse less often and therefore spend less time at the breast, this can lead to a higher incidence of jaundice and weight loss in newborns. A swaddle also prevents a newborn from displaying early signs of hunger like trying to get their hands in their mouth. In the very early days and weeks when learning cues and communication is still in progress limiting these early cues could potentially cause feeding problems. Limiting direct contact between mother and baby could also have an effect on milk supply. http://www.nancymohrbacher.com/blog/2010/12/3/rethinking-swaddling.html

7) Interferes with Elimination Communication - If you are planning to use natural infant hygiene with your infant, a tight swaddle will also limit your newborns ability to communicate elimination cues and your ability to acknowledge eliminations quickly.

There was, of course, no mention of any of this when my son was born and constantly being brought to me tied up in his flannel prison of sadness; only insistence that babies love to be swaddled when my baby so obviously did not. My instincts told me that the swaddle wasn’t right for us and I am happy I listened to them because knowing what I know now about it I would have been a lot more adamant that the hospital staff stop doing it.

I am, of course, not suggesting that no one should swaddle their infants ever. If your baby seems to enjoy playing cabbage roll then by all means don’t eliminate the practice from your repertoire completely. However I would say that the points above are very good reasons to limit the time an infant spends in a swaddle. All of the benefits of a tight swaddle can be achieved in other ways that do not pose the same potential risks. A good tummy to tummy hold in a sling or wrap for instance. So if you have the option to wear your baby, or have a family member spend some skin to skin time with your baby then why not do that instead when you can?

What I am saying is that swaddling really isn’t the magical cure all that many of us are led to believe and there is absolutely no harm in leaving it out of your life if that’s what you want to do. There is certainly nothing wrong with a baby who doesn’t enjoy it, so don’t feel bad when you quickly un-wrap your newborn the second a caregiver hands them to you.