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.

How Our Homebirth Saved Christmas

Growing up, Christmas was my favorite holiday. My family, thankfully, never emphasized the commercial aspect. We simply enjoyed spending time together and exchanging heartfelt gifts. Since I got married, the holidays have been increasingly stressful. With double the family, our time is spent rushing hurriedly from one gathering to another, staying for long enough to make an appearance. Adding kids to the mix made it increasingly difficult. The stress was hard on the kids, and I felt guilty for putting them through the ringer each year. I had come to dread the entire month of December. This year, I received a special gift--one that caused me to slow down and reconsider what's really important.

On Christmas day, I was 36 weeks, 5 days pregnant. I woke up feeling a little pressure down low, but didn't think anything of it. I am a firm believer in letting a baby come when he's ready, and had bookmarked a link about why at least 39 weeks of pregnancy is better for baby. I planned to share it when people started asking, "Have you had that baby yet?!" By about 10 that morning, I knew that I would have no need to share it. It took a few more hours to convince myself and my labor support that this was the real deal.

By 10, I was having regular contractions--about 3-5 minutes apart--but I could talk through them. I have had pretty regular Braxton-Hicks contractions in the past, and I certainly didn't want to birth my baby so early. Plus, I didn't want to disrupt anyone's Christmas unless I was completely sure. We decided that I would rest on my side for a while and see if things continued to progress. My husband took the kids out visiting. This slowed my contractions to between 5 and 7 minutes apart. They stayed that way as long as I didn't get up. By around 6 in the evening, the family had finished their visiting and my parents were free to take our three older kids to their house.

That's when I got vertical. Anyone who tries to tell you that position is not important during labor is wrong! Assisted by gravity, my contractions went from somewhat painful and 3 or 4 minutes apart to almost unbearable and 2 minutes apart. I slumped over the birthing ball some, sat on it some, swayed and rocked a lot, and paced back and forth to the toilet over and over again. Nothing seemed to work for comfort. I decided to soak in the tub for a while to help relieve the pain. It slowed things down again, but they soon picked back up and then, whoah, did they pick up! After a day of questioning myself, I finally felt sure that I was in active labor. We called our midwife and asked her to come.

Our midwife arrived around 7:30 and determined that I was 4-5 centimeters dilated. She gave me about 30 minutes alone with my husband to work through labor, but by that point, I did not feel there was any working through it. I did not want him to touch me, and I could not hold still. Then again, it hurt too much to move. I had been through transition before, and this was it. How did I ever go through this lying in bed or strapped into a car seat? After 45 minutes or less, I was pretty sure I felt ready to push, and asked him bring the midwife into the bathroom. "Are you sure?" he asked. That's when I yelled at him (sorry, babe!). After a long day of self-doubt, I was over being questioned. I was ready!

After hearing me yell, the midwife was as sure as I was. She went straight to our bedroom and prepared for the delivery. I wanted to try squatting on a birthing stool, but it hurt too much, and I ended up lying on my side instead. I decided to try a push or two, after which my water broke. Suddenly, the pain subsided and my body could do nothing but push. It was beyond my conscious control. As our midwife turned around to ready her supplies, my husband saw our baby's head emerge and jumped quickly to catch it. Two pushes later, my youngest son was born into my husband's hands on Christmas night, right there in our own bedroom. Shortly after, we were cleaned up and snuggled into our own cozy bed.

I truly believe that our homebirth made a positive difference. The whole birth experience was so peaceful and free from drama. So far, I have seen this reflected in my little guy's calm demeanor and in my own easy recovery. It even seems to have cast a peace over the household. Best of all, my Christmas baby has turned the holiday around for me. From now on, the stress of the holidays will be overshadowed by the memory of this special Christmas night. I will remember cuddling my 8-pound bundle of hope and looking forward to the promise that his new life represents. He reminds me that what is at the very heart of Christmas--and of life itself--is love. When a child is welcomed into the world surrounded by love, he can grow to spread that love to family, friends, and maybe even to all mankind. I can't think of a better way to give him that start.

Bedsharing Past Infancy

Cosleeping and Bedsharing can be two very different animals.  Cosleeping doesn't have to be bedsharing but bedsharing is always cosleeping.

The best place for a baby to sleep is either in the same bed (bedsharing) or same room (cosleeping) as the mother.  Having spent 9-10 months inside their mother, near their warmth, breathing, and heartbeat, it can be a very rough transition to be away from that.  Listening and feeling the mother's breathing and heartbeat regulates the baby's heartbeat and breathing, lowers the risk of SIDS, helps establish a better breastfeeding on demand relationship, and can help both of you sleep better at night.

I started bedsharing with my daughter when she was 2 weeks old.  We really tried to have her in the crib because that is what "normal" parents did, and eventually I couldn't take the lack of sleep and the crying any longer.  I pulled her into bed with my husband and me and never looked back.

My daughter turns four next month and we still bedshare most of the time.  Last summer, when I was was pregnant with our son, she had just started sleeping in her own room, which was her own choice, and when I started having issues with my pregnancy, she came back with us.  When we lost the baby, I kept putting off getting her back to her own bed.  None of us were interested in her leaving.  She was a huge comfort when we needed her most.

Now that she is almost four, she wants to be her in own bed again, but doesn't want to leave our room.  So, we have a compromise.  Her mattress is on the floor right next to our bed, and she has free reign on which bed she wants to sleep in at night.  Some nights she will sleep in her bed all night, others she comes into our bed in the middle of the night, and nights which are fewer and fewer she sleeps all night with us all night.

Many would tell me that she is dependent on us to sleep, and it makes me laugh.  The truth is, it is the opposite!  Because of our losses and things that we have been through, I feel like I need her close more than she needs me close.  Loss changes a person, whether it's a baby, your sister, mother, father, cousin.  It changes it your perspective on life, and since our losses, my mind goes to places that make me uncomfortable.  I worry all the time about losing my daughter.  Having her in the same room with me, even if it isn't the same bed all the time, comforts me.  I think she knows that and hasn't chosen to go back to her own room because of it.

Many families have different reasons for bedsharing or cosleeping past infancy, one of the more popular ones in the natural community is that they are still nursing.  Just because your child is older than a year or two or three doesn't mean they have to be in their own bed in their own room, and that's okay.

The benefits of cosleeping and bedsharing don't end at a certain time.  It is the same as nursing.  Your child doesn't magically become "too old" to stay in your room or your bed.  Every family feels that age differently.  Some stop wanting to sleep with their children when they start to flail around at night as inevitably all toddlers do, others like their children to be out of their bed by the time they eat solid foods.  Still more don't like to have their children with them at all.

Cosleeping and bedsharing both have amazing benefits, but again, it's a choice for your family.  If your family chooses either of those, it is good to know that you can choose when to stop.  My daughter is so independent and strong, and personally I feel that knowing I am still just an arm's reach away helps that.  I think that growing up with that comfort helped her to feel more confident in herself.  She isn't going to always need me just because she is still in our bed sometimes.  She isn't going to be terrified to go to her own room when she is ready.  She won't be in our bed forever like some believe.

You can keep your child in your room and your bed even if you aren't nursing any longer.  You can keep them in your room when they talk and walk and are their own person.

There isn't an age where it is unacceptable.  This is your family.  Make the choices you need to make to raise happy, healthy, independent children.  For us, that is keeping her in our room just for peace of mind, though I know that those days are slowly coming to a close.