Many thanks for looking after our baby Hayden in Hospital and he will be seeing you again around 6 weeks. A question about swaddling, Hayden really likes to be swaddled, he will be 1 month old tomorrow. How long should we continue to swaddle him? I have read about some concerns after 1 month with interfering with mobility and development? What is your advice?

D  Done properly, swaddling is a useful and safe practice for young babies. It quite definitely helps to calm them and improves their sleeping pattern for a couple of reasons:

  •  The swaddled position reminds them of how they were in the womb, the arms across the chest, bent at the elbow; and the legs flexed at the hips and knee, with the knees slightly splayed.
  • All babies have a ‘startle reflex’ during the first 3 months. If the baby’s head drops backwards, extending the neck, their body thinks that they may be falling, so the arms involuntarily fling out and make grasping movements in the air. It really upsets them. Swaddling the arms suppresses the reflex.

There are, however, a few precautions that should be taken when swaddling your baby:

  • Very important is that the baby should sleep on his back. We know that all babies should be put down ‘back to sleep’ anyway, but it is even more important if they are swaddled, as their limb movement and ability to wriggle around, to keep their airway clear, is restricted by the wrap.
  • For the same reason it is important to make sure you’re your baby cannot wriggle free of the swaddling cloth and get it over his face, which might restrict his breathing. Also make sure that there are no other sheets, wraps or bumpers in the cot which might do the same thing.
  •  Still on the subject of breathing, it is important to make sure that the swaddle is not too tight around the baby’s chest. It should be snug but you should be  easily able to get a couple of fingers between the baby’s chest and the wrap.
  •  It is important to make sure that your snuggled up baby doesn’t get too hot, so keep the room at a moderate temperature and do not use too heavy a wrap in warmer weather.
  • Now the worry about the hips and swaddling. It is also very important to be sure that the legs have some freedom of movement, with the hips flexed and the knees slightly splayed. This position helps in the development of the hip joints. Over the first year or so, as a result of the pressure exerted by the ball of the head of the femur (or leg bone) the socket deepens to form a nice stable joint. Strapping the legs straight out over months can cause ‘hip dysplasia’ in which the socket is too shallow – a serious orthopaedic problem.
  • After the age of 2 months babies get more mobile and are a little more able to free themselves from their wrap (which might possibly cover their face). Some can also roll over into the prone (front facing down) position. It is well known that sleeping in the prone position increases the baby’s likelihood of SIDS/SUDI and this is even more so if the baby is also swaddled. So after this age, review whether swaddling is necessary for your baby, and, if it is, increase your vigilance and attention to your technique.

There has been a recent controversy in the news regarding the safety of swaddling. On consideration, the danger was seen to be predominantly in childcare centres where older babies were cared for in large groups, with less intense supervision than with the parents. These babies were sometimes put on their fronts to sleep, and had busy carers who may have swaddled too tightly. Also swaddling a larger, mobile baby who has never been swaddled before, was found to be at increased their risk, for the reasons outlined above.

Swaddling in the home, especially using the professional swaddlers (such as the one from Ergobaby), is a safe and very useful technique which can give you a baby, who is calmer, and sleeps longer.