Should You Swaddle?By Claudia Anrig, DC The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.1 Still popular in Europe, there appears to be a resurgence of swaddling in North America among the holistic movement, making it an important topic for parents, particularly those expecting a child or blessed with a newborn. The purpose of swaddling is to calm the infant and promote sleeping. This technique is often grouped with the traditional soothing techniques of nursing, massage, skin-on-skin contact and baby carrying. One benefit of swaddling may be that babies cry less: "The movements of the arms and legs cause the baby to startle. This is upsetting to the baby and causes over stimulation. When they are over stimulated, newborns cry in an attempt to block out the stimuli. When they are swaddled, the jerky arm and leg movements are kept to a minimum, resulting in less crying."2 Another benefit noted by Hughes is that swaddled babies are less likely to scratch their faces with their fast-growing nails. Holistic medical physicians Feder and Neustaedter both recommend the practice of swaddling in their respective books, Natural Baby and Childcare and The Holistic Baby Guide.3-4 Why Consider Swaddling? In The Happiest Baby on the Block, pediatrician Harvey Karp, MD, suggests a newborn needs the imitation of the womb during their first three months of life. The "five S's" that help replicate that environment are swaddling, side or stomach position, shhh-ing sound, a swinging motion and sucking.5 How to Swaddle3,8
Is Swaddling Safe? Thach addresses the issue of safety in his article, "Does Swaddling Decrease or Increase the Risk for Sudden Infant Death Syndrome?" He notes: "Fortunately in the present study, as noted previously, swaddling does not appear to impair sub-cortical arousals that are essential for adequate pulmonary function and appear to be the primary mechanism in terminating obstructive apnea in infants."6 In an extensive review, "Swaddling: Boosts Baby Sleep, Stops Colic and Reduces Infant Risks," Dr. Karp notes two studies that have shown babies who sleep on their back and are swaddled have a 33 percent less risk of SIDS than unwrapped back-sleeping babies. He suggests swaddling might actually reduce the incidence of SIDS and accidental suffocation, in addition to providing other benefits to both mother and child:1
Addressing Other Concerns Does swaddling enhance or interfere with nursing? It appears not to create an interference; in fact, a calmer baby may enhance breast-feeding and improve maternal well-being. Does swaddling cause infant hip dysplasia? The International Hip Dysplasia Institute states it's safe as long as the baby can flex, and the hips can flex and abduct.7 Can swaddling prevent or reduce shaken baby syndrome (SBS)? According to Karp, the No. 1 reason for SBS is infant crying, and one study found 89 percent of parents who shook their babies visited a doctor prior to assaulting their babies, seeking advice on how to calm their infant. He comments that if maternal well-being were improved, it could reduce possible stressors leading to SBS.1 Suggested Swaddling Protocols
Divided Opinions Opinions remain divided on the issue of swaddling, and just last year, new guidelines from the Registered Nurses Association of Ontario (RNAO) addressed the possible unsafe practices of swaddling, since there is no evidence on a "safe way."9 The guidelines note the following concerns: 1) Swaddled babies placed on their stomach may increase the risk of SIDS; 2) There is a risk of overheating or the blanket suffocating the infant; 3) Swaddling may lead to hip abnormalities. The RNAO concluded the safest approach is for infants to sleep on their backs, alone, in a crib that meets national safety standards. The guidelines also recommend avoiding the use of blankets, pillows and other types of sleep aids. The bottom line? Ask your doctor whether they recommend swaddling and present them with this article to help promote an informed discussion. References
Claudia Anrig, DC, practices in Fresno, Calif., and is on the board of directors of the International Chiropractic Pediatric Association, an organization that can answer your questions regarding the value of chiropractic care during and after pregnancy. |