New parents often learn how to swaddle infants from hospital nurses.  When done correctly swaddling can be an effective technique to calm infants and promote sleep.  There are some guidelines to ensure it is done safely.

To reduce the risk of SIDS or Sudden Infant Death Syndrome, it’s important to always place your baby to sleep on the back for the first 6 to 12 months. It is even more important when babies are swaddled.  Stop swaddling as soon as the baby shows any signs of trying to roll over which may be as young as 2 months of age.  Rolling over generally occurs between 3 to 7 months old. Sleep clothing such as a wearable blanket or sleep sack is appropriate to keep a baby warm.  No loose objects like pillows, blankets, toys or bumper guards should be in the bed.  Wearable blankets or sleep sacks that compress the arms, chest and body should also stop when there are signs of starting to roll over.  Sleep sacks that do not swaddle and allow the baby to move freely can be used indefinitely.   A loose blanket, including a swaddling blanket that comes unwrapped, could cover the face and increase the risk of suffocation.  Swaddling can increase overheating potential.  It’s associated with sweating, damp hair, flushed cheeks and/or rapid breathing.  The mattress should be firm. The room should be 100% smoke free. Never place your baby to sleep on a couch, sofa or arm chair. Keep the baby in the same room where you sleep for the first 6 months to a year and if possible close to your bed.  It’ll make it easier to feed, comfort and watch your baby.

Swaddling too tightly may lead to a hip problem. with the legs held straight instead of allowing for the legs to bend up.  To swaddle correctly, spread the blanket out flat with one corner folded down.  Lay the baby face up on the blanket with the head above the folded corner.  Straighten the left arm and wrap the left corner of the blanket over the body and tuck it between the right arm and the right side of the body.  Then tuck the right arm down, and fold the right corner of the blanket over the body and under the left side.  Fold or twist the bottom of the blanket loosely and tuck it under one side of the baby.  Make sure the hips can move and that the blanket is not too tight.  At least two or three fingers should fit between the chest and the swaddle.

Peace,

Irwin J. Kash MD