Swaddling might sound outdated but some parents say it helps their baby to sleep. Here we talk about its benefits and risks, and tips for safe swaddling.
You might have seen a friend’s baby wrapped up like a cute mini fajita or witnessed the Royal baby Louis’ first TV appearance. If so, you know what a swaddled baby looks like. Here’s what you need to know about swaddling.
What is swaddling?
Swaddling is a traditional practice of wrapping a baby up gently in a light, breathable blanket to help them feel calm and sleep. They should only have their body wrapped and not their neck or head.
The idea is that being swaddled will help your little one feel snug and secure, like how they felt in your womb.
What are the benefits of swaddling my little one?
Often people say swaddling seems to help calm their little one, helping them settle more easily and sleep for longer. Yet there is little research to support these theories.
It’s also thought that swaddling prevents unnecessary wake-ups caused a baby’s startle reflex (Irving, 2014). This is because a swaddled baby’s arms and legs will be contained as they’re wrapped gently in a blanket. That means they will be less likely to startle themselves awake with their flailing limbs.
A growing parenting trend considers the first three months of your baby’s life to be a transitional fourth trimester. The idea is that the first three months of your baby’s life is a complex transition period for them after they emerge from the womb to the outside world (Ockwell-Smith, 2012). Considering this, it makes sense that babies would enjoy being wrapped gently (not too tightly) so they feel secure like they did in the womb.
Medical opinion on whether swaddling is a good practice or not is divided. So, if you’re considering swaddling your baby, make sure you always follow safe swaddling guidelines to protect your little one.
What are the risks of swaddling my baby?
Swaddling your baby carries some risks. It’s potentially unsafe if your baby is not swaddled properly. There’s also a risk of your baby overheating if they are wrapped in too many blankets, in covers that are too heavy or thick, or if they’re wrapped too tightly.
See below for how to swaddle safely.
It’s not a good idea to wrap your baby while breastfeeding as breastfeeding causes them to get hot quickly and they might overheat. Your baby will also have a more natural positioning and latch well on the breast if they are not restricted by swaddling (RCM, 2013).
Another consideration is that routine swaddling might supress the baby’s voice and that might delay the response to the baby (RCM, 2013). Research has shown swaddled babies feed less frequently, suckle less effectively and that their inhibited arm movement affects their arousal pathways (RCM, 2013).
Some evidence suggests that tightly swaddling a baby could increase their chance of developing hip dysplasia (a developmental problem with a baby’s hip joint) (van Sleuwen et al, 2007; NHS, 2013). You can help lower this risk by making sure you don’t swaddle your baby too tightly (International Hip Dysplasia Institute, 2018). You can also use hip-healthy swaddling techniques to reduce your baby’s risk of hip dysplasia.
Make sure your baby is able to move their hips and knees freely to kick. A newborn baby’s legs should be able to fall into a natural position in a frog style.
Sudden infant death syndrome risk and swaddling
The effects of swaddling on sudden infant death syndrome (SIDS) is unclear. Recent decades have seen a general decline in deaths due to SIDS (The Lullaby Trust, 2016; NHS, 2018). This is thought to be because of clear recommendations that it’s safer for babies to sleep on their backs rather than on their front or side (The lullaby trust, 2016).
Swaddling may prevent babies from turning from their back to a face-down position, potentially protecting them from SIDS. Yet once a baby can roll over, they could be at increased risk of SIDS if they’re swaddled. This is because head lifting and turning is crucial to avoid suffocation and that is impeded when a baby’s arms are restrained by its sides when they’re swaddled (RCM, 2016).
Is swaddling my baby safe?
Yes, if you follow safe sleeping and safe and hip friendly swaddling guidance for babies. Current baby sleeping advice is to always lay your little one down to sleep on their back and avoid front or side positions for sleep, especially if your baby is swaddled (Pease et al, 2016). In addition, you should stop swaddling your baby when they show the first signs of rolling over (Nelson, 2017).
How do I swaddle my baby safely?
Follow these seven safe and hip friendly swaddling tips:
- Swaddle your baby using thin, breathable materials. Suitable cloth includes cotton receiving blankets, cotton muslin wraps, or specialised cotton-winged baby swaddles (The lullaby trust, 2018). Don’t over layer them (The lullaby trust, 2018)
- Don’t swaddle your baby above their shoulders – their neck and head should never be swaddled (The lullaby trust, 2018).
- Wrap your baby firmly but gently (not too tightly) (Greviskes, 2012; NHS, 2013). Tight swaddling that stops your baby's hips and knees moving freely is not recommended. Swaddling your baby too tightly might cause hip dysplasia, which is where the hip does not form correctly (International Hip Dysplasia Institute, 2018; NHS Choices, 2013).
- Use hip-healthy swaddling techniques to reduce the risk of hip dysplasia. Make sure your baby is able to move their hips and knees freely to kick. Your baby’s legs should be able to fall into a natural position (like frog legs).
- Always put your baby to sleep on their back. Never put a swaddled baby to sleep on their front or side (International Hip Dysplasia Institute, 2018).
- Check your baby’s temperature regularly to make sure they don’t get too hot or overheat (The lullaby trust, 2018). Check they’re wearing suitable clothes for the weather too (Irving, 2014).
- If someone else looks after your baby, make sure they also know about safe sleeping advice and how to swaddle safely. Take your time to show them and explain safe swaddling and make sure they know to always put your baby to sleep on their back (The lullaby trust, 2018).
How long can I safely swaddle my baby for?
Swaddling should only be introduced when your baby is a newborn. As soon as they show signs that they’re learning to roll over or they can already roll over, you need to transition them away from swaddling (Greviskes, 2012; Pease et al, 2016). This is so they can use their hands and arms freely to adjust their head position if they roll over onto their side or front (RCM, 2013). Your baby could start learning to roll over as early as around two to three months old.
For more about how to swaddle your baby safely read our step-by-step guide to swaddling.
This page was last reviewed in September 2018.
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You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.
Greviskes A. (2012) The benefits and risks of swaddling your baby. Available at: https://www.nymetroparents.com/article/How-to-Avoid-Hip-Dysplasia-When-Swaddling-a-Baby [Accessed 13th September 2018].
International Hip Dysplasia Institute. (2018) Hip-healthy swaddling. Available at: https://hipdysplasia.org/developmental-dysplasia-of-the-hip/hip-healthy-swaddling/
Irving J. (2014) Swaddling: benefits, risks and current advice. Nursing in Practice. Available at: https://www.nursinginpractice.com/article/swaddling-benefits-risks-and-current-advice [Accessed 13th September 2018].
Nelson AM. (2017) Risks and benefits of swaddling healthy infants: an integrative review. CAN Am J Matern Child Nurs. 42(4): 216-225.
NHS (2013) Swaddling may damage babies' hips, expert warns. Available at: https://www.nhs.uk/news/pregnancy-and-child/swaddling-may-damage-babies-hips-expert-warns/ [Accessed 13th September 2018].
NHS (2018) Sudden infant death syndrome (SIDS). Available at: https://www.nhs.uk/conditions/sudden-infant-death-syndrome-sids/ [Accessed 13th September 2018].
Ockwell-Smith S. (2012) The fourth trimester – AKA why your newborn is only happy in your arms. Available at: https://sarahockwell-smith.com/2012/11/04/the-fourth-trimester-aka-why-your-newborn-baby-is-only-happy-in-your-arms/ [Accessed 13th September 2018].
Pease AS, Fleming PJ, Hauck FR, Moon RY, Horne RS, L'Hoir MP, Ponsonby AL, Blair PS. (2016) Swaddling and the risk of sudden infant death syndrome: a meta-analysis. Pediatrics. 137(6). pii: e20153275. Available at: http://pediatrics.aappublications.org/content/early/2016/05/05/peds.2015-3275 [Accessed 13th September 2018].
RCM (2013) A binding issue. Available at: https://www.rcm.org.uk/news-views-and-analysis/analysis/a-binding-issue [Accessed 13th September 2018].
RCM (2016) 'Sleep position and swaddling affects SIDS risk'. Available at: https://www.rcm.org.uk/news-views-and-analysis/news/sleep-position-and-swaddling-affects-sids-risk [Accessed 13th September 2018].
The Lullaby Trust (2016) Rates of sudden infant death syndrome go down to lowest on record but baby charity says more lives could be saved. Available at: https://www.lullabytrust.org.uk/rates-of-sudden-infant-death-syndrome-go-down-to-lowest-on-record-but-baby-charity-says-more-lives-could-be-saved/ [Accessed 13th September 2018].
The Lullaby Trust (2018) Safe swaddling. Available at: https://www.lullabytrust.org.uk/safer-sleep-advice/swaddling-slings/ [Accessed 13th September 2018].
The Lullaby Trust (2018) What is sudden infant death syndrome (SIDS)? Available at: https://www.lullabytrust.org.uk/safer-sleep-advice/what-is-sids/ [Accessed 13th September 2018].
van Sleuwen BE, Engelberts AC, Boere-Boonekamp MM, Kuis W, Schulpen TW, L'Hoir MP. (2007) Swaddling: a systematic review. Pediatrics. 120(4):e1097-106. Available at: https://www.bmj.com/content/347/bmj.f6499 [Accessed 13th September 2018].