The first time you lay eyes on your new bundle of joy, he or she is likely to be wrapped snuggly in a swaddled blanket sleeping comfortably. That is no coincidence, says Fozia Saleem-Rasheed, M.D., a neonatologist at William Beaumont Hospital in Royal Oak.
“Swaddling mimics the snug environment the baby was accustomed to in the womb,” she explains.
It is this familiarity that leads many babies to feel comforted when swaddled and thus more likely to sleep better and for longer. Yet, this age-old practice is not without its dangers, like Sudden Infant Death Syndrome (SIDS), overheating or injury, so new parents need to learn the best practices for safe swaddling. Here are some top tips to keep in mind:
Not too tight
Parents often worry about making the blanket too loose for fear, but swaddling a baby too tightly and with his or her legs straight can result in hip dislocation, notes Saleem-Rasheed. Aim for a middle ground in swaddling tightness.
Stop at 2 to 3 months
Saleem-Rasheed cautions that swaddling a baby past 2 or 3 months of age can present additional dangers as the baby becomes more active. “At a few months of age, the baby’s activity may cause the swaddle to come undone,” explains Saleem-Rasheed, herself a mother of four. “Then you have loose blankets in the crib, which can lead to choking or suffocation.”
Consider a sleep sack
Saleem-Rasheed prefers parents use a swaddler or sleep sack that zips. Swaddlers like the Halo SleepSack Swaddle allows babies to be swaddled with their arms close to their body thanks to velcro flaps sewn in to the sack, so they can’t be used incorrectly. If you do plan to use a blanket to swaddle your baby, ask your pediatrician to demonstrate proper swaddling technique while still in the hospital after the baby’s delivery.
Saleem-Rasheed notes that the gold standard is to swaddle with baby’s arms out. Susan Dendrinos, R.N., director of Specialty Care Services at Henry Ford West Bloomfield Hospital, and formerly the nursing manager for the birthing center, concurs. “If the baby is swaddled and rolls over – especially if his arms aren’t free – he can end up face down unable to breathe,” she explains. For that reason, she advises parents who choose to swaddle, at a minimum, do so with baby’s elbows bent and hands out near his or her face.
Watch the weather
In warm weather months, Saleem-Rasheed says parents who swaddle their infant should pay close attention to the temperature in their home. “If it is very hot and the home is not air conditioned, the baby should be dressed in a single light onesie and swaddled in a thin blanket,” she says. She points to the thin muslin blankets like those by Aden + Anais as appropriate for warm weather months.
“The concern with overheating is that the baby may fall into a deeper sleep and not arouse as easily, which increases the risk of SIDS,” she explains.
Counsel all caregivers
The American Academy of Pediatrics notes that 1 in 5 SIDS deaths occurs while an infant is in the care of someone other than a parent. Therefore, it’s critically important that parents talk to those who provide care for their baby on safe sleep practices.
“At two or three months of age, your baby may be in a child care setting,” Saleem-Rasheed notes. “You want to make sure the care provider is not swaddling the baby too tightly or swaddling if the baby is older.”
No stomach sleeping
Saleem-Rasheed stresses that baby should under no circumstance be swaddled and put to sleep on his or her stomach. That’s another SIDS hazard.
Hold baby often
While swaddling infants is a common practice, Saleem-Rasheed stresses that babies find a lot of comfort in just being held.
“I encourage parents to try simply holding their baby first to offer comfort,” she says. “Many parents want to swaddle the baby and put him or her down, but nothing mimics the womb better than holding your baby in your arms.”
This article was originally published in August 2013 and has been updated.