Is it O.K. to swaddle our baby?

Before we left the hospital the nurses showed me how to wrap our baby in a little blanket so that her arms and legs were all snuggly.  They called it a swaddle, we called it the baby burrito.  Henrietta is now six weeks old and we think the swaddle is really helping her, but someone in my mom’s group told me that she heard swaddling was dangerous.  This doesn’t make sense to me!

You aren't the first parents to be confused! Your friend has heard about the newer cautions about swaddling newborns if they are sleeping on their sides or tummies, which is never recommended for young babies, anyway.  Rachel Moon, M.D., who has been the spokeswoman for the recommendations said she was worried that a swaddled baby who was old enough to roll over might be placed on her back and then flip over. Of course, it would be pretty difficult for a young baby to flip over when swaddled. Most babies can't roll over until they are three months old and can use their arms for momentum. Once a baby can do that, she can also get her hands to her mouth to suck for comfort, which is is a good signal that it's time to move past swaddling anyway.

If you are placing Henrietta on her back for sleeping, (and I hope you are!) then it doesn't make any difference whether you have swaddled her. The reason that babies benefit from being swaddled during the newborn period is to help them stay in the cozy and confining environment that they got used to during the end of pregnancy. 

Newborns are in a state of transition for at least three months after birth, which has sometimes been called the fourth trimester. They need to be held and fed and comforted around the clock, much to the dismay of their exhausted parents.  Fortunately, wrapping or swaddling a baby closely in a light blanket called a receiving blanket will often help a baby to settle into a calm state.  The swaddle also helps restrain the baby’s arms and legs which during the early weeks will often jerk into what is called a startle reflex.  The startle is a “primitive reflex” and dates back to the time when mommies had tails and lived in trees and their babies had to hold on to keep from falling.  The clenched fists you see in a newborn are primitive reflexes as well, and come from the time when  babies needed to clutch to mom’s fur!

To swaddle your baby, you have to master a technique that is very simple, although much easier to watch on YouTube than to describe.  A thin blanket is used to wrap the baby.  In the early weeks, it’s helpful to have her arms downward with elbows slightly flexed so that they can’t wiggle out, because this prevents baby from smacking or scratching her face. As baby gets older, it’s a good idea to unwrap the arms.  The bottom of the swaddle should be wrapped loosely enough so that a baby's legs are in a frog position in order to keep the hip joints in the proper position and avoid hip dysplasia. Here’s a video that shows a number of safe ways to wrap a swaddle: https://www.youtube.com/watch?v=LLqfRQdUP7k

Some of the blankets that are sold to ease the work of swaddling are fine as long as they don't overheat a baby. Babies don’t need to be hot at night! The optimal temperature for a baby’s room is about 70 degrees F.  Some sleep outfits are thick and bulky, which keeps a baby still but can lead to overheating, so be cautious..

Most parents find that the best time to use the swaddle is when a baby is fussy or sleepy as the coziness will assist in calming her. Adding movement and shushing noises, and offering your finger or a pacifier for her to suck will usually help a baby return to a state of womb like contentment, at least temporarily. Putting your baby to sleep on her back in the swaddle will often help her to fall asleep and stay asleep longer.

It’s better to loosen the swaddle when you are nursing or feeding so that your baby will stay awake,  In addition, many babies will grab at the edge of the loosened blanket while nursing and that may become a natural association with the pleasure of feeding--and that’s how a blanket can become a transitional object for lovey.

As Henrietta gets older you may notice that she resists being wrapped or may even try to break out of the swaddle you've carefully constructed. This is the time to ask yourself, if the same thing that was comforting is now seen as distressing what is my baby telling me? No doubt she's telling you that it's time to move on. In fact the first sign that it is time to deswaddle at least some of the time is when your baby can start getting her hand to her mouth. Once she can do that, she can learn to soothe herself to sleep without your help and may be able to sleep longer. If you keep her swaddled she won't be able to practice that important skill.

You can gradually make the transition by noticing which hand she favors bringing to her mouth.  Let that one be free first.  She may have trouble coordinating the movement at first but with practice it will be easier. She has to try and sometimes fail in order to learn.  There’s no perfect time to make the switch. You may notice that for a few nights Henrietta sleeps less well, because once a baby has developed a sleep habit, change is disruptive.  Don't worry. After a few nights, she’ll be back to her normal sleep pattern, perhaps even better.