Swaddling: Why do it and when to stop?

Swaddling a newborn baby is a common practice. In my newborn care classes, it is one of the first things parents are eager to learn about. There is an instinctual impulse to hold a newborn baby close, to wrap them in a blanket to keep them warm, and to help them feel secure. And though there may be short term benefits to swaddling, it is not something you have to do, nor is it something all babies like or need.

Why swaddle?

The main purpose for swaddling is to help your baby make the transition from womb to world. While in the womb, your little one experienced a snug, secure space with little room to move. Once born, your newborn experiences their reflexive movements in a whole new way. One of the most pronounced reflexes is the moro or startle reflex which is when your little one throws their arms out wide when a sudden noise or sensation startles them. The arms may shake and then contract back with their hands trying to grasp something to hold. This is often followed by crying. This reflexive movement can occur when a newborn is placed on their back while sleeping. The movement of placing them down can sometimes elicit a startle response.

It’s important for newborns to be placed on their back for sleep, but your baby might be more restless if the moro or startle reflex occurs while they are in this position, which is where the swaddle comes in. Your baby is more likely to not startle awake if their arms are tucked into a swaddle. 

Is it safe?

We know that safe sleep guidelines include placing a baby down in their own sleep space like a bassinet or crib on their back on a firm flat mattress without any loose or soft bedding, bumpers, pillows, sleep positioners, stuffed animals or hats. This is to protect them from SUIDS which stands for Sudden Unexpected Infant Death Syndrome (SIDS is a sub category of SUIDS,which also includes other conditions. (About SUID and SIDS.) Using a swaddle for the first couple of months is considered safe, as long as you are following safe sleep guidelines.

When is the best time to stop swaddling?

The main concern with keeping a baby swaddled is that once they learn to roll to their side and tummy they are at a greater risk for SUIDS if their arms aren’t free. They can’t lift their head as easily and can’t push themselves up on their arms or hands if they are swaddled. This is why the AAP recommends that babies no longer be swaddled past 2 months.

Most babies start rolling between 3-6 months, but some start as early as 2 months. It’s important to have them out of a swaddle before they start to roll and not wait until they roll to make the transition. Once you are no longer using a swaddle, you can use a wearable blanket or sleep sack. This will keep your baby covered even while they move around. They can move their arms freely while in a sleep sack. It’s also important for their hands to be uncovered once you are no longer swaddling.

So, swaddling is meant to be a short term transitional support for your little one as they get used to moving their arms. The idea is to help your baby adapt to life outside the womb, but not to keep them from developing more control over their movements. You are looking for a balance between getting some sleep and giving your baby a chance to move. Movement is key to helping a baby develop the strength they need to support their head and upper body. If you use a swaddle for too long it can slow down development and can be harder to wean them off the swaddle as they become accustomed to sleeping that way.

Here are a few important reminders when swaddling your baby:

• Not all babies like it! If your little one just won’t settle once they are swaddled, and are more comfortable with their arms free, then you don’t need to swaddle them. You can go right to using a wearable blanket instead of a swaddle.

• It’s best to only use the swaddle for sleep rather than keeping your baby’s arms contained throughout the day. You don’t have to swaddle for every nap. Night time sleep is when it’s the most helpful.

• It’s important to keep the swaddle loose around your baby’s hips so that the hip joint can flex to develop properly.

• You want to be sure your baby isn’t too warm in the swaddle. Being overheated can be a SIDS risk, so be sure your little one isn’t wearing a hat while sleeping, that the room they are sleeping in isn’t too warm and has good air circulation, and they do not have too many layers under the swaddle.

• Be sure the swaddle isn’t weighted. You don’t want the material to be too heavy or bulky as that can make it harder for your baby to adjust their sleep position.

• It’s best to swaddle your baby’s arms so they are bent with the hands tucked up under their chin rather than down at their sides. Most babies prefer to have their arms up rather than down while sleeping. Just be sure the swaddle isn’t so tight they can’t breathe easily. It can be snug across the shoulders, but not too tight across the chest.

• If you bring your baby into bed to nurse or cuddle, be sure to remove the swaddle. This is especially important if you decide to bed-share. The AAP recommends that newborns sleep next to, but not in the same bed as parents, but if you do, you want to be sure your baby is not swaddled so they can move around more easily.

A blanket swaddle vs. a velcro swaddle:

Most parents start with a blanket swaddle and then use a velcro swaddle if their baby just won’t stay swaddled in the blanket. The purpose in swaddling is to help your baby settle to sleep while on their back without startling awake. If they get their arms out and remain asleep then it’s not a problem. The blanket will be under your baby’s arms so the risk of it covering their face is minimal. 

If you find that your baby is very restless with their arms free then using a velcro swaddle will help keep them inside the blanket. You still want to have your baby’s arms tucked up rather than down in the velcro swaddle, and that it’s not too tight around their chest or hips. Also, you want to be sure to unswaddle them when it’s time to feed so you can adjust their position either on the breast or bottle. It’s also important that your baby isn’t swaddled while burping as it can be less effective. 

There are many different kinds of velcro swaddles, You might want to try a couple of different kinds to see what works the best for your baby. That said, you don’t have to buy a bunch of different swaddles, as you are only going to be using them for a very short period of time. 

Also, beware of the marketing on some swaddles that say their swaddle will keep a baby sleeping through the night. A baby in the first two months should not be sleeping through the night as they need to feed frequently to gain weight and to build your milk supply if you are breastfeeding. 

And, be wary of swaddles that say you can keep using them until the baby is 6 months or older. If your baby’s arms are pinned down or enclosed in a blanket and they can’t get their arms or hands free it isn’t a safe way for them to sleep, especially after 2 months of age. You want to be sure your baby is no longer swaddled before they start to roll.

Here are steps for how to swaddle your baby in a swaddle blanket:

1. Use a blanket that isn’t too thick that has some stretch to it. You want a blanket that’s big enough to wrap around your baby, but not so big that you have more fabric than you know what to do with.

2. Lay the blanket down so the longest sides are at the top and bottom (if it is a square blanket then this doesn’t apply)

3. Fold one of the top corners down to about the center of the blanket. This will make a triangle at the folded corner.

4. Place the baby in the center of that triangle so your baby’s head is above the fold and the shoulders are below.

5. Bring one side across your baby’s body in a diagonal from shoulder to bottom. Be sure you bring your little one’s arms up to their chest as you are doing this. Tuck the blanket under their bottom. It should be snug at the shoulder but not so snug that your baby can’t move their arm a bit.

6. Then bring the bottom corner up so that it comes to your baby’s tummy. There should be fabric loose around their legs and hips.

7. Finally, bring the other side across your baby’s shoulder (bring baby’s arm to their chest) and tuck it under baby’s bottom.

When it’s time to stop swaddling your baby:

It can be nerve wracking to remove the swaddle, especially if your baby is sleeping well with it on, but it’s an important step for safety reasons as well as to help your baby get used to their arms moving.

It may not seem like it, but all the arm swinging, squirming and hand movements are how your baby will eventually learn how to settle to sleep. Babies will often bring their hands to their mouth as a way to find comfort, even though they may not be able to keep their hand in their mouth for long. Most babies spend a few minutes moving around before sleep, so when you stop swaddling you are giving them a chance to move and work on finding ways to settle themselves. They will still likely need your help to let go to sleep, but that practice time is important.

When it’s time to stop swaddling your baby you can do it gradually, unless your baby has already rolled over from their back to this tummy while in their crib or bassinet. If that happens then you have to stop swaddling right away and use a sleep sack so their arms are free.

If you do have time to do this slowly, here are some suggestions for how to make this transition. I will say, I am not one to suggest just swaddling one arm as a beginning step. Babies like to use both sides of their body when moving and to have one arm contained while the other is moving around can be destabilizing and confusing. I think it’s best to have both arms unswaddled or both arms swaddled.

The Unswaddling Process:

• Once your baby is 2 month old, begin to do a sleepy time routine with your baby before you put them down for a nap or for bedtime. This can include a feed, a diaper change, singing a little song, closing the curtains, turning on a sound machine, and rocking your baby for a few minutes. All of this happens unswaddled.

• Then place your baby down in their bassinet or crib on their back. You can rub their head and tummy for a minute and then step back to let them have 2-3 minutes  to move and vocalize. You want to give your baby time to use their arms and their body movements to find ways to settle, without expecting they will get there right away. They might make a humming sound, or fuss a little, but if they become upset you will be right there to help them.

• If your baby starts to become upset, you can offer them a pacifier, if you are using one. Then put your hands on your baby’s chest and hum. You can hold their hands for a minute while you do this, but only briefly. See if that’s enough to help them calm so they can settle.

• If they continue to escalate, then put them in their swaddle to see if that is enough to help them let go. If not, then pick your baby up while they are swaddled and rock/walk for a few minutes until they are calm and sleepy, then put them back down. If they become upset again, pick your baby up and rock them to sleep, and transfer them into their crib. Try to stop rocking once they are asleep in your arms and hold them in stillness while standing at the crib before you place them down.

• Each day, wait a few minutes longer before you swaddle your baby, until you are giving them around 10 minutes to work on settling themselves. At that point use a sleep sack rather than the swaddle and if they need help getting to sleep, you can rock them in your arms while they are in the sleep sack. 

This process helps your baby make the adjustment slowly and gives you a chance to go back to swaddling if they just can’t settle without it. This makes it less stressful for both you and your baby. Once you are no longer swaddling your baby, you may find this blog helpful if your little one is resisting sleep.

Conclusion:

Swaddling can be a great tool to help babies adjust to life outside the womb and to give you a chance to get some much needed rest until your baby’s moro reflex becomes less activated while they are lying down on their back while sleeping. Just remember that it’s meant to be used for just a short period of time. The more time your baby spends moving around the stronger they become and the less they will be bothered by their arms moving.

I know this transition can be challenging. It’s hard to give up doing something that gives you precious sleep. But the longer you wait to stop swaddling the harder it can be to let it go. If you are struggling with this adjustment, please reach out. I would be happy to support you through this big transition. Send me an email to schedule a no cost introductory call!

Disclaimer: Elizabeth Green's Early Parenting Sleep Consultations and written material are for educational purposes only and are not meant as medical advice. All spoken and written information is to be used at each parent's discretion.