Baby

“Elisabeth screamed from the minute she was born.” That’s how Jo-Anne Elder recalls the arrival of her daughter. Since she also had Elisabeth’s twin brother, Gabriel, to look after, Elder felt, frankly, overwhelmed. “I just thought — I can’t do this! I was afraid I was going to have at least one of them crying all the time and I couldn’t imagine what I was going to do.”

As Elder sat in bed, nursing Gabriel and listening to Elisabeth start to cry yet again, her nurse suggested she try swaddling her unhappy baby. “I wasn’t comfortable with the idea at first,” Elder admits. “It wasn’t how I’d imagined looking after my babies.”

But when the nurse bundled Elisabeth up like a little burrito, she stopped crying almost immediately and fell asleep. Elder was astonished and relieved.

Swaddling babies is traditional in many cultures around the world, but less common in North American or western European families. Harvey Karp, paediatrician and author of The Happiest Baby on the Block, became interested in swaddling after working on a hospital team dealing with child abuse. “I saw babies who had been abused because their parents were frustrated that they couldn’t stop the crying,” he says. “So I began to study infant development and see if there were things that could help.”

When he found that in some cultures the persistent crying we call colic doesn’t exist, he looked for differences in baby care routines. He’s distilled those into the “Five S’s” — and the number one S is swaddling.

For some babies, Karp says, being bundled may be all it takes to settle down. “Swaddling keeps your baby from flailing his arms around and startling himself,” he explains, “and then he can focus on the other things you are doing to help him calm down.”

The best blanket for swaddling is a large square, not a rectangle, Karp says, and babies need to be wrapped quite tightly for the technique to be effective. He points out that some babies may seem to struggle at first, as they push against the blanket to find the limits, but most come to happily anticipate being bundled and relax as soon as they are positioned on the blanket.

Another bonus: Swaddling helps some little ones sleep better on their backs, adding as much as an extra hour or two of sleep each day. Research from the Washington University School of Medicine in 2002 found that swaddled babies placed on their backs fall asleep more readily and often sleep longer.

Concerns about swaddling — that it can restrict breathing, cause hip problems and lead to overheating — were also considered by the researchers. They found, for example, that the babies’ oxygen levels remained unchanged. As for hip joint development, Karp says this is only an issue when a baby’s legs are held in a rigid extension when swaddled. “I recommend that the arms be snug,” he adds, “but the legs have flex room.”

To avoid overheating, Karp advises that when it’s warm, a swaddled baby should wear just a diaper — no sleeper or undershirt. Or the swaddling blanket could be a light cotton sheet cut into quarters. Plus, your infant’s head should never be covered. Researchers found that a baby’s temperature was not significantly increased when these guidelines were followed.

Is swaddling the way to go for every baby? Not always. Elder found that while Elisabeth loved being in a snug little bundle, Gabriel was happier with his arms free. Even in the Washington University study, about ten percent of the babies did not fall asleep better when swaddled.

But for those babies who do settle when swaddled — with or without other soothing techniques — knowing how to bundle your baby safely can help keep crying under wraps.

Soothing Solutions

Paediatrician Harvey Karp’s Five S’s for soothing babies are:

1. Swaddling;

2. Shushing (saying “shhhh” near your baby’s ear, or having some other white noise);

3. Side or stomach lying (only while on your lap or in your arms);

4. Swinging (jiggling, rocking, moving your baby);

5. Sucking (at the breast, on a parent’s finger, on a pacifier).

It’s a Wrap

Here is the swaddling technique touted by Harvey Karp, paediatrician and author of The Happiest Baby on the Block. Spread out the blanket in a diamond shape and fold the top corner down. Lay your baby on top, with her neck at the fold. Fold one top corner down and across her body, holding baby’s arm straight at her side, and tuck it under her. Fold the bottom corner on the same side up. Now fold the other top corner down, holding her second arm at her side, and pull it snugly to about the middle of baby’s chest. Bring the bottom of the blanket up and across your baby’s body, wrapping it snugly. Notice that your baby’s legs can still flex and move, but her arms are held still.

Originally published in Today's Parent, September 2003