Six-month-old Oscar has been swaddled since birth. His mom, Kate Della Fortuna, also swaddled her daughter, Everly, but not her older son, Jacob.
“With Jacob, we mainly co-slept so I didn’t feel comfortable swaddling,” she says. (Swaddled babies may not be able to free themselves from an unsafe position in a family bed.) “But it has been a godsend for Oscar and Everly. Oscar tends to flail around and wake himself up. When he’s wrapped up snugly, he sleeps longer and goes back to sleep easier.” Della Fortuna says swaddling helps her little one catch the zzzs he needs, which means she and her husband get more uninterrupted slumber, too.
Read more: How to swaddle>
Like pretty much every decision parents make, swaddling is a contentious topic. The age-old technique—wrapping baby up in a blanket with his arms and legs secure, so he sleeps more soundly—has been practised and recommended by caregivers for years. (Swaddling has seen even more popularity since the “back to sleep” campaign almost 20 years ago.) Now, recent studies are questioning the safety of the swaddle, and moms and dads are debating whether they should keep their new bundles wrapped or unwrapped.
“Swaddling has been shown to increase ‘quiet sleep’ and sleep duration. It can help babies become accustomed to sleeping on their backs, which decreases the risk of SIDS,” says Maple, Ont., paediatrician Umberto Cellupica. While he doesn’t routinely tout swaddling to new parents, he doesn’t discourage it either. “I’ll talk to parents about how to properly swaddle if they are dealing with irritability, crying or colic. I think the benefits outweigh the potential risks, which are few.”
Paediatric physiotherapist Maureen Luther holds the opposite opinion. Luther, who works in the Neonatal Follow-up Clinic and NICU at Sunnybrook Health Sciences Centre in Toronto, says swaddling can be interpreted as a form of restraint. “There are concerns about the increased pressure through the chest that can compromise breathing, concerns for hip dysplasia due to the legs being tightly wrapped in a straight position, and overheating the infant,” she says. Luther says newborns should have the freedom to move their hips, knees and arms in their sleep. “They should also have access to put their hands in their mouths for self-soothing,” she says. Plus, a tight burrito wrap keeps an infant’s head facing up instead of letting it fall naturally to the side, which is a safer position if she spits up in the night.
Still, both Cellupica and Montreal paediatrician Denis Leduc agree that any risk associated with swaddling is caused by improper technique. “The risk of SIDS is 12 times higher for a swaddled infant who is placed on his belly; if the infant’s face ends up against the mattress and his arms and legs aren’t free, it is much more difficult for him to wiggle or turn out of trouble,” Cellupica says. Leduc adds that respiratory problems are related to wrapping the baby too tightly. “On the other hand, swaddling too ‘loose’ could result in baby’s head being covered, or strangulation.” When parents follow the recommendations for safe sleep environments (no bumper pads, pillows or duvets), and use proper techniques, Cellupica says swaddling can work. “If a baby is calmer and getting more sleep, parents are calmer and more rested. This improves the whole family’s well-being, which can only be good for a baby,” he says.
For now, Oscar will remain a burrito when he’s put to bed. Says mom Della Fortuna: “Do I think swaddling a healthy baby, under normal circumstances, in seasonably appropriate conditions works for us? Absolutely.”
A version of this article appeared in our Fall 2013 Pregnancy issue.
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