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Elena Donovan Mauer

Point & Counterpoint: Swaddling

Should you wrap baby like a burrito or stick to a sleep sack? The age-old practice of swaddling has come under attack. Check out both sides of the story and decide what’s right for your baby.Plus:How to Swaddle a NewbornWhen to Stop Swaddling

Swaddling Is a Proven Sleep Tool

Harvey Karp, MD

“Swaddling is a way of helping babies not upset themselves and be able to stay in a calmer state, so they can sleep better. Studies have shown that swaddled babies don’t wake up as often and cry less.”

It Keeps Babies Safe

“To help prevent SIDS, parents are taught to put baby to sleep on his back. If he’s un-swaddled, it’s easier for him to roll over, shoot his arms out and upset himself. Mothers can’t stand this and are more likely to bring baby into bed with them, or do some other unsafe sleep practice. Crying can also trigger postpartum depression, marital conflict and abuse.”

You’ll Relish in Extra Sleep

“If you use swaddling combined with white noise, you can add one hour to your baby’s sleep within a few days. That’s the way you’re going to get effective sleep and prevent problems from happening four or five months, when babies tend to wake at night again.”

Hip Problems Aren’t an Issue

“There have been questions about swaddling causing hip dysplasia. The International Hip Dysplasia Institute recommends safe swaddling, and there hasn’t been an increase in reports of hip dysplasia in the US since swaddling has become more widespread. The only studies connecting the practice with hip problems were where the legs were very tightly restricted, in a Navajo papoose, for example. It’s very easy to check a baby for overheating. Unless you’re using a heavy blanket or live in a hot climate, this shouldn’t be an issue.”

It’s Hard to Do It Wrong

“You almost can’t wrap them incorrectly using modern swaddling blankets. Unless you wrap it tightly around baby’s legs without any room to move, you won’t cause problems.”

Harvey Karp, MD, is a pediatrician and author of The Happiest Baby Guide to Great Sleep

Wrapping Baby Isn’t Safe or Helpful

Maureen Luther, BSc, MA

“People say swaddling is good because while in the uterus, the baby is confined, but that’s actually not true. Their legs are bent, not straight, and they’re able to bring their hands toward their mouth. Developmentally, they’re meant to self-soothe by sucking on their hands. Babies are supposed to be moving around. Put your baby in a double sleeper or a sleep sack that leaves his hands free instead of swaddling.”

Nope, It’s Risky

“Safe sleep guidelines say that a baby should be in bed with no blankets, no bumper pads and no toys. If you’re swaddling using a blanket, in a way, that’s against a safe sleep environment. What if the blanket comes loose? Swaddling is used by parents who want to get their baby go to sleep. It inhibits a reflex that can startle a baby and wake him up. But that reflex prevents them from getting into a deep sleep, and if baby doesn’t wake easily, that could be a SIDS risk.”

Sleep Benefits Aren’t Clear

“Studies on swaddling have shown very inconsistent results. Swaddling a baby may mean about nine minutes less crying in a 24-hour period get. But what did it take to get that baby to go to sleep? The thing is, swaddling is an intervention. Why start it? Once your baby starts moving around and the blanket can move and cover his face, now you’ve got to get rid of that blanket.”

The Positioning Just Isn’t Right

“To bundle a baby with his arms down to his sides and his legs down straight is not a developmentally appropriate position. His hips and knees should be bent. Hip dysplasia, body temperature and chest compression are the biggest concerns about swaddling. The hips can be bound too tightly, and the baby can overheat.”

There’s Too Much Guesswork Involved

“It’s not really clear what you mean by proper swaddling — and why are you doing it? It’s not really developmentally appropriate.”

Maureen Luther is a pediatric physiotherapist at the Neonatal Intensive Care Unit and Neonatal Follow-Up Clinic at Sunnybrook Health Sciences Centre in Toronto