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To Swaddle or Not to Swaddle

Get informed on swaddling and get ready for parenthood.

Any parent of a 0-12 month old infant may be concerned about Sudden Infant Death Syndrome (SIDS). Are there ways to prevent SIDS and other sleep-related infant deaths like suffocation or strangulation? Yes. New data supports the link between swaddling infants in a blanket or cloth and SIDS.

"I did it with my kids and they turned out fine," you may hear. Or, "it's not risky if you do it right." As a new parent, you probably have a lot of questions. Friends and family usually offer a great deal of advice, some good and some questionable. It's important to remember that ideas, opinions, information and medical knowledge all change.

Swaddling a baby for sleep increases their risk of suffocation, respiratory infections, hip dysplasia and overheating. Recent studies show swaddling can increase the risk of SIDS by about one-third and that swaddling nearly doubled the risk of death for children who were swaddled and slept on their stomachs and sides.

Swaddling babies is dangerous for several reasons:

  • Overheating: Some babies who die of SIDS are found to have an abnormality in the area of their brain that controls breathing. Overheating, which can occur with swaddling, may increase the risk of abnormal breathing.
  • Decreased arousal: Swaddling inhibits the "startle" reflex, which infants normally have until 4-5 months of age. Some babies may need their startle reflex to help them remember to breath. Stomach sleeping also inhibits the startle reflex.
  • Roll-over suffocation: Rolling movement is possible as early as 8 weeks. Babies can suffocate if they roll onto their backs while swaddled.
  • Strangulation or smothering suffocation: A blanket swaddle or improperly used swaddle device can become loose, cover the baby's face or wrap around the neck.
  • Hip dysplasia: A tight swaddle forces the baby's legs into a straight and down position, which is exactly the opposite of their leg position in the womb. This position can force their hips out of socket and cause hip dysplasia, chronic hip dislocation and arthritis lasting into adulthood.
  • Respiratory infections: A tight swaddle keeps the baby from being able to take full breaths, which could worsen respiratory infections.
  • Impairment of normal development: Babies self-sooth by mouthing their hands and fingers. This isn't possible if their arms are down.
  • Possible impairment of successful breastfeeding: Some swaddled infants gain less weight when exclusively breastfed during their first few weeks of life in comparison to un-swaddled babies.

To keep baby warm, try using a sleep sack, which allows for free movement of the hips. Let the baby keep their hands near their face. Remove when breastfeeding so you and your baby can benefit from skin to skin contact.

Cook Children's pediatricians are here to offer additional resources and practical advice to keep you informed and your baby safe. We're with you every question of the way.

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