Swaddling Q and A (Swaddling Series, Part 2 of 3)

Isis baby Evan is swaddled arms down using the Miracle Blanket.

“Why arms down? It seems like an unusual position.”
When babies are swaddled with the arms across their chests, tucked adorably up by their chins, two things may happen that disrupt sleep. The first issue is that young babies commonly wake themselves up with their hands and flailing arms. When swaddled with the hands by the face, in a lighter sleep, a baby’s movements batting around the face will likely bat himself awake, or, will stimulate the rooting reflex, making the baby move around more to seek a nipple, which quickly leads to frustration (and an awake, crying baby).

“My baby’s Houdini – he can get out of anything!”
The second issue is that when the arms are flexed across the chest, they are able to “fight the swaddle” and use reflexive movements to push against the blanket, with good strength and leverage. If they push and loosen the blanket enough, they will likely get an arm out, and then it’s all over – a flailing, crying, awake baby with a loose blanket in the crib. Even if the arms are positioned down by the sides, but not snugly enough, the baby will eventually slide them up and across the chest and you’re back to the situation described above. These are the babies with parents who say “My baby’s a Houdini. He can get out of everything!” A good swaddle blanket paired with a good swaddle technique, are equally important. With the arms snuggly swaddled down by the baby’s sides, they have no leverage with which to push against or “break” the swaddle. They may wiggle around a little, but if it’s an effective swaddle, it should hold snug and the baby will remain safe and secure. A large, thin, stretchy blanket makes for an excellent swaddle blanket. Learn how to do the  Isis Super Swaddle technique, and see the ABC Blanket.

“But what about feeding cues – mouthing the hands is an early sign of hunger, isn’t it?” Sort of. When the baby is really young, during the first few weeks, the focus is on getting breastfeeding well established, and that means feeding early and often, and at any opportunity, especially before the baby moves from a calm state to a frenzied state. So, the mouthing of the hands is a nice way of us telling parents – “Oh, you see that? He’s in a light sleep stage, starting to wake up, he’s calm- Try feeding him!” We don’t advocate swaddling with the hands down during the earliest days and weeks. However, once feeding is well established and your baby is steadily gaining weight, your focus may begin to shift from “how can I get this baby to eat more/better?” to “how can I get this baby to sleep for more than 45 minutes at a time?” Snug, arms-down swaddling might be the answer. And, if your healthy baby is hungry, he will wake up and let you know, swaddled or not.

“But what if my baby hates the swaddle?”
He might– at first. Not all babies love the act of being swaddled. After all, it is a form of restraining. The question to ask yourself is, “once your baby is swaddled, does he sleep longer?” If the answer is yes, then you, as the adult, may need to make the executive decision for your baby. “I know you don’t like being swaddled, but once you are swaddled, you sleep better, and that’s better for you, and better for all of us because we all need to rest!” There are probably lots of things your baby doesn’t love: having his diaper changed, or having a bath, or getting shots at the pediatrician, but these are all things you do anyway because you know that overall, it’s in his best interest to do so. We all need restful sleep! It’s not his fault – physiologically, he’s designed to sleep next to his mom and nurse on and off all night. Since in our current culture and practice, the common focus seems to be teaching a baby to sleep on his back, alone, on a firm flat mattress, (and for increasingly long periods of time), we might need to help him out a bit, and that’s what we’re doing. (For another perspective, read our article, Informed Bed-Sharing)

“I read that swaddling was bad for a baby’s hips!” It is true that certain types of swaddling are not good for a baby’s hip development: a baby’s legs should not be restrained rigidly straight and turned inward. For example, old fashioned “swaddling boards” positioned babies in this manner. Instead, your baby’s legs and hips should be slightly turned out, slightly flexed and “frog-like”, with some leg and hip movement. This allows for correct placement of the leg and hip joints for proper development.

“What if my baby sleeps fine without the swaddle?” Cool! If he sleeps just as long (or longer) unswaddled, then by all means, don’t swaddle. There certainly are babies like that! However, I find more babies that do benefit from being swaddled, but the parents stopped after only a few weeks because they thought the baby either didn’t like it, or didn’t need it. I also see a fair number of babies whose parents stopped swaddling after 3 or 4 months because the pediatrician told them the startle reflex was gone, and who then begin to see more restless nights that they first attribute to the vaccinations received at the same pedi visit. Once they begin swaddling again, longer sleep stretches return.

Nancy Holtzman RN BSN IBCLC CPN
Vice President of Clinical Content and eLearning
Isis Parenting

Read the entire swaddling series: Part 1: The Story Behind Swaddling, Part 2: Swaddling Q&A and Part 3: Transitioning Baby Out of the Swaddle.  Learn how to do the  Isis Super Swaddle technique, and see the ABC Blanket.

About Nancy Holtzman RN IBCLC CPN

Nancy is a Vice President at Isis Parenting and leads Clinical Content. As one of the original co-founders, she was instrumental in the creation of many prenatal and new parent programs at Isis Parenting, helping to develop the Isis vision in its earliest stages. Nancy has over 25 years of clinical nursing experience including ten years at Boston’s Beth Israel Hospital, and is a mother/baby nurse educator, a board certified lactation consultant and board certified pediatric nurse. She is the founder of the Great Beginnings New Mothers Group series which has now reached over 10,000 Boston-area mothers. She speaks and writes for a national audience about breastfeeding and infant development, and has served on the board of MLCA, the Massachusetts Lactation Consultants Association. She received a BS from Northeastern University College of Nursing, and a Certificate in Advanced Pediatric Assessment from Boston College. Nancy lives in Boston with her husband, two teens and a rescued Bichon. Find her tweeting about all about babies at @nancyholtzman

3 Responses to Swaddling Q and A (Swaddling Series, Part 2 of 3)
  1. Camara
    March 2, 2011 | 10:25 am

    When my son was in the hospital he didn’t mind me swaddling him, but once we got home (1 week later) he started to bust out of his swaddle like he was The Hulk. lol One thing I did notice is he didn’t sleep as well once I stopped swaddling him, so do yourself a favor and keep it up, your child is fine and warm.

  2. [...] long as it works, and as long as its safe. In my example in Part 2, just because the startle reflex diminishes doesnt necessarily mean its time to stop [...]

  3. [...] Diaper and swaddle your younger infant now. Many babies sleep better swaddled until 4-6 months, before making the transition to a sleep [...]

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