Both of my babies loved to be swaddled. It helped them calm down and I always experienced them happier and easier to console while snuggled & bundled. My experience isn’t unusual. Research in the past has found that swaddling rates are increasing and it can help newborns with sleep awakenings while also creating a slight reduction in crying in babies under 2 months, and may help babies have more quiet sleep. So the new study out today in Pediatrics evaluating the relationship between swaddling and Sudden Infant Death Syndrome (SIDS) therefore caught my attention. The study pooled research and data from 4 previously published studies to look at risk for babies who are swaddled. Although the data and findings in this new study don’t prove relationships, it does evaluate risks for babies who are swaddled versus risks for babies who were not.
Pediatrics Study Finds Swaddling On Side And Stomach Increases SIDS Risk
- Meta-analysis of 4 studies looking at relationship of swaddling with SIDS risk that spans data from babies in 2 decades and 3 diverse areas of the world: United Kingdom, Australia, and United States (Chicago).
- Conclusion: Current pediatric advice to avoid tummy and side positions for sleep especially applies to infants who are swaddled.
- Swaddling risk increased with age in infants. Infants who were swaddled over the age of 6 months had a double increased risk of SIDS.
- Swaddling risk varied with position of sleeping. The risk was highest for babies swaddled and put on their tummy while also higher for babies put on their side and then those swaddled and put on their back compared with babies not swaddled.
Reminders For Safe Sleep And Swaddling
Always place your baby to sleep on back in a bare, boring crib. Tight sheet on firm mattress with no blankets, bumpers, stuffed animals, or pillows. No sleep positioners, either! We’ve not learned of any benefit to sleep positioners and sleep monitors in decreasing SIDS risk. Also sleep positioners are soft bedding and may even increase risks.
- No Side Sleeping Recommended: Avoid swaddling and placing your baby on their side. There is no benefit or safety boost with side sleeping and this study suggests it may increase risks for baby if the baby is swaddled.
- No Tummy Sleeping Recommended: Do not put baby to sleep on their tummy. Prone sleeping (sleeping on tummy) is associated with an increased risk of SIDS. This is especially true for babies who normally sleep on their back and then are put down to sleep on their tummy (18-fold increase risk for SIDS in babies who sleep on their backs when put to sleep on their tummy). Tell your babysitters and helpers and grandmas this tip so they keep with back-to-sleep.
- Swaddling: Consider eliminating swaddling when your baby starts showing signs of being able to roll over, this usually happens around 3-5 months of age. The risk of a baby rolling over and getting onto their side or stomach while swaddled may increase risk of SIDS.
- Swaddling tips: In the conclusion of the study, researchers note the official Dutch guidelines for swaddling (a country with a low rate of SIDS), “Because of the likelihood of rolling to the prone (tummy) position, the official advice is to never initiate swaddle after the 4th month, stop swaddling as soon as the child signals he or she is trying to turn over, and always stop swaddling before the 6th month as babies will be able to roll over.”
- More Info on Reducing risks of SIDS: SIDS is uncommon in infancy but most likely to happen in infants between age 1 and 4 months so parents can take precautions to decrease risk (back to sleep, breastfeeding, no soft bedding, no cigarette smoking in home). Advice over the years to put babies on their backs in bare cribs has significantly decreased risk. Additionally, here’s a video on Understanding SIDS Risks (inherited risks and environmental risks), a post on the risks from bumpers and the call for a ban on sales here in the US, post on risks about soft bedding, a post on pacifiers and benefits to sleep, and a post on Why I Hate Sleep Positioners.
Meredith Piscitelli says
Will post on my Perfect baby Massage Facebook page.
This is about swaddling. Swaddling is good up to a certain age, as Dr. Swanson points out. Please, heed her advice.
There are other reasons for SIDs, also, not to be ignored.
Wendy Sue Swanson, MD, MBE says
Thanks, Michelle. Appreciate you sharing and getting the word out. Hoping this just helps parents feel good about choices they are making for safe sleep!
Curious as to why sleeping on a softer surface increases risk. Like a firm, not thick, pillow?
Health Sciences says
Thank you so much for sharing such a great #Tips. Hope this is very helpful for me..
Kimberly Bepler says
Thank you for this. I am passionate about giving parents options to swaddle safely (specifically hip healthy and respectful of the baby’s preferred arm position) and also to match the approach to each infant and their particular need or stage. I have a free video site with 7 different swaddling options that parents find helpful as a how-to. They reflect these same safety recommendations as well. I thought it might be a good site to recommend to your patients who need hands on help but don’t have a doula or another educator available to them. It’s called 7 Swaddles and we recommend it in Portland through the Providence and Legacy hospital systems. I know Pediatricians don’t have time to teach parents how to swaddle, but this is an easy way to learn and they can watch them over and over until they are confident.
Wendy Sue Swanson, MD, MBE says
Thanks for sharing the links!