How to Swaddle a Baby Safely and Effectively
Swaddling can be an effective way for new parents to calm a restless infant and help them clock some shuteye—but you’ve got to get it right.
As timeless as a lullaby and nearly as soothing as being rocked in a parent’s arms, swaddling baby’s body has been recommended across generations—and cultures—as a trusted way to settle fussy babes. But although swaddling may be time-tested, it isn’t without risk.
“Swaddling is definitely something you can do to help calm a fussy baby,” says Amanda Lea, RN, a pediatric nurse with the Monroe Carrell Jr. Children’s Hospital at Vanderbilt University Medical Center in Nashville. “I completely understand how it feels when you put your baby down for a nap, and the dog barks—or the mailman knocks on the door. As a parent, you don’t want your baby to be woken up.” However, she continues, “The downside of swaddling is it decreases the startle reflex and spontaneous awakening, which can be dangerous.
Knowing safety basics and how to properly swaddle your baby is the best way to enjoy the benefits of swaddling an infant—like longer periods of sleep—while also reducing possible risks.
Keep Things Snug and Secure
Studies have shown that a swaddled baby tends to sleep for longer stretches than infants who aren’t. “There are some theories that swaddling mimics the tightly packed environment of the womb,” notes Jennifer Sonney, PhD, ARNP, PPCNP, BC, FAANP, FAAN, an associate professor at the University of Washington School of Nursing in Seattle.
But what’s more likely, according to Dr. Sonney, is that swaddling dulls a newborn’s moro reflex (commonly known as the startle reflex). This hardwired reflex is most present in the earlier months of age and causes your little one to fling their arms up and grasp at the air (often waking themselves up in the process) when there’s a sudden change in sensation such as a loud noise, a bright light, or even just a change in position, like when you’re transitioning them from your arms to his crib. By restricting arm movement, a swaddle blanket helps prevent baby from startling themself awake.
The Basics of Swaddling
Infants, especially preemies, aren’t always able to regulate their body temperature effectively—after all, they’ve spent the past nine or so months in a temperature-controlled environment. This makes your little one especially sensitive to overheating in a swaddling blanket, Lea explains. If your newborn’s cheeks seem flushed, or if they’re starting to sweat, you’re probably bundling too snugly or with a blanket that’s too bulky.
Tight swaddling can also make it difficult for your baby to breathe, Dr. Sonney notes. “Make sure the wrap is secure, but not so tight that it restricts the ability for baby’s chest to properly expand.” Additionally, you should be sure to keep the swaddle blanket loose around the hips to prevent hip dysplasia; baby’s legs should be able to bend up and out at all times.
On the other hand, too loose swaddling, like loose blankets, can also pose risks if your little one gets tangled up in it. Should a blanket come unwrapped, it becomes a strangulation and suffocation hazard, putting baby at a greater risk of sudden infant death syndrome (SIDS) by having loose cloth in their sleep space.
“You don’t want the top of the blanket to slip over the shoulders closer to baby’s head and cover the mouth or nose,” explains Dr. Sonney. “They can begin breathing in their own carbon dioxide.”
As a rule of thumb, keep the top of the blanket level with your newborn’s shoulders when you swaddle, and make sure you can slide two of your fingers between the swaddling and your little one’s chest.
Reduce Rollover Risk
“Swaddling is helpful,” Lea advises, “but you have to be careful how and when you do it.”
The American Academy of Pediatrics (AAP) recommends that parents stop swaddling their newbies at about the two-month mark. Seem too soon? Consider this: Many babies begin rolling over, or at least attempting to, when they’re around 2 months old—and often do it when you’re not looking. Even the most attentive parents can be surprised to find out their wee one has mastered this milestone.
“The babies who get into trouble are the ones who are on their stomachs,” notes Rachel Moon, MD, a pediatrician at the University of Virginia School of Medicine in Charlottesville, Virginia, and chair of the AAP’s’ Task Force on SIDS.
Because of this, the AAP advises parents always to put baby down to sleep on their back on a flat surface. Still, a 2- or 3-month-old infant can roll onto their stomach overnight or during naptime. “If they’re swaddled, they have no defense mechanism,” Dr.Moon says. “It’s a very hazardous situation.”
As you transition away from swaddling, take the opportunity to firm up your baby’s sleep routine and begin building good sleep habits, Dr. Sonney suggests. Gradually wind down activities, reduce stimulation, and dim lights as the evening progresses. Then, after a bath, a feeding, and a cuddle, put your baby down in their crib at a predictable hour each night. “Sleep is very habit-based,” Dr. Sonney explains. “If you follow the same routine every night, the body will come to expect sleep.
Transitional swaddles are another option to consider if you want to continue safe swaddling once baby hits the rolling milestone. These wraps allow for an arms-up position inside the swaddle (which still helps with the startle reflex), or you can opt to keep one arm out (or both) depending on what best soothes your baby. Once your wee one has fully grown out of the swaddle phase, you can move to a sleep sack (also known as a wearable blanket) for warmth and general comfort.
Step-by-Step Swadding Instructions
STEP 1
Spread a large, lightweight blanket (muslin is a popular choice to avoid overheating) on a flat surface.
STEP 2
Fold the top corner of the blanket down to form a triangle with the bottom corner. Place baby in the center of the triangle, with their shoulders just below the fold.
STEP 3
Place baby’s right arm, slightly bent at the elbow, flat against their body. Take the left side of the wrap and bring it across your baby’s chest, tucking the edge of the wrap under their body.
STEP 4
Pull the bottom of the blanket up and tuck the fabric into the top of the swaddle.
STEP 5
Bring the right side of the wrap across baby’s chest, tucking the fabric underneath to secure it.
Sleep Like a Baby
Dr. Moon also hopes to change the conversation on infant sleep in general. We often think of a “good sleeper” as a baby who sleeps through the night. But for newborns, that’s not a realistic expectation.
“A 2-month-old baby is not going to sleep seven hours straight,” she says. “They’re designed to wake up every few hours. “This is a normal phase that won’t last forever.”To Moon, a good sleeper is one who wakes up in the night to feed, then falls easily back to sleep afterward. Lea agrees. “If you have a baby who’s sleeping for three- or four-hour stretches, I think you’re definitely winning,” she says. “You have a good sleeper.”
