Swaddling a newborn at night is one of those skills that most new parents develop over time.
As a former newborn hospitalist, I used to amaze a new mom with my swaddling skills as I wrapped her baby into a tiny cute burrito. There really is nothing cuter than a swaddled baby in my opinion.
Wrapping a newborn baby in a snug fitting blanket or swaddle sleep sack helps the baby to feel secure, cozy and keep baby warm. Additionally, it prohibits their ability to have a Moro or startle reflex which helps both you and your baby to get extra sleep.
In this article, we will look at both the risks and benefits of swaddling a newborn at night and during daytime sleep, when to quit and what to look out for.
What are good swaddling techniques?
As I stated earlier, swaddling is a technique of wrapping a baby tightly in a blanket to help them feel secure and sleep better. There are many different wrapping techniques, but some of the most common include:
- The traditional swaddle: This is the simplest swaddling technique. You will need a large, lightweight blanket. Fold one corner of the blanket down to create a triangle. Place your baby on the blanket with their head at the top of the triangle. Bring the bottom corners of the blanket up and over your baby’s body, crossing them in the middle. Bring the top corners of the blanket down and over your baby’s arms, tucking them in at the sides.
- The arms-out swaddle: This is a good option for babies who don’t like to have their arms confined. To do this, swaddle your baby as you would for a traditional swaddle, but leave their arms out. You can also tuck their hands into their armpits to help them feel more secure.
- The double swaddle: This is a good option for babies who are very active. To do this, swaddle your baby in a traditional swaddle, then wrap them in a second blanket. This will help to keep them snug and prevent them from unwrapping themselves.
Safe Sleep
Whether you chose to swaddle your newborn or not depends on you, but always be sure to follow safe sleep recommendations no matter how you put your baby to bed.
Place a baby face up on a firm mattress with a well fitting sheet. Remove any loose blankets as they can be a risk of suffocation. Don’t put any pillows or stuffed animals in the bed with a baby.
Additionally, do your best to avoid bed sharing. When a newborn sleeps in the same bed as a parent or other caregiver, there is a greater risk of suffocation or falling from the bed. You want your baby to be in a safe sleep space that is separate from your bed but in the same room with you for the first several months.
What about their hips?
Hip dysplasia can be one of the risks of swaddling a newborn, especially if it is a really tight swaddle. In order to combat this risk, be sure to wrap your swaddling blanket around the baby with enough room that their legs can move freely within the blanket. This will allow their hip joint to stay in a more neutral position and avoid hip problems.
Safety considerations
- Always swaddle your baby on their back. Swaddling your baby and placing them face down increases the risk of Sudden Infant Death Syndrome (SIDS).
- Use a soft, lightweight blanket that is large enough to wrap your baby snugly without restricting their movement. A too-tight swaddle can restrict breathing, while a too-loose swaddle can allow your baby to wiggle out and get tangled in the blanket. If you choose to use a swaddle sleep sack, be sure that it is the appropriate size for your baby.
- Make sure the blanket is not too tight or too loose. You should be able to fit two fingers between the blanket and your baby’s chest.
- Leave your baby’s face uncovered. Covering your baby’s face can increase the risk of suffocation.
- Check on your baby to make sure they are comfortable and not overheating. Swaddled babies are more likely to overheat, so it is important to keep an eye on their temperature. The key is to use a breathable blanket. If you are swaddling for night time sleep, be sure that the room is cool enough and don’t overdress your baby before you swaddle them.
- Avoid swaddling a baby with certain conditions– check with your pediatrician for specific medical advice, but in general you should avoid swaddling a baby with certain risk factors like hip dysplasia, respiratory problems or illnesses
- Avoid weighted swaddles– there are theoretical safety concerns with weighted swaddles. We don’t know how much weight is too much to sit on a newborn’s chest. Additionally, baby’s chest walls are made of cartilage and potentially can be crushed by a weighted blanket or swaddle. Just because it is marketed for babies does not mean that it is safe.
Reasons to stop swaddling
Once your baby begins to roll, it is time to ditch the swaddle and exchange it for a sleep sack or wearable blanket instead. This occurs for most babies just prior to 2 months of age. It is part of my anticipatory guidance at the 1 month well child visit.
If a baby is in a swaddle blanket and rolls onto their face, they are at risk for suffocation. The swaddle keeps them from being able to use their arms to get out of this dangerous sleep position.
Getting your baby to sleep no matter if you swaddle or not
Establishing a sleep routine can be difficult at first. Newborns don’t have the normal sleep and wake cycles that are cued by dark and light as their pineal glands aren’t mature enough to produce melatonin well.
You can help your baby to get into a good routine from day one. As you are working towards a true sleep schedule, you can start by having night time sleep occur in a cool and dark room and daytime sleep to occur in a bright and noise filled room.
Additionally, white noise can help your baby to sleep more soundly and for longer periods of time. Early on, babies need to wake frequently overnight to eat. As time goes on, sleep for babies will start to fall into a more regular routine and their night time sleep will stretch for 4-5 hours at a time.
Want to have a newborn expert on your side?
Not only am I a pediatrician, but I am also a lactation consultant/ breastfeeding medicine specialist. In addition, I am an expert in all things newborn. I offer breastfeeding medicine consults, concierge breastfeeding medicine packages, fourth trimester care packages and memberships to my pediatric practice.
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© 127 Pediatrics; September 2023
This article exists for informational purposes only and should not be construed as medical advice.
Dr. Andrea Wadley is the owner, pediatrician, and breastfeeding medicine specialist for 127 Pediatrics. She has an established house-calls-only concierge pediatric practice in Colleyville, TX. She is also the owner and operator of the 127 Pediatrics Online Breastfeeding Medicine and Education Center.
