Wrapping, swaddling or restricting baby's arm movements: how to do it safely, and does it help with sleep, anyway?
Will wrapping make your baby more settled?
I don't recommend wrapping or swaddling babies, although you might often hear it suggested. Parents might even be told that if they don't wrap their baby, he will startle himself awake in the night and the family's sleep will worsen! This is not true.
The research shows that wrapping does increase the amount of quiet sleep a baby has the first time wrapping is used. And when wrapped, babies make fewer transitions from quiet into active sleep. But when we look closely at the research, it doesn't show that wrapping, as a pattern over time, makes babies
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Cry less.
Babies startle in active sleep all the time. From an evolutionary perspective, babies have a greater proportion of light or active sleep each sleep cycle in the first months of their lives because being in active sleep is protective. In active sleep, babies are more able to rouse if there is a breathing threat.
But babies don't necessarily surface into waking up when they startle! If your baby is startling and waking excessively in the night, it's not the startle itself that's the problem.
Your baby's excessive night waking is most likely due to immature or disrupted body clock settings, which you can address using the steps in The Possums Sleep Program. But your baby is having so much active or light sleep because of the excessive night waking, that she might surface into wake-ups from her normal startle responses much more often, too. This problem won't be solved by wrapping.
How to wrap your baby safely
Having said that, families weigh things up and make their own decisions, experimenting to see what works for them. Some families like to wrap their little one, or to use a swaddle suit or sleeping sack which restricts arm movement. If this is the case, then it's important to know how to wrap your baby or use the swaddle suit safely.
Here are four steps which keep your baby as safe as possible when you are using a wrap, swaddle, or swaddle suit.
Safety step #1. Avoid overheating
Use a light, breathable cloth like muslin or cotton to wrap or swaddle your baby. If wrapping or swaddling or a swaddle suit results in overheating, it increases the risk of Sudden Infant Death Syndrome (SIDS) or Sudden Unexpected Death in Infancy (SUDI).
From an evolutionary perspective, babies regulate their body temperature by being close to a loving adult's body, and by adapting the way they lie on a surface in response to the air temperature around them. This is why wrapping or swaddle suits aren't safe when your baby
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Shares your bed
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Has a fever or infection
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Has too many layers of clothing under the wrap or suit
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Is wearing a beanie or head cover.
Safety step #2. Don't wrap once baby is trying to roll
Most babies will start rolling over between four and six months of age. Some babies start trying to roll over from as early as two months of age - and there are even occasional very active little ones who roll over from when they are newborns!
Wrapping or swaddle suits aren't safe to use once your baby starts trying to roll over. The problem is that if she does get onto her tummy, she won't be able to roll onto her back again if her arms are tucked away or restricted by the wrap or swaddle suit. If something gets in the way of her mouth and nostrils when she's on her tummy, but her arm movement is restricted, she will find it harder to protect her own breathing.
If your baby has been wrapped or swaddled or in a swaddle suit each time he sleeps, it might take him a few nights to get used to being out of the swaddle, once he is starting to roll.
Safety step #3. Make sure baby can bend her hips freely when wrapped
Straight-legged swaddling makes it more likely that babies develop dislocateable hips, which affects the development of their hip sockets. This is why the cloth or sleep sack needs to be loose from below your baby's waiste if you are wrapping her. She needs to be able to move and bend her hips, legs and feet freely.
Safety step #4. Make sure baby is able to breathe easily
Leave baby's head or neck free to ensure her breathing is protected, when you wrap or swaddle her.
The tighter the wrapping or swaddling, the more a baby's rate of breathing increases. Because baby can't take in normal volumes of air, he compensates by breathing more rapidly. Tight wrapping of the chest can drop your baby's oxygen levels. For this reason, it's important to make sure your baby isn't so tightly wrapped that his breathing is restricted.
There's no clear evidence that wrapping increases a baby's risk of respiratory infections.
Recommended resources
You can find videos about how to wrap in a hip-healthy way here.
Protecting your baby's motor development
The holistic NDC or Possums 8-step approach to supporting baby's motor development
The NDC evolutionary perspective on positional plagiocephaly, motor development, and sleep
Selected references
Dixley A, Ball HL. The impact of swaddling upon breastfeeding: a critical review. American Journal of Human Biology. 2023;35:e23878
Dixley A, Ball HL. The effect of swaddling on infant sleep and arousal: a systematic review and narrative synthesis. Frontiers in Pediatrics. 2022; Article 1000180: DOI 10.3389/fped.2022.1000180
Dixley A. Like a drug: a mixed-methods anthropological interrogation of swaddling. Durham University. Durham E-Theses Online: http://etheses.dur.ac.uk/14315/, 2022.
Einspieler C, Prayer D, Marschik PB. Fetal movements: the origin of human behaviour. Developmental Medicine and Child Neurology. 2021;63:1142-1148.
Meyer LE, Erler T. Swadding: a traditional care method rediscovered. World Journal of Pediatrics. 2011;7(2):155-160
Nelson AM. Risks and benefits of swaddling healthy infants: an integrative review. MCN American Journal of Maternal Child Nursing. 2017;42(4):216-225
Pease AS, Fleming PJ, Hauck FR, Moon RY. Swaddling and the risk of Sudden Infant Death Syndrome: a meta-analysis. Pediatrics. 2016;137(6):e20153275
Richardson HL, Walker AM, Horne R. Influence of swaddling experience on spontaneous arousal patterns and autonomic control in sleeping infants. Journal of Pediatrics. 2010;157:85-91.
