Wrapping, swaddling or restricting baby's arm movements: possible downsides and busting more sleep myths
Busting myths about wrapping or swaddling
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. But you might be a family who likes to wrap or swaddle your baby, in which case you can find out about safety here.
Here are three myths about wrapping or swaddling, and the facts.
Myth #1. Wrapping or swaddling protects against Sudden Infant Death Syndrome or Sudden Unexpected Death in Infancy
Wrapping doesn't protect against Sudden Infant Death Syndrome (SIDS) or Sudden Unexpected Death in Infancy (SUDI).
In fact, some researchers even have concerns that wrapping or swaddling might increase the risk of SIDS, especially if babies are placed to sleep on their sides or tummies when wrapped.
Myth #2. Being wrapped or swaddled is like being inside the womb
Wrapping, swaddling and swaddle suits don't mimic a baby's experience inside the womb.
From midway through the first trimester of pregnancy, babies' brains are randomly generating spontaneous movements. The development of sensory motor neural pathways depends upon the sensations baby receives back in response to these spontaneous 'general movements', both in the womb and then after birth. Sensory feedback stimulates more motor or movement exploration, in cycles of ever richer sensory motor experience, which increasingly reinforce baby's desire or intention to make more movements.
You can find out about your baby's motor development here.
Even in late pregnancy, though your baby's movements became more constrained inside your womb, his body and those little limbs were still pushing against the elastic tissues of the wall of your womb and abdomen, stimulating sensory feedback for ongoing musculoskeletal and neural development.
But muslin cloth for wrapping has minimal give. Wrapping may suppress baby's tendency to make movements, given the relative lack of sensory feedback. Most babies are incredibly resilient. But it is possible that wrapping or swaddling a baby who is more vulnerable (for genetic or other unknown reasons) might affect that baby's sensory motor development, because of reduced sensory feedback. This could be especially true if baby is wrapped for long periods night and day, which happens when parents have been advised that wrapping is necessary for better sleep.
Some researchers have also expressed concern that long periods of being wrapped (which happens if babies are wrapped for every sleep, day or night) might impact negatively on babies' motor development, although this hasn't been investigated.
Myth #3. Wrapping or swaddling or using a swaddle suit will improve baby's sleep or crying
- You can find out what the research says about wrapping or swaddling and how it affects baby's sleep or crying here.
What are possible downsides to wrapping or swaddling a baby?
- You can find out how to wrap, swaddle or use a swaddle suit safely here.
Here are three other problems which to my mind could be caused by wrapping, swaddling, or use of a sleep suit, even though they haven't been properly investigated in the research.
Possible downside #1. Wrapping or swaddling baby might interfere with breastfeeding success
Babies need to be unwrapped when they are breastfeeding. This is because wrapping interferes with the way babies fit into their mothers' bodies. Also, babies need their hands bare and their arms freely moving and wrapped around their mother's breast and body, to
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Switch on their breastfeeding reflexes
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Be settled and positionally stable at the breast
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Avoid causing pain and damage of the mother's nipple.
Studies have shown that wrapped breastfed babies gain less weight. One study showed that wrapped babies breastfed only six or seven times in a 24-hour period, which is not frequent enough to maintain milk supply for most women.
I think these findings are explained by two things.
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Women are more inclined to put off breastfeeding or space out breastfeeds when they know they have to go through the process of unwrapping the baby, or unzipping the swaddle suit and freeing the little arms to feed, then wrapping the baby up again, or zipping the baby into the swaddle suit afterwards! It makes a quick breastfeed much harder than it needs to be.
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It's also possible that a baby is less likely to cue for a feed when wrapped, given her difficulty moving. When baby is wrapped, it may be that only her late feeding cues, once she is dialled up and crying, are noticed by the parents. Her more subtle cues through little movements are inhibited or not obvious, due to the physical barrier of the wrap or swaddle.
Possible downside #2. Wrapping or swaddling might interfere with return to sleep in the night
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In the night, having to re-wrap or zip up the baby into a swaddling sleeping suit after a breastfeed can wake up the baby, who had become very dialled down at the breast.
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Bottle feeding babies need to have their hands free when feeding, too, to help switch on their feeding reflexes and to communicate to you about how the feed is going. A baby might use her hands to push away the bottle, or she might show you by splaying her hands wide open that she doesn't want to feed, or has had enough. Similarly, having to re-wrap or zip baby up into a swaddling sleeping suit after a bottle feed delays return to sleep.
Parents have often told me over the years how wrapping their little one after breastfeeds or feeds during the night is surprisingly disruptive, making it much harder for everyone to get back to sleep quickly.
Possible downside #3. Wrapping or swaddling might interfere with your baby's capacity to communicate with you
Your baby communicates with the whole of her body. Small physical movements are an important way she tells you what is happening for her, and by which she creates to and fro communications with you. This exchange of physical communication, combined with your and your baby's sounds and facial expressions, helps the two of you get in sync. The more time your baby is wrapped, the less opportunity you and your baby have for interacting. It's difficult to read the subtle communications a baby makes with movements if baby is wrapped or swaddled.
The physical barrier of wrapping might mean less sensory data can be exchanged between babies and loving adults when they are in the same room. Yet researchers think that this kind of exchange is protective of your baby in the night.
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.
Douglas PS. Pre-emptive intervention for Autism Spectrum Disorder: theoretical foundations and clinical translation. Frontiers in integrative neuroscience. 2019;13 (66):doi.org/10.3389/fnint.2019.00066
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.