A Ban on Swaddling?

This is a guest post from pediatrician and Parents advisor Harvey Karp, M.D.—whom parents know as the creator of The Happiest Baby on the Block book and DVD. Dr. Karp wanted to weigh in on the controversy surrounding swaddling and share his insights on the topic. As the author of The Happiest Baby Guide to Sleep, he’s passionate about the role proper swaddling can play in getting babies to sleep.

Some baby-care ideas are totally 21st century, like using a CD of special white noise—all night—to boost a baby’s sleep throughout the first year. Some practices, on the other hand, are totally old school, like swaddling.

Baby wrapping is ancient and was super popular until the 1800s when American moms began abandoning it en masse. Some stopped it because they felt it was passé, while other moms bought into the spreading new belief that wrapping deprived new babies of their freedom.

Then, in 2002, parents began to take a new look at this old technique (thanks in no small part to the swaddle advice in my The Happiest Baby DVD/book). This came on the heels of renewed interest in other ancient, but neglected, traditions, like yoga, meditation and breastfeeding. These time-honored health traditions surged in popularity… because they work!

Likewise, swaddling made a huge comeback propelled by the great success parents had with it and the multiple studies finding it effective at reducing crying and boosting baby sleep. Today, swaddling is recommended in most parenting books and the American Academy of Pediatrics’ (AAP) website. Swaddle blankets have even become one of America’s top baby shower gifts.

But, unexpectedly, all of that is being put in jeopardy by a dramatic—and unscientific—new day care regulation being pushed by the National Resource Center for Health and Safety in Child Care and Early Education, in Aurora, Colorado.

In 2011, the group decided swaddling (even in gossamer thin blankets) was unnecessary and risky and should not be used after a couple of weeks or months. They said swaddling might hurt a baby’s hips—but while there has been a connection between improper swaddling and hip dysplasia (with legs wrapped tightly while straight), it’s safe when swaddling allows legs to bend up and out at the hips. The group also said that swaddling might overheat a baby (no study shows overheating from swaddling, unless the head is covered or the room is hot), or might cause SIDS if loose blankets wrap around the baby’s face (studies show that only loose bulky bedding—like comforters—are a SIDS risk, not light muslin ones).

The NRC’s work is usually quite good, but this time they went way out on a limb…without the science to support them. And now, many state governments (including Minnesota, Pennsylvania, and Texas) have taken these unfounded recommendations and turned them into ridiculous – even dangerous – new regulations that literally ban swaddling in day care settings.

While it is true that the AAP warns parents not to put loose or bulky bedding in a baby’s crib, they never said that correct swaddling is unsafe. In fact, a new AAP review praises snug wrapping: “Swaddling, when done correctly, can be an effective technique to help calm infants and promote sleep.” The AAP believes that more studies may even show swaddling to be a useful way to reduce SIDS.

We doctors are very concerned about SIDS. Crib death plummeted 50 percent after we started implementing the Back to Sleep campaign in the mid-1990s, but rates have not dropped in over a decade (2000 deaths/yr). And, even more upsetting, is the fact that infant suffocation is up 400 percent over the past 15 years!

Why so many sleep deaths? Because babies don’t sleep well on the back. (Did you know that babies sleep so much better on the stomach that, before 1992, parents were told never to let the baby sleep… on the back?!) Today, leading SIDS experts recommend correct swaddling to prevent fussy babies from accidentally rolling to the stomach or exhausted parents from using unsafe sleep practices (stomach position or bedsharing) in a desperate bid to get more sleep.

(The wisdom of this advice is supported by a recent study which found that moms who swaddle are about twice as likely to put their baby down in the safer back position.)

And, besides reducing SIDS risk, safe swaddling may also prevent the other serious problems triggered by infant crying and parental exhaustion, like postpartum depression, breastfeeding failure, child abuse, overuse of medication, trouble losing your pregnancy weight; and even the burden on companies from the reduced productivity and increased health care costs of exhausted new parent employees.

Swaddle bans are shortsighted and wrongheaded. They will confuse parents and may well lead to more infant crying… more parent exhaustion… and more serious complications and deaths.

If you are unhappy with the swaddle ban at your daycare, take action! Make a petition asking to return the right to you to decide whether or not your baby can be swaddled, circulate it to other parents in your center, and send it to your state’s governor. (And, please let me know when you do it! Twitter: @drharveykarp).

Check out the proper way to swaddle in this video.

Image: Baby via Shutterstock

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  1. by NoAdditives

    On March 11, 2013 at 7:36 pm

    Like anything, bed sharing can be safe and can offer better sleep for both parents and babies. It has also been shown to promote better breast feeding habits, and in at least one study has been shown to reduce the occurrence of sleep apnea in babies.

  2. by Christy

    On March 11, 2013 at 7:59 pm

    I’ve always swaddled and it has made a huge difference in the way my children have slept. Love the 5 S’s.

  3. by ElizaJane

    On March 11, 2013 at 8:04 pm

    Yes, as NoAdditives said, bedsharing can be very safe and the best choice for some families.

  4. by Brenda

    On March 11, 2013 at 10:19 pm

    We swaddled our first with a swaddle sack. It kept his arms in but allowed his legs to move. I LOVED the sacks and swaddling was the only way to calm him down when he was a newborn. He slept so much better in those sacks. If swaddling is done correctly, it is 100% safe and we will be swaddling our baby due in April, as well.

  5. by Nae

    On March 11, 2013 at 11:00 pm

    That’s why I think it’s best to stay home with your baby and not put them in daycare ( day care banned swaddling in this article.) . If you want to be able to make all the choices in raising them- keep them at home with you.

  6. by Stephanie

    On March 11, 2013 at 11:59 pm

    This is part of the reason why we bedshare. My son hated being swaddled and refuses to sleep in a crib or pack and play ever since he was born, and trust me we tried the crying it out method, bedsharing worked for us and I’ve read all the cons and pros of it and we just found it better for everyone involved.

  7. by Hillary

    On March 12, 2013 at 9:36 am

    My daughter slept worse when swaddled. She did fine on her back in footie jammies. But she would fight if swaddled and confined. She is still that way at 4. Not all things work for all kids and she often co slept with me.

  8. by jennifer

    On March 12, 2013 at 9:46 am

    re they trying to ban everything? whats wrong with swaddling? unless its dangerous no they shouldn’t ban it, I swaddled my kids and they loved it. I think sometimes people forget we live in the land of the free , where people should make these choices individually whatever is good for them.

  9. by Swaddling Your Baby | Stephanie Robin 'The Blog'

    On March 12, 2013 at 10:25 am

    [...] recent controversy over swaddling and the relation it can have to an increased risk of hip dysplasia, I thought [...]

  10. by mallori

    On March 12, 2013 at 1:56 pm

    I work in a daycare and can understand this to a certain extent. We are not allowed to use any blanket in the cribs, but we do use sleep sacks. Some parents bring the swaddle sleep sacks. It is completely up to the parent as far as which sleep sack is used. But blankets do not belong in cribs in a daycare situation. Especially with the risk if SIDS and having a blanket in the crib would make the daycare liable for the baby’s safety. Think of how guilty a daycare provider would feel if they lost an infant in their care due to SIDS and they were blames because if a blanket.

  11. by Around the Web… |

    On March 12, 2013 at 2:22 pm

    [...] Movement pushing for ban on swaddling – Parents.com [...]

  12. by Maria

    On March 12, 2013 at 10:32 pm

    Bedsharing is NOT UNSAFE. It is the norm in MOST non-western cultures.
    This article starts out calling for caution of unscientific “truisms” and goes right ahead to cite a few!

  13. by Crimson Wife

    On March 19, 2013 at 1:48 pm

    Timely post! A local daycare just got shut down by the state last Friday because swaddling infants was considered “improper restraint”. I couldn’t believe that when I heard the news…

  14. by Annalyn

    On March 24, 2013 at 8:32 pm

    The way I swaddle just makes sure the arms are somewhat tight to the body. Legs are free to bend (so no problems here!) and of course, you choose the blanket for the situation. Usually a light one will do just fine. I think swaddling is really a fantastic way to not only calm babies and help them sleep, but to help them feel secure and to stop their reflexes from startling them all night. I recommend that after the first few weeks you only swaddle at night and by 6 months (or when baby sits up if that is sooner) you try to stop.

  15. [...] with making the ancient practice of swaddling vogue again, has vented his frustration on CNN and in Parents magazine. (He also is a frequent contributor to The Huffington [...]

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  17. [...] How to enjoy the benefits – and avoid the risks – of swaddling: Swaddling dramatically improves a new baby’s sleep. Yet, many states are shockingly banning this ancient parenting tool. Smart moms should do it and Dr. Karp will teach them how to do it properly and safely.  With swaddling, I simply have to giggle: my daughter was too wiggly even on day one to be swaddled.  The nurses at the hospital could not pick her jaw off the floor, seeing how quickly my little squirmy-wormy got herself out of that baby burrito.  Yet my son LOVED to be swaddled.  I, in fact, invested in some larger-size swaddlers, to allow him to do so through about six or seven months.  (Remember, my son is the kid who loves to sleep!)  You can read more about his stance on swaddling here, and his reaction to the ban on swaddling in some states here. [...]

  18. [...] Parents.com is getting in on the fun by talking about swaddling as well. [...]

  19. [...] swaddling as a common practice is less than happy with this new advice. In fact, in an article for Parents magazine, Karp stated “In 2011, the group decided swaddling (even in gossamer thin blankets) was [...]

  20. by Sleeping Aides

    On December 18, 2013 at 8:58 pm

    [...] seems to be controversial these days but back when my daughter was born (again, a little over a year ago, crazy how quickly [...]