Monday, March 11th, 2013
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.
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