A recent study called into question the safety of swaddling. Find out more about the connection between swaddling at SIDS, and learn the best practices to protect your sleeping infant.

By Hollee Actman Becker and Nicole Harris
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Swaddling your baby—or wrapping him tightly in blankets—can make him feel safe and secure by imitating the womb environment. This might allow him to sleep more soundly at night, which comes as a much-needed relief for sleep-deprived parents. 

But you might want to hold onto the blanket: a 2016 study published in the journal Pediatrics showed swaddling a baby may increase the risk for sudden infant death syndrome (SIDS)—which, according to the Centers for Disease Control and Prevention (CDC), kills about 3,500 children in the U.S. each year. The condition is characterized by unexpected infant death while sleeping. 

So what’s the deal? We investigated the link between swaddling and SIDS risk to break down the confusion. 

Can Swaddling Increase the Risk for SIDS?

In the 2016 report from Pediatrics, researchers analyzed the results of four previously published studies that included 760 babies who died of SIDS and 1,759 who did not. What they found was that swaddling a baby upped the risk of SIDS.

"Babies who were swaddled were 50 to 60 percent more likely to die of SIDS," said lead researcher Dr. Rachel Moon. She added that when the swaddled babies were then placed on their stomachs to sleep, the situation was even worse: Those infants had 13 times the risk of dying from SIDS. (Stomach-sleeping is a known risk factor for SIDS, and experts recommend exclusive back-sleeping until your baby turns one).

The danger of swaddling also increased as babies approached 6 months of age, most likely, Moon said, because by then they can roll over by themselves, which usually happens at around 4 months. "The take-home messages are, if the baby is getting old enough where they can roll, they shouldn't be swaddled," she explained, adding that they shouldn't sleep on their stomachs or sides, either.

Swaddling has another danger that wasn’t studied in the report: If babies get very warm, they might have more difficulties waking themselves up. This is especially important because the risk of SIDS increases if Baby has trouble arousing when experiencing breathing difficulty. Parents should also realize that a loose swaddling blanket could potentially cause strangulation, which is yet another risk factor of sudden infant death syndrome. 

Swaddling and SIDS: Should I Keep Swaddling My Infant?

Anna S. Pease, lead author of the Pediatrics study, told The New York Times that the results should be interpreted with caution, since the study is limited. "We already know that side and prone sleeping are unsafe for young babies," she said. "So the advice to place children on their backs for sleep is even more important when parents choose to swaddle them." 

In other words, parents should always put their child to sleep on their backs, but this guideline is crucial when swaddling. You should also avoid putting a swaddled infant on his side, since this position makes it easier to flip onto the stomach. 

If you decide to swaddle your baby, always follow proper safety advice.  According to Steven A. Shapiro, D.O., chair of the Pediatrics Department at Abington–Jefferson Health, never swaddle him too tightly. “Baby needs to be able to move around and have the ability to kick and squirm,” he says, adding that you should position the baby with his hands above his head. 

You also shouldn’t swaddle your baby once he starts to roll over on his own. If he rolls from his back to stomach, the swaddle could increase his SIDS risk, according to the American Academy of Pediatrics

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