Myth vs. Fact: Should You Tightly Swaddle Your Newborn?

Many people believe that a tightly swaddled newborn is a happy, comfortable and comforted baby. But what some parents don’t realize is that while wrapping your baby with a blanket can provide comfort, it also can harm the baby if done incorrectly.

Swaddling is one of those popular S’s — making shushing sounds, swinging the baby and encouraging sucking — that help calm fussy newborns. It’s an age-old approach to help babies feel calm and comfy.

Now, a new advisory — and technique — recommends revisiting a common practice used by our grandmothers’ grandmothers.

“You want to swaddle the baby to mimic the feeling of being in the womb. If your baby does not feel warm and secure, then you won’t have a happy baby,” said Danielle Harrison, R.N., a Perinatal Services nurse at Homestead Hospital. “But you also need to make sure you don’t do it too tightly because it can cause problems.”

Ms. Harrison, a swaddler extraordinaire, is frequently asked for tips by parents as they get ready to take their baby home from the hospital. She shows them, step by step, the safest approach.

Swaddling also is addressed at childbirth education classes at South Miami Hospital’s Center for Women & Infants.

“We teach the proper swaddling techniques so parents can have a chance to practice with the instructor present,” said childbirth educator Janine Balkin, R.N.

While this practice may provide a newborn with a feeling of security, studies have found that swaddling too tightly can hinder the baby’s lung function by restricting chest movement. At the same time, swaddling too loosely can increase the risk of sudden infant death syndrome if the blanket comes loose and covers the baby’s face.

“We use swaddling in the hospital setting to help maintain the infant’s temperature; however the use of swaddling at home is not necessary,” said Maite Hanford, R.N., nurse manager for Mother-Baby/Women’s Services at Baptist Hospital.

Some parents still want to give this traditional technique a whirl, especially when they have a fussy baby. If that’s the case, they should use moderation. Studies have shown that regularly wrapping a child too tightly can also lead to an abnormal development of the hip joint, causing the ball of the hip to dislocate from the hip socket.

Here’s why:  Babies naturally pull their knees up, and forced extension of the legs and knees causes increased tension in the hamstring and hip muscles. This can lead to loose ligaments, instability and, eventually, dislocation.

To avoid the problem, the International Hip Dysplasia Institute, the American Academy of Pediatrics and the Pediatric Orthopaedic Society of North America recommend a more contemporary form of swaddling that provides room for hip and knee movement.

While the infant’s arms and torso can be wrapped snugly — not overly tightly — the legs should be covered loosely and be free to move. Most importantly, they should never be wrapped in a “straight down” position.