Swaddling is an age-old practice of wrapping infants in blankets or similar cloths so that movement of the limbs is tightly restricted. The earliest examples of swaddled babies come from Crete and Cyprus 4,000 to 4,500 years ago. Examples have been found in ancient Greek and Roman tombs and probably the most famous record is from the New Testament concerning the birth of Jesus in Luke 2:6-7, “and wrapped him in swaddling clothes.”

Swaddling fell out of favor in the 17th century. Starting in the 1500s, a Swiss surgeon showed how the tightened bandages could cripple the baby. In the 17th century, the scientific opinion began to change against swaddling as it was observed that wet nurses would bind babies up and leave them for long periods without washing or comforting them. The British philosopher John Locke became a lobbyist for not binding babies at all. And 100 years later, Jean Jacques Rousseau also rejected the practice.

There has been a renewed interest in the use of swaddling, although medical and psychological opinions on the effects of swaddling remain divided. Some modern medical studies indicate that swaddling helps babies fall asleep and helps keep babies on their back, which lowers the risk of Sudden Infant Death Syndrome. To complicate matters, another study indicated that swaddling increased the risk of SIDS and that certain swaddling techniques may increase the risk of hip dysplasia.

Healthychildren.org stresses that parents should know the risks of swaddling. Swaddling can be an effective technique to help calm infants and promote sleep. However, if you plan to swaddle your infant there are a few guidelines that need to be followed.

A swaddled baby should be placed only on its back and monitored so it doesn’t accidentally roll over. An adult should be able to get two fingers between the baby’s chest and the swaddle. Stop swaddling when the baby shows any signs of trying to roll over. This usually happens around 2 months of age.

Swaddling may decrease the baby’s arousal so that it’s harder for the baby to wake up. That’s why parents like swaddling as the baby sleeps longer and doesn’t wake up as easily, but it’s known that decreased arousal can be a problem and may be one of the main reasons that babies die of SIDS.

The American Academy of Pediatrics recommends these tips for putting babies to bed safely:

• Place the baby on its back to sleep and monitor if swaddled;

• No loose blankets/pillow/soft toys in the crib;

• Beware of products that claim to reduce SIDS;

• Babies are safest in their own cribs — not the parents’ bed or recliner;

• Make sure the baby isn’t too hot, particularly with swaddling;

• Consider using a pacifier; and

• Place the crib in an area that is always smoke free.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

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