Swaddling is a smart strategy for helping your newborn sleep more soundly. Tucking her in a snug wrap can make her feel safe and secure as she adjusts to life outside the womb, keep her cozy and warm as her internal thermostat ramps up, and prevent her from flailing her arms and legs and triggering the startle reflex.
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But within a couple of short months, it'll be time to kiss the practice goodbye. Though safe for newborns (provided you're swaddling in accordance with other safe sleep guidelines), swaddling becomes risky as your baby gets older and becomes more mobile.
So when exactly should you stop swaddling your baby, and how can you ease your little one's transition to swaddle-free sleep? Here's what you need to know.
Experts recommend that you stop swaddling your baby when she starts trying to roll over, which can happen around 2 months. While your baby may not actually roll over until 3 or 4 months, it is safest to stop swaddling before your little one rolls over.
Once your baby is mobile and rolling, a swaddle can pose a possible suffocation and strangulation hazard if it comes loose or your child's movement is restricted.
And it's not just a safety issue. As your baby gets more mobile, being confined to a wrap can prevent her from practicing age-appropriate motor skills, which could negatively impact her development.
With all this considered, you might be wondering whether it makes more sense to stop swaddling even earlier, say, when your baby is a month old. Unless your baby is showing signs of being more mobile and attempting to roll over, there's no need to stop swaddling quite that early, especially if it seems to help your baby sleep better.
But if you want to stop sooner ' maybe you're tired of the whole swaddle wrapping thing or your baby doesn't seem to sleep any better with a swaddle than without ' it's perfectly fine to do so. Babies don't need to be swaddled, and some actually snooze more soundly without being wrapped up.
Though before you give up on swaddling altogether, you might want to consider looking into a Velcro or zipper swaddle wrap. Some parents find them easier to use, and some babies seem to prefer them to old-fashioned blankets.
After wrapping and unwrapping your baby more times than you could possibly count, stopping swaddling can feel like the end of an era. And if her swaddle blanket has become an integral part of her sleep routine, you might worry that stopping could seriously throw things off.
The good news is all babies eventually adjust to sleeping without a swaddle. And of course, you could certainly try stopping cold turkey to see how your baby responds. You never know ' she might sleep just as well as before!
But if you suspect that wouldn't be the case (or you don't want to risk a bad night's sleep experimenting), you can also try a more gradual approach. Here's how to do it:
Swaddling your baby with one or both arms out is perfectly safe, as long as you continue to wrap her blanket securely. In fact, some newborns prefer being swaddled with one or both arms free from the very beginning.
Another swaddle transition option: Trade your swaddle blanket for a transitional sleep sack. These swaddle wrap/wearable blanket hybrids offer a similar snugness to a wrap, but don't come with the risk of potentially being kicked off while your baby is sleeping.
If you choose to use one of these sleep sack products, just keep in mind that you'll eventually have to transition your baby out of that too ' either because she outgrows it or because it, too, becomes unsafe as she starts moving more.
Ultimately, there's no one best way to stop swaddling ' so do what you think will work best for your baby and you. And if you're unsure or have questions, reach out to your baby's pediatrician.
It's understandable that you might worry your baby won't sleep as well without her swaddle. But rest assured, even if your baby initially has a tough time transitioning, she'll eventually get used to it.
Remember, you still have lots of tools at your disposal for helping your little one sleep. Establishing a calming bedtime routine with a predictable pattern ' like a bath, feeding, rocking and a lullaby or a story ' can help your baby unwind and, hopefully, fall asleep.
Creating a soothing ambiance by dimming the lights, speaking softly and playing white noise can help too. And finally, don't discount the power of touch: Infant massage can calm a fussy baby and get her in the zone to fall asleep.
And even though you can no longer use a swaddle blanket, you may still be able to use a swaddle-sleep-sack hybrid to bridge the transition. You could also go straight to trying a regular sleep sack ' basically, a wearable blanket that, depending on the model, your child may be able to continue to use well into toddlerhood (though you may need to size up as she gets bigger).
Swaddling is a smart sleep strategy for newborns. But once your little one is about 2 months old and reaches the point of trying to roll or kick free of her swaddle blanket, it's time to move on. Here's to the next exciting phase of babyhood!
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By: Rachel Y. Moon, MD, FAAP & Danette Glassy, MD, FAAP
New parents often learn how to swaddle their infant from the nurses in the hospital. A thin blanket wrapped snuggly around your baby's body can resemble the womb and help soothe your newborn. When done correctly, swaddling can be an effective technique to help calm infants and promote sleep.
But if you plan to swaddle your infant at home, you need to follow a few guidelines to make sure you are doing it safely.
To reduce the risk of Sudden Infant Death Syndrome, or SIDS, it's important to place your baby to sleep on their back'every time you put them to sleep. This may be even more important if your baby is swaddled. Some studies have shown an increased risk of SIDS and unintentional suffocation when babies are swaddled if they are placed on their stomach to sleep, or if they roll onto their stomach. If babies are swaddled, they should be placed only on their back and monitored so they don't roll over.
Stop swaddling as soon as your baby shows any signs of trying to roll over. Some babies start working on rolling as early as 2 months of age, but every baby is different. There is no evidence with regard to SIDS risk related to the arms swaddled in or out.
Infant sleep clothing, such as layers of clothing or a wearable blanket or sleep sack, is preferred over blankets and other coverings to keep a baby warm. A safe sleep space for infants should stay free of any loose bedding or soft objects. However, as with regular blanket swaddling, the use of wearable blankets or sleep sacks that compress the arms, chest and body should stop once a baby shows signs of starting to roll over. Sleep sacks that do not swaddle and allow the baby to move freely can be used as long as you want.
Parents should know that there are some risks to swaddling. Swaddling may decrease a baby's arousal, so that it's harder for them to wake up. That is why swaddling can seem so attractive to new, sleep-deprived parents'the baby sleeps longer and doesn't wake up as easily. But we know that decreased arousal can be a problem and may be one of the main reasons that babies die of SIDS.
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The AAP recommends parents follow the safe sleep recommendations every time they place their baby to sleep for naps or at nighttime:
Place your baby on their back to sleep on a firm, flat surface and monitor them to be sure they don't roll over while swaddled.
Do not have any loose blankets in your baby's crib. A loose blanket, including a swaddling blanket that comes unwrapped, could cover your baby's face and increase the risk of suffocation.
Do not use weighted swaddles or weighted blankets, which can place too much pressure on a baby's chest and lungs.
Use caution when buying products that claim to reduce the risk of SIDS. Wedges, positioners, special mattresses and specialized sleep surfaces have not been shown to reduce the risk of SIDS.
Your baby is safest in their own crib or bassinet, not in your bed.
Swaddling can increase the chance your baby will overheat, so avoid letting your baby get too hot. The baby could be too hot if you notice sweating, damp hair, flushed cheeks, heat rash and rapid breathing.
Consider using a pacifier for naps and bedtime.
Place the crib in an area that is always smoke-free.
See How to Keep Your Sleeping Baby Safe: AAP Policy Explained for more information and tips.
Babies who are swaddled too tightly may develop a problem with their hips. Studies have found that straightening and tightly wrapping a baby's legs can lead to hip dislocation or hip dysplasia. This is an abnormal formation of the hip joint where the top of the thigh bone is not held firmly in the socket of the hip.
The Pediatric Orthopaedic Society of North America, with the AAP Section on Orthopaedics, promotes "hip-healthy swaddling" that allows the baby's legs to bend up and out.
Use only a thin blanket for swaddling.
To swaddle, spread the blanket out flat, with one corner folded down.
Lay the baby face-up on the blanket, with their head above the folded corner.
Straighten their left arm and wrap the left corner of the blanket over your baby's body, tucking it between their right arm and the right side of their body.
Then tuck the right arm down, and fold the right corner of the blanket over her body and under their left side.
Fold or twist the bottom of the blanket loosely and tuck it under one side of the baby.
Make sure their hips can move and that the blanket is not too tight. You want to be able to get at least two or three fingers between the baby's chest and the swaddle
Some child care centers may have a policy against swaddling infants in their care. This is because of the increased risks of SIDS or suffocation if the baby rolls over while swaddled, in addition to the other risks of overheating and hip dysplasia.
Compared to a private home, where one or two people are caring for an infant, a child care center usually has a number of caregivers who may have variations in their swaddling technique. This raises a concern because studies show babies who are not usually swaddled react differently when swaddled for the first time at this older age. They may have a harder time waking up, which increases their risk of SIDS.
The difference in the advice for swaddling at home or the hospital nursery, versus in a child care center, really comes down to the age of the child and the setting. A newborn can be swaddled correctly and placed on their back in his crib at home, and it can help comfort and soothe them to sleep. When the child is older, in a new environment, with a different caregiver, if they are learning to roll or perhaps haven't been swaddled before, swaddling becomes more challenging and risky.
Rachel Y. Moon, MD, FAAP is a pediatrician and SIDS researcher at the University of Virginia. She is also a Professor of Pediatrics at the University of Virginia School of Medicine. Her research centers on SIDS and SIDS risk factors, particularly in high-risk populations, such as African Americans and infants attending childcare. Within the American Academy of Pediatrics (AAP), she is chair of the Task Force on SIDS and Associate Editor for the journal Pediatrics. Dr. Moon is also the editor of Sleep: What Every Parent Needs to Know.
Danette Glassy, MD, FAAP, is a member of the American Academy of Pediatrics Councils on Community Pediatrics and Early Childhood, as well as the Washington Chapter of the AAP. She practices in Mercer Island, Washington
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