Alarm bells rang out across the Internet this week as a new study published in the May edition of the journal Pediatrics suggested that swaddling babies may increase the risk of sudden infant death syndrome (SIDS). With headlines like “Swaddling infants could be more likely to cause SIDS, study shows” and “Swaddling increases SIDS risk in babies” it’s no wonder parents and caregivers are concerned. It’s important, however, as we make decisions about infant care, that we dig deeper into the study itself.
To begin with, it’s important to note that this new study does not suggest that we stop swaddling infants all together, and in fact, it expressly highlights the benefits of infant swaddling including “more quiet sleep,3 fewer spontaneous arousals during quiet sleep,4 and a slight reduction in excessive crying in infants aged <7 weeks.5” They also point to “improvements in neuromuscular development for very low birth weight infants,6 reduced physiologic and behavioral distress among premature infants,7 and improved calming and sleep for infants with neonatal abstinence syndrome.8” in some populations.
What needs to be emphasized here is that swaddled infants must be placed on their backs, as the researchers found that the risk of SIDS appears to increase when swaddled infants are placed on their stomachs or sides for sleep. The American Academy of Pediatrics echoed this in their response to the study, and reiterated the following points:
• The association between swaddling and SIDS remains unclear
• The risk of SIDS is directly related to sleeping position.
• The risk is doubled for infants who are swaddled AND found on their stomachs or sides.
In addition, parents and caregivers should be aware that there’s an increased risk for swaddled babies who can move from their backs onto their stomachs and side, which is at around four to six months when babies begin to roll over, so it’s a good idea for parents to discuss the with their baby’s pediatrician. A good solution to mitigate risk may be to wean off the swaddle around that point or transition to a sleep sack, which provides babies with a comforting—yet safe—snugness.
-Carole Kramer Arsenault, RN, IBCLC