Swaddling

Swaddling involves wrapping or bundling babies in cloth blankets with the arms restrained to dampen the startle response and provide a sense of comfort. The paper by Price is timely because of the rising popularity of infant swaddling in Western societies. 

Studies have demonstrated that swaddling promotes sleep consistency and duration while encouraging infants to remain in the recommended supine position during sleep.

It has been found that both swaddling and stomach sleeping limits arm movement, which can lead to a decrease in the startle reflex. A reduction in startles results in a better sleep maintenance but can also depress spontaneous arousals.

It is important to ensure that during swaddling it is advised to use thin materials in order to prevent overheating.

Developmentally, children need to be able to move and be able to bring their hands to their mouths. If swaddling, keeping their hands closer to their face and not pinned by their sides will allow this natural movement.

Traditional swaddling involves wrapping infants with the legs straight and the hips and knees extended. This practice should be discouraged because it increases the risk of developmental dysplasia of the hip and hip dislocation.

Proper swaddling methods restrain the upper extremities but allow hip flexion-abduction and knee flexion.

A longer duration of swaddling beginning at birth produced a greater rate of dislocation and more severe dysplasia than the shorter period of swaddling. The authors concluded that earlier swaddling and prolonged swaddling were more detrimental to hip development in this experimental model.

Resources

1. Price, C.T. Swaddling and Hip Dysplasia: New Observations. 2012. The Journal of Bone and Joint Surgery 94(92): 1-2.

2. Kato et al. Spontaneous Arousability in Prone and Supine Position in Healthy Infants. Sleep 29(6):785-791.