How to swaddle a baby for optimal sleepUpdated Jul 07, 2022
At the hospital, the nurses took a simple blanket and created a cozy cocoon for your newborn with just a few folds and tucks. Now that you’re at home, you have no idea how to wrap those wriggling baby limbs in the same way. Sound familiar? If so, get ready to say goodbye to your swaddling insecurities. Welcome to Swaddling 101!
IN THIS ARTICLE:
What is swaddling?
Swaddling is a method of snuggly wrapping your baby in a blanket. When done correctly, the blanket should stay secure around the baby, can help calm fussiness, and may even improve sleep.
The technique’s been used for millennia, although modern swaddling undoubtedly looks a bit different than it did during paleolithic times. For one thing, our blankets are probably a lot cuter. We know a lot more about safety now too.
Swaddling can look really easy — especially if you watch a labor and delivery nurse magically wrap your newborn into a baby burrito in under 10 seconds. Don’t be intimidated! In reality, it takes most people some practice to master.
Why it works, especially in the so-called "fourth trimester"
A swaddle can improve sleep in two ways. First, it can simulate the womb. This “back in the womb” feeling can help soothe infants and promote sleep. It may also decrease a baby’s arousal, meaning they wake less and sleep longer.
Second, swaddling can help prevent a full awakening caused by both the startle and Moro reflexes. The swaddle limits the movement of a baby’s arms, which means they’re less likely to awaken when you transfer them to their bassinet, they move around in their sleep, or the dog barks.
Startle and Moro reflexes
Thought the startle and Moro reflexes were the same thing? You’re not alone. While the startle and Moro reflexes are often used interchangeably, they’re now understood to refer to separate mechanisms. The startle reflex is movement in reaction to unexpected stimuli (e.g. noise, light, or movement), while the Moro reflex is triggered when an infant feels like they’re falling. You’ll often see the Moro in action when you go to place your newborn baby in their crib and their arms flail out to the sides. The Moro reflex disappears by 5 - 7 months of age, whereas the startle reflex is maintained into adulthood.
Is it safe to swaddle at night?
Swaddling can help newborns sleep soundly, but it’s not without risk. While “decreased arousal” may improve sleep, it may also be a leading factor in SIDS fatalities.
The American Academy of Pediatrics (AAP) recommends monitoring swaddled babies when they sleep. Placing babies on their back and in their own safe sleep space while swaddled is your safest bet. Make sure their sleep space is free of loose bedding and soft items, like pillows or stuffed animals. If you plan on bed-sharing (which the AAP doesn’t recommend), also plan on leaving the swaddle off.
Primary safety concerns include the increased risks of:
SIDS or suffocation if baby rolls over while swaddled, or if blankets become loose
Hip dislocation or hip dysplasia when swaddled incorrectly
Follow a few common sense precautions while swaddling to help keep your baby safe and sound. Wrap the blanket securely, but not too tight; ensure legs have room to move; and don't add too many layers beneath the swaddle blanket.
Types of swaddles and how to choose
The great thing about swaddling is that you only need one piece of equipment: a standard rectangular (or square) baby blanket.
There are other options for swaddling though, too. Today, parents can choose "ready made" swaddle blankets with zippers and velcro (so you don't need to master folding and tucking). Avoid weighted swaddles; the June 2022 updated AAP guidance for safe sleep notes that they are not safe, and therefore not recommended.
For infants that object to having their arms pinned down at their sides, there are also hands-up swaddle blankets. If you’re looking for a swaddle that grows with your child, you might opt for a transitional style that moves from an arms-in swaddle to an arms-out wearable blanket.
There’s no one “right” choice here. The best swaddle for your baby is the one that you can safely use to improve sleep. Especially big or strong newborns may bust out of a swaddle made from a smaller baby blanket and need a larger blanket or zippered swaddle to ensure that the swaddle doesn’t come undone. When using a swaddle blanket, make sure to check the manufacturer’s recommendations for safe use.
Step-by-step how to
First, a little disclaimer: Our graphic will make swaddling look simple, but the cartoon baby isn’t kicking like a mini soccer star. Expect that it will take time to master your swaddling technique. If your baby is wiggly or fussy, it can be extra challenging to swaddle correctly. Like with many things in life and parenthood, practice makes progress!
Step 1: Place your blanket on a flat surface in a diamond shape, so that one corner is at the top. Fold this top corner down. How much you’ll want to fold it will depend on the size of your baby and the size of your blanket.
Step 2: Lay your baby onto the blanket (face up) with their head above the folded corner.
Step 3: Gently guide the left arm down to your baby’s side. Take the right corner of the blanket and wrap it around your baby’s left arm and body. Tuck the blanket under their back. Chances are you’ll need to distract your baby. Sing your favorite television theme song, or make funny faces, to grab their attention.
Step 4: Wrap the bottom corner of your blanket over your baby’s feet and tuck it into the top of the first fold. Now guide your baby’s legs so that they’re positioned up and out — like a frog — to ensure they’re enough room. We don’t want the legs to be tightly restricted, as that can cause issues for developing hips.
Step 5: Place your baby’s right arm down, against their body, and wrap the last corner (the one on the left side) over and around your baby’s body. Tuck the swaddle into the fold at the back to keep it secure.
Arms out adaptation
If you want to gradually wean away from the swaddle, you may choose to transition out of the blanket in stages. This works best if your baby is past the newborn stage, but hasn’t shown any signs of rolling yet.
In this case, we’d begin by leaving one or both arms out of the swaddle, so that your baby can get used to having some freedom of movement, while still keeping the rest of the body secure. Once your baby adjusts to having both arms out, you can remove the entire swaddle. Go ahead and swap it out for a wearable blanket, which can provide warmth and comfort, while allowing much more movement of the limbs.
When to swaddle
Swaddling is a great trick for improving baby sleep — but there's a specific age window to keep in mind.
When to start
You can start swaddling your newborn on the very first day. Consider asking your nurse at the hospital for a demonstration, as they tend to be swaddling pros.
When to stop
For safety reasons, it’s critical to stop swaddling when your baby starts to show signs of rolling over. This can happen as early as 2 months of age!
Since it’s essential that loose blankets stay out of a baby’s sleeping area, you’ll also want to stop swaddling if your baby is busting out like a little Houdini. In this case, a ready-made zippered swaddle might be a better fit, as long as your baby isn’t on the verge of rolling.
5 Tips for safer swaddling
1. Avoid overheating
Since swaddled babies run the risk of overheating, it’s important to consider the temperature in their bedroom, the thickness of the blanket, and the clothing your baby is wearing. Your baby may be too hot if you notice sweating, damp hair, flushed cheeks, heat rash, and/or rapid breathing.
In warmer rooms, a thin cotton blanket over a short sleeve onesie can work well. In cooler environments, you might opt for long sleeve pajamas under the swaddle.
2. Practice when baby’s calm
Try to introduce (and practice) swaddling when your infant is relaxed and fed. This increases the chances that they’ll stay calm while you master your swaddle technique.
It’s true that swaddling is known for its soothing effects. However, introducing something unfamiliar to an already cranky baby can add to the challenge. Either way, don’t forget that singing, noises, and funny facial expressions can be great distractions!
3. Aim for snug, but not too tight
While you want your baby to feel cozy, we don’t want to restrict chest movement. Ensure you can fit 2 - 3 fingers in between the baby's chest and swaddle.
It’s also important to follow hip-healthy guidelines when swaddling, which means allowing enough space for your baby to move their legs up and out to the side.
4. Place on their back, in their own sleep space
The AAP recommends placing infants to sleep on their back, and monitoring them when swaddled. Since bed-sharing can increase risks, opt to place your baby in their own bassinet or crib when swaddling.
5. Stop before rolling starts
It's time to stop swaddling as soon as your baby starts trying to roll. The risk of suffocation is increased if a swaddled baby rolls over onto their stomach. Look out for these signs: rolling onto their shoulder or side; kicking one leg over the other; twisting their upper body one way and their lower body the other way; and/or regularly rocking side to side.
Q: Is it possible to swaddle too loosely or too tightly?
Yes. For safety reasons, it’s important that your baby’s swaddle is wrapped securely around their body. Be sure that their chest movement isn’t restricted and their legs can move up and out.
Q: Can you feed your baby while they're swaddled?
It’s best to swaddle your baby after a feeding. This ensures that your infant can use their hands while eating, and makes it easier for them to take in a full feeding.
Q: What materials are best?
Soft, thin blankets made from natural materials — like cotton or bamboo — are the most popular options for swaddling blankets. Many parents prefer the breathable weave of cotton muslin blankets for their swaddles.
Q: What about swaddling on a hot summer day?
Since swaddling can increase the risk of overheating, make sure that the layers underneath are appropriate for the weather. A thin onesie or even just a diaper may be all you need under the swaddle blanket. Remove the swaddle if you see signs of overheating (i.e. sweating, damp hair, flushed cheeks, heat rash, and/or rapid breathing).
Q: My baby wiggles out of the swaddle. What am I doing wrong?
You may find your newborn escaping from the swaddle if the blanket’s too small or wrapped too loosely. Try a bigger blanket or a “ready made” swaddle geared toward your baby’s age and size.
Note: The content on this site is for informational purposes only and should not replace medical advice from your doctor, pediatrician, or medical professional. If you have questions or concerns, you should contact a medical professional.