When I first became a mom in 2014, I knew very little about infant sleep. The first of my friends, and the first in our family to have babies, the terms ‘wake window’ ‘drowsy but awake’ and ‘self soothe’ were entirely foreign to me. Literally the only thing I knew was what I saw in the hospital – if you want your baby to sleep, you had to fold a blanket into a magical cocoon that calmed them long enough to put on a fresh adult diaper or take a shower.
Now, 3 kids and 6 years later, I know that ‘drowsy but awake’ and expecting a baby to ‘self soothe’ are myths. What I never learned as a mom, and only truly understood through extensive study and research to become a certified paediatric sleep specialist, is that the magical swaddle is actually no longer recommended, and is potentially harmful to our babies.
Babies are born with 6 primitive reflexes that are meant to be integrated and ‘lost’ as the baby grows and develops. After rooting and sucking, the most commonly recognized primitive reflex is the moro reflex, which is also known as the startle reflex. If startled by a loud sound or movement, a baby will throw back the head, extend out the arms and legs, then pull the arms and legs back in. When it comes to swaddling, there are two main reasons that it has commonly been recommended, and the first is to help combat this startle reflex by restraining the baby’s arms and legs.
The issue with swaddling to discourage the moro reflex is that, in order for babies to integrate their primitive reflexes, they need the opportunity to overcome them, and swaddling discourages this. There are some studies that suggest if a baby’s primitive reflexes are retained (i.e. if babies don’t have an opportunity to work through the reflexes and integrate them naturally), that it can contribute to a child becoming hypersensitive to different types of sensory input including temperature, touch, movement, visual and/or sound. This is a really contentious point, but the more relevant point, as it relates to sleep, is that the swaddle has to come off at some point, and the sooner you remove it (or, ideally, not use it at all), the better. Once a baby is able to roll, swaddling becomes entirely unsafe, and needs to be stopped immediately.
The second reason swaddling is often seen as the holy grail of infant sleep is because it gives the baby the feeling of a tight hold, which is supposed to mimic the feeling of being in the womb. If you’re reading this, you’re likely already a parent yourself and know first hand that the fourth trimester is real – babies crave constant contact from their primary caregiver and swaddling can give mom and dad a little break. As a mom of little kids myself, I totally get the attraction of using the swaddle for longer stretches of sleep. The trouble is – and here is where the new recommendations against swaddling come into play – that if used incorrectly, a swaddle can cause a suffocation risk to a baby. Additionally, swaddling puts a baby into a deeper state of sleep (which is why most traditional sleep consultants praise its use), but research shows that the deeper the state of sleep, the higher the risk for SIDS.
The moro reflex is actually a natural, built in protective mechanism. Aside from the obvious initial purpose, which was to startle a baby if there was an external danger (baby wakes at the sound of the lurking sabre tooth tiger, which wakes mom, and mom scares off said tiger), its purpose is to startle baby awake if baby’s breathing slows down too much. Remove the ability to startle, and this extra layer of internal protection is now gone. One of the primary causes of SIDS is apneas – sudden periods of stoppage in breathing – while baby is sleeping.
And finally, if you are a breastfeeding parent, swaddling can interfere with the breastfeeding relationship. Babies need their arms and hands to explore in order to find the breast, and restricting hand movement can make latching, and breastfeeding in general, much more difficult.
So if I’ve now convinced you as to why I don’t recommend swaddling to my clients, you’re probably thinking, what am I going to do instead? Here are a few tips to help get through the newborn stage without swaddling:
- Use a sleepsack that allows for swaddling the body only: my personal favourite is the Halo (linked on my website for purchase), because it is loose on the feet, and you can swaddle the baby’s torso only, allowing the arms to be free, while giving a tight feeling across the body
- When putting baby down to sleep, place baby’s arms on either side of the head (as if they are flexing their muscles), and gently press on the arms so that baby can feel the mattress below them
- Babywear – this is not a solution for night time sleep, but babywearing can give parents a reprieve from holding the baby, while still giving baby the contact he or she needs. This also allows primary caregivers to tend to older children, prepare a quick meal, or go for a walk, all while having some hands-free holding time. As a mom, I always enjoyed using the Baby K’tan for infant wearing (click here to purchase).
- Allow baby to be exposed to some noise while napping. If baby is able to tolerate some background noise, he or she will be less likely to startle at sudden changes in noise or position.
- Practice some form of co-sleeping. Choose the method that feels right for you, whether it is room sharing, sleeping with a sidecar crib or bassinet, or bedsharing (in the absence of any risk factors, while practicing the Safe Sleep 7). The American Academy of Paediatrics and the Canadian Paediatric Society both recommend keeping baby in the primary caregivers’ bedroom until 1 year of age. Babies attach through the senses, and proximity to the primary caregiver, where baby can hear, see, touch or smell mom or dad, will give baby the feeling of safety and security to have sounder sleep
- Lean on your village of support. Until 5 months of age, babies have an indiscriminate attachment, which means they will be happy being held by anyone. Ask for help if you need it, whether it’s a friend or relative during the day, or a partner at night.
- Don’t be afraid to hold your baby – often! Despite what well meaning relatives may tell you, you can’t spoil a baby. Giving your baby the closeness and comfort they need by being held is not doing anything wrong – if it feels right to you to pick up, cuddle, rock, bounce or otherwise hold your baby, then trust your gut. You will not ‘pay’ for it later!
If you are struggling with your infant’s sleep, I am always here to help! Click here to book your free discovery call.