What is old is new and what is new is old as they saying goes. Nothing could be more true when it comes to swaddling infants, that ancient practice that has enjoyed a resurgence of popularity among todays parents. Just go into a baby store and you will know what I am talking about; baby blankets for swaddling, swaddle wraps (a blanket with pockets for the infant’s arms and legs along with Velcro), wearable blankets (a blanket with holes for the arms and head zippered up the front), and sleep sacks (a sack with an opening for the infant’s head), along with other variations. Most parents will agree that these swaddling devices sooth babies and create a warm environment for the infant but are they safe?
The dangers of swaddling have been known about for decades; over bundling and heat illness, suffocation if the wrap gets loose and gets near an infants face, an infant who rolls over while wrapped and smothers, being wrapped too tightly restricting breathing, pieces of the swaddle coming loose or damaging an infant’s mouth. In a recent retrospective study published in the Journal of Pediatrics, the authors reviewed deaths and injuries from swaddles between 2004 to 2011 in the US. In all, they found 22 infant deaths in part or totally attributable to swaddling. Here was the breakdown:
• 5 cases involving wearable blankets (1 death, 2 injuries, 2 potential injuries);
• 18 cases involving swaddle wraps (8 deaths and 10 potential injuries);
• 1 death involving an unspecified product (either swaddle wrap or wearable blanket); and
• 12 deaths involving swaddling in ordinary blankets.
Swaddling remains a useful tool for parents to soothe a fussy baby but this new study reminds us of its limitations and dangers. Parents need to be vigilant not to overwrap their infants and get them too hot, wrap them too tightly and restrict their breathing or leg movements, ever leave a child swaddled who can flip onto their stomachs and smother face down, or have a wrap that can get anywhere near a child’s face. 22 deaths out of approximately 21 million babies born during the study period isn’t exactly an epidemic but maybe if the limits of swaddling are better understood, we can make the next number collected be ZERO! Let’s hope. Until next time.
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2. J Pediatr. 2014 Jan 30. pii: S0022- 3476(13)01591-6. doi: 10.1016/j.jpeds.2013.12.045.