Tag Archives: swaddling

Swaddling Harmful? (Article)

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.


Your comments are welcome at my blog, www.docsmo.com.

Smo Notes:

1. http://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/pages/Swaddling-Is-it-Safe.aspx

2. J Pediatr. 2014 Jan 30. pii: S0022-   3476(13)01591-6. doi: 10.1016/j.jpeds.2013.12.045.

Infant Deaths and Injuries Associated with Wearable Blankets, Swaddle Wraps, and Swaddling, McDonnell E1Moon RY2.


Happiest Baby on the Block (Book Review Pedcast)

 Help support DocSmo.com by buying this reviewed book using this affiliate link. You get Amazon’s best price and DocSmo.com earns a small affiliate marketing fee.  Thank you.


The Happiest Baby on the Block

by Dr. Harvey Karp

Bantam Books

June 2003


Welcome to another edition of DocSmo.com.  I am your host, Dr. Paul Smolen, a general pediatrician with now 31 years of practicing experience to share with you.  A few months ago I started reading and writing reviews of some of the interesting parenting books available to parents.  My hope is that I will learn a lot and I can share some of these insights with my listeners.  I might also inspire you to read and discuss books related to children.  I am excited to bring you a great book today by Dr. Harvey Karp called:  The Happiest Baby on the block.  I think you need to put this one on your must read list if you have very little babies around your house or contemplate new arrivals in the future. So lets get right into it, shall we?

Anyone who has experienced a colicky baby knows how difficult and frustrating it can be to try and console a very fretful infant less than 3 months of age. What is going on with these babies?  Why do they cry so much? You are doing everything possible and still they often cry inconsolably:  why?  Dr. Karp attempts, and to a large degree, succeeds in answering that question in his book, “The Happiest Baby on the Block”.   In a nutshell, here is what he believes is going on:  Dr. Karp believes that many human infants are born, unable to cope with the barrage of stimuli presented to them. Traditionally, we call these babies “colicy”.  He contends that human babies are born about three months before they have the coping skills they will need.  He speculates that if birth was delayed 3 more months, their brains would become so large that they would not be able to get through the birth canal.  Birth just has to happen because waiting is just not possible. He also contends that a colicy immature babies crying is their response to any irritation, both external and internal.  “Easy” babies have graded crying in proportion to what is bothering them, but “colicy” babies have a  “one size fits all cry”.  For them it’s all or none.

Dr. Karp takes all this information one step further. He believes that even the fussiest baby can be consoled and made content by simulating the conditions in the womb.  He thinks these really fussy babies are the ones that are really homesick for the womb, and that simulating conditions there is the ticket to baby happiness.  Things were pretty good in the womb:  warm, weightless, gentle motion, constant food with background music of the placenta.  Never hungry, never thirsty with no responsibilities.  Sounds pretty good.

Most of the book is spent with describing Dr. Karp’s method for simulating womb conditions, which he contends, will make even the fussy babies change into the “Happiest Babies on the Block.”  In a detailed way, he describes what he calls the 5 S’s of soothing a baby: 1. Swaddling, 2. Side position, 3. Swishy noise (loud), 4. Swinging, and finally 5. Sucking.  He calls the combination of these 5S’s the “Cuddle Cure” for infant crying.

So now for my take on this book.  I can’t hide my enthusiasm… Dr. Karp has written a classic.  This is a great book, which changes the way we look at very small infants. I think this book will be a must read for parents for decades. Dr. Karp has managed to take what is known about infant behavior and bring it to life for parents.  The book is easy to read and understand, extremely informative, and even funny.  You can tell that Dr. Karp is a practicing pediatrician because his advice is practical, practical, practical.    He understands what parents confront with a colicy baby; he sympathizes, and helps parents take charge.  He takes a look at infant crying from a cross cultural and biological viewpoints.  Amazing.

In the edition that I read, some of Dr. Karp’s advice is outdated or just wrong.  He advocates a side position for sleeping infants: a clear no from the AAP in today’s standards.   He advocates for co-sleepers, even giving “safe co-sleeper” hints.  The newest safe sleep guidelines specifically exclude co-sleeping.   He also recommends that swaddling be done with the arms inside the wrap, which some experts disagree with.

Mothers for generations have known about swaddling, soothing noise, swinging etc., but Dr. Karp has put these tools together into a “method”.    He should be applauded for his efforts and I think this book is a valuable tool for parents of young infants.  A classic.  A must read.  I give it 5 DocSmo stars on a 1-5 scale:  my highest rating possible.  Congratulations Dr. Karp.  Well done.

I welcome our comments at my website, www.docsmo.com.  If you enjoy thinking and talking about children, DocSmo.com needs to be in your weekly diet.  Most weeks, I add new content twice weekly.

This is Dr. Paul Smolen, Doc Smo, broadcasting from studio 1E in Charlotte, NC, and thanking Dr. Karp for his shedding so much light with his Happy baby insight.

Until next time.