Swaddling: A Second Look


 

 

 

Harvey Karp’s book The Happiest Baby on the Block has changed the landscape of parenting in the US. As a result of its irresistible title, easy to learn method and national network of 2500 teachers, most new parents in the US today are instructed to swaddle their babies. Despite this popularity, there are growing concerns that swaddling is not the cure-all parents hoped it would be.

Since the publication of the book in 2003, I have increasingly heard reservations from health professionals about its recommendations. A nurse practitioner wonders if the shushing sound recommended in the book can hurt the baby’s ears. A renowned neonatologist worries that preventing a baby from flapping his or her arms to cool down might hurt temperature regulation. And, more recently I began to hear that routine swaddling had adverse effects on breastfeeding.

As a result of these concerns, I commissioned Gussie Fauntleroy to write an article on swaddling, which we’re releasing today. It is accompanied by a piece by renowned lactation consultant, Nancy Mohrbacher. And, our web editor, Melanie Mayo, has put together a special report on swaddling.

For even more coverage of the subject, read Mohrbacher’s exceptional critique of swaddling and debate with Dr Karp on its merits in the International Journal of Childbirth Education. She looks at alarming research: Swaddling newborns delays the first breastfeeding and leads to less effective sucking. Swaddling during the early months puts an infant at risk for respiratory illness, hip dysplasia, overheating and SIDS. And, finally, a small, 2010 study showed The Happiest Baby interventions ineffective in reducing crying.

Take a breath. Many parents have found swaddling helpful and these articles are not meant to discredit their experience. This research comes as shocking news to us all. We do not mean to offend other parents; we all want our babies not to cry. Rather, we hope to shed light on a practice that has benefits, but that has become dogmatic and thus may interfere with parental instinct.

 

The first question one certainly asks is, “If I don’t swaddle, what else will I do.” Here are some things that have been shown to be highly effective:

Hold your baby.

Breastfeed your baby.

Walk around holding your baby.

Rock your baby.

According to neurologist Richard Restak, MD, “Physical holding and carrying of the infant turns out to be the most important factor responsible for the infant’s normal mental and social development.” Neural and neuroendocrine functions underlying emotional behaviors are responsive to early experiences in enduring ways. For example, the anthropologist Margaret Mead found in her research that the most violent tribes were the ones that withheld touch in infancy.

I realize that these swaddling articles are provocative; I hope they will also be helpful. We’ll be talking more about their findings in the community and on Facebook. Please join us to share your comments, concerns and suggestions.

 

 

Peggy O’Mara  (101 Posts)

Peggy O’Mara founded Mothering.com in 1995 and is currently its editor-in chief. She was the editor and publisher of Mothering Magazine from 1980 to 2011. The author of Having a Baby Naturally; Natural Family Living; The Way Back Home; and A Quiet Place, Peggy has lectured and conducted workshops at Omega Institute, Esalen, La Leche League International, and Bioneers. She is the mother of four.

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39 thoughts on “Swaddling: A Second Look”

  1. Wow, I’m surprised by this article as it appears they are not familiar with Dr. Karp’s methods. I am a doula and was a nanny for twins from birth to age 2 and was fortunate to hear Dr. Karp’s lecture in person and used and taught his techniques to many parents. They work. However, I’d like to clarify a few points:

    -Dr. Karp does not encourage babies to be swaddled immediately after birth…there are far too many studies showing that babies should be held skin to skin by their mothers immediately following birth.

    -His techniques are meant to be used when babies have colic or are crying inconsolably…sometimes just holding and bouncing doesn’t work.

    -He talks about swaddling very specifically and suggests leaving the blanket loose around the hips to prevent hip dysplasia.

    -If a baby is being breastfed, there is no reason for her to be swaddled (skin to skin is great), though in the case of colic it proves to be helpful in calming the baby down in order for her to latch.

    – There is no reason to leave a baby swaddled once he has calmed down, meaning the baby is always held while swaddled, which leaves no room for one to overheat or have respiratory issues because mama (or whomever) is right there.

    I don’t know what I would have done with the twins I was responsible for had it not been for Happiest Baby On the Block. His techniques work WELL and I don’t understand why he is coming under fire. It is good to reiterate the safety measures when using these techniques, but to say that just holding and bouncing works, well, that just doesn’t sound like a mother talking.

  2. I have to concur with Melissa’s understanding of Dr. Karp’s recommendations. I never read any suggestion that a baby should be swaddled all the time, and there was nothing at all about newborns.

  3. We literally would have gone bonkers without Karp’s techniques. When baby wearing and all day nurse-ins failed to quiet our fussy babe, swaddling, shooshing, and bouncing succeeded.

    Sometimes it just seems like mothering.com has to work against whatever is popular and common place…

  4. I did not read The Happiest Baby book until after my first daughter was past her colic, and I always wonder how much it might have helped her. We did all the breastfeeding, holding and carrying, and she still screamed and screamed, for hours. I missed out on her babyhood because it was so stressful to have such an unhappy baby.

    Personally, I think swaddling is an essential tool for parents to have in their bag of tricks, particularly in the era of “back to sleep”. Some babies seem to have a stronger startle reflex which, in my experience, led to very poor sleep unless baby’s arms were swaddled. We are careful to leave our babies legs loose so that they are able to rest in a flexed position, eliminating concerns about hip dysplasia. I was thankful to have Dr. Karp’s suggestions to add to my parenting repertoire for babies 2,3 and 4. No, they weren’t magic cure-alls, but had their time and place.

  5. I never swaddled, there was some innate feeling not too. I cant explain it. The alternatives given in the article made me smile. I wish they could go without saying!!

  6. I agree with many of the comments above – most of which are it was a good TOOL to have in addition to all the other healthy parenting things we were doing. I’ve read his book and chose to use some of his ideas, to a degree, but skipped the swaddle and used the ring sling instead; which luckily was enough for my little one!

    I think Mothering and parenting experts in general need to remind people 2 key things: “everything in moderation” and “a time and place for everything”. Unfortunately I do think there are parents out there who just swaddle their babies the majority of the time, including when feeding; and that’s not good. And I live in a town where they swaddle fresh newborns THEN hand them to the mothers, after being weighed, poked, eyes gooped and assessed (unless you come in with a birth plan specifically stating otherwise and are a nurse like me so it is respected to a T…shameful).

    So no, don’t mis-critique Dr. Karp BUT recognize that their are people out there who think they are following his program by swaddling all the time!

  7. I am glad this type of awareness is finally coming forth. It seems so clear to me that infant swaddling goes against all primal instincts. There is no other species that would restrict the movement of its young – probably because no other species has ventured as far from primal birth and parenting as humans have.

    As someone who has been studying pre- and perinatal psychology for almost a decade, my intuitive thought about swaddling is that it will leave the child with a long-standing imprint of powerlessness — since he or she does not even have dominion over moving his/her own body at will. My sense is that swaddled babies may be going into a mild form of parasympathetic shock when swaddled. Their system is shutting down to deal with the insult and this is why they “fall asleep” – or disassociate, depending on how you look at it.

  8. I agree with others that have said this is a misreading of Happiest Baby on the Block. He offers the five S’s – five different techniques only one of which is swaddling. They can be used all at once or you can use what works for you. My baby was colicky and without these tips I don’t know how we would have made it through those first few months. We didn’t swaddle much, but I wore her in the Baby K’Tan all day and we bounced and shhhhh’d all the time and it was the only thing that worked. I nursed as much as she wanted, but sometimes she simply didn’t want it. All she wanted was to be bounced and shhh’d. You do what you have to. Also, I believe that Dr. Karp addresses the concern that the shhhing might be harmful to baby’s ears and concludes that it is not.

  9. Gussie delineated my own concerns about swaddling. I wish the old information about relux hadn’t been included. Excellent research shows that reflux is another good reason for putting babies of their backs, so the trachea is on top instead of below the gush. Both SIDS and asphyxiation are less in babies with reflux who sleep on their backs. AAP concurs.

  10. Parents need tools. Babies sometimes need help and swaddling is a lifesaver for some. To the poster who suggests that what looks like calming could really be a form of parasympathetic shock, do you ever think about how babies’ movement is restricted in utero, very similar to being swaddled? Are they in shock in utero too? And the sounds of shhhushing are certainly no louder than the sounds baby hears in the womb. I get the feeling that many of the anti-Karp people have not read his book or watched his video. Sometimes I think we resent him for being popular but he is the first to say he did not invent any of these methods of baby soothing- he is helping us to get back in touch with what our grandmothers knew, the wisdom we’d forgot in the age of gadgets. Of course skin to skin is best. of course babies should not be swaddled at birth, all the time or when nursing and of course we should not swaddle hips- Dr.Karp does not advocate any of these scenarios. Babies also should not be swaddled after they are trying to roll. I think these are really important cautions but let’s not throw the baby out with the bathwater, eh?

  11. I wish I had not swaddled my little girl as an infant. I believed it was the thing to do, but that belief interfered with my parental instinct. Now, looking back, I realize it did not bring my baby any calm but the contrary; she protested and hated being swaddled. I believe it could also have interfered with breastfeeding and I am remorseful for having subjected my little baby to this practice. I regret not having trusted my own intuition and do feel quite stupid.

  12. I think all mothers should also trust their parental instinct. ALL babies are different. And, all babies respond different.

    There are helpful suggestions all over the place if you study, including in this book. There are also a lot of pockets of bad information. People should study all they want, and LOOK not listen, at the results. Use judgement, not all information is correct, a lot of it is not correct. A lot of it is, you have to look for yourself and decide for yourself what is right for your baby. But, the more knowledge and experience the more you can decide for yourself.

  13. This article is absolutely ridiculous. It’s shameful. I clung to Dr. Karp because it was the ONLY parenting book available that went with my attachment parenting beliefs. Instead of leaving my baby in the crib to cry out of desperation, or putting him in the bouncy seat all day, I was able to swaddle him up, shush him, and rock him in my rocking chair. So many parents have found the wisdom Dr. Karp brings forward as a way to CONNECT with their children.

    I am horrified that the author would choose to include the “dangers of swaddling” being SIDS, various other health problems, and breastfeeding difficulties. This is fear mongering and praying on mothers’ natural desires to keep their babies safe. I agree with the above poster that said that sometimes it feels like mothering.com just wants to be contrary to popular thought. Attachment parents should be thanking Dr. Karp every day for helping parents understand that babies need breastfeeding for food AND comfort, and that babies enjoy being rocked to sleep as opposed to simply laying them in their crib and wondering why they keep crying. Why do I always feel like attachment parenting advocates WANT parents to suffer? It’s not enough that women provide the sole nourishment for their children, carry them all day, and attend to their every need day and night until they learn to sleep for themselves… now we must take away a tool that can potentially give them sanity. Quoting a small study that swaddling doesn’t reduce crying is simply poor journalism. I could probably find a small study that would prove anything, but it wouldn’t be valid because it doesn’t have a large enough subject base.

    This just makes me SO angry. There are mothers who are struggling through the newborn phase who are currently finding some peace with swaddling but are now unwrapping their infants out of FEAR because of this article, even if their babies were soothed by swaddling. That’s just not fair.

  14. I totally agree, Melissa! I’m a mama to a beautiful, attached 2 year old and the nanny to an almost 2 year old and a 4 month old who are also well-attached, loving, and engaged with the people around them. All three were swaddled—and all three were also held and cuddled so much that people comment now on how muscular my arms are. Swaddling is what made naps possible in the early months for the older two, and what makes naps possible now for the youngest. My daughter’s favorite thing in the world is still “ninny” (nursing), so I don’t think swaddling her during colicky periods when she WOULDN’T nurse to help her calm down had an adverse effect on our breastfeeding at all.

    That said, I do think it’s good to bring scrutiny to any “easy fix”—-although you and I obviously “swaddled responsibly” and didn’t neglect other parenting techniques, many, many people probably do. I think that’s what the article is trying to say, although it does seem like the community at Mothering might not be the recipients who need this info the most—aren’t we all proponents of holding our kids and loving them as much as we can?

  15. Actually, there are countless other cultures AND species that restrict movement in infants to some extent: what do you think baby wearing does? A baby can’t wave his arms about while being worn in a sleeping position in a wrap or a sling–and that is why we swaddle. 0-3 month olds (the age Karp recommends swaddling for) are still in the very early stages of learning control over movement; they can’t just think “Oh I’d like to not whack myself right now”, especially when they’re upset or tired—their movements become spastic and a little restriction of the arms is helpful for calming down and getting to sleep. Karp does NOT recommend swaddling as a general rule—obviously babies need time to explore their bodies and learn how to move them. But saying that it makes a newborn feel helpless to not have control over his movement because he’s swaddled when in reality he hasn’t learned to control his movement yet period just doesn’t make sense.

  16. GREAT REVIEW! I agree with all your thoughts you said in your article, especially at the beggining of your article. Thank you, your post is very useful as always. Keep up the good work! You’ve got +1 more reader of your super blog:) Isabella S.

  17. Dear Peggy,

    Thank you for providing a forum for this important discussion about swaddling.

    Of course, we all want babies to be content, have colic resolved and to nurture them with close contact, skin-to-skin (by ALL caregivers) and breastmilk. In fact, the basis of my approach – the 4th trimester – is all about reducing separation.

    I believer that is why my work has received broad support from attachment advocates and is taught in hundreds of WIC clinics across the US.

    “Bursting with wisdom! Some of the best ideas about babies I

  18. Does that long-standing imprint of powerlessness start in the womb? Not actually a lot of free movement going on in there during the last few weeks. What changes at birth that makes it suddenly oppressive?

  19. Not highlighted in the post, but in one of the linked articles, is the fact that swaddling in infants sleeping on their backs reduces SIDS by 30%.

  20. Many Native American tribes traditionally swaddled 24/7 for the first 6 months of life, yet their children grew up to be independent and highly coordinated. Today, we can do an even better job of baby calming and sleep promotion than ancient cultures did by using hip-safe swaddling and white noise.

  21. Dear Dr. Karp, thank you for your eloquent reply. I just wanted to thank you in the midst of this brouhaha for helping our family survive the fourth trimester of our colic stricken darling. We are a breastfeeding, baby wearing family that co-slept and when nothing else worked (screaming while nursing, screaming while being held, screaming while floating in mamas arms in a warm bath) the “five s'” gave us all some relief! We even have pictures of me nursing our swaddled little guy–it was the only way he could calm down enough to eat at times! And boy, did he love to eat when he wasn’t crying (he doubled his birthweight by his 2 month well baby visit!)

    As a parent it sometimes feels like there is no way to win, that no matter what choice we make will be the wrong one–and that in doing something out of love we will somehow destroy the precious being we have been charged with. So often the things I read in/on Mothering exploit those fears–taking good parents and fueling the kind of anxiety that prevents folk like me from being at peace and truly enjoying parenting.

    Parent guilt is a powerful sell and the industry that surrounds inspiring fear in parents sells magazines, draws website traffic, sells new contraptions and causes us to throw out the old. So lets hear it for parents who do their best–whatever that best is–parents who swaddle and shush, parents who babywear and breastfeed, parents who read umpteen stories at night and snuggle feverish children in the wee small hours. Lets hear it for mamas and mommys, moms and dads, dadas and papas, kinship caregivers and others–folks charged with the care of children–folks who do their best. And, lets hear it for all those who help these folk by giving them true tools–tools that will allow peace, tools that allowed exhausted mamas like us to still the crying, nurse the baby, snuggle close and watch the small flutters of sleeping eyelids and the gentle sighs of a “finally” sleeping infant.

    So, thank you.

  22. This is entirely anecdotal, but I believe swaddling would have improved our breastfeeding relationship. My son was unable to latch without a nipple shield, and he would flail his little arms around while nursing, knocking or pulling the nipple shield off. This added many frustrating minutes to every nursing session. It wasn’t until months after I had weaned him that I realized that swaddling him would have helped calm him to nurse and would have kept his little arms in check so we could get a good latch without knocking the stupid, fiddley little shield off over and over.

  23. My son would not have slept longer than 5 minutes at a time if he wasn’t swaddled. He used to startle and wake himself up constantly. I swaddled him for about 4 months! His legs were always free to move and he still woke up every 2-3 hours for a feeding, but he would not fall asleep unless he was swaddled. Eventually he would break out of the swaddle, so we stopped. The other HBOTB techniques were the only ones that worked for him when he was a colicky infant. I breastfed constantly, held him all the time, co-slept, and tried many other things. Shushing, bouncing, and swaddling worked every time.

    I do think that hospitals should give new mothers information regarding skin to skin contact with newborns and how amazing it is, because I didn’t know about it at all and my poor DS was swaddled in the bassinet the whole time we were in the hospital if I wasn’t nursing him. I wish I would have known more about how beneficial it is to have skin to skin contact.

  24. Yes but wearing a baby in a wrap on you is much different to swaddling. Yes, the baby is being wrapped tightly in something but there are numerous differences. Firstly a baby being worn is up on the mum’s chest. It can smell mum and mum’s milk. Secondly it is in an upright position which is the best position for a baby to be held (cradle holding was developed for bottle fed babies). Thirdly the position of the baby is completely different – the legs are in an “M” shape which does not constrict the legs down together. Instead the hips are spread. The shape of a newborns spine is a “C” and by being worn facing mum it is supporting this natural shape of the spine. While a baby is being worn mum is aware of baby’s needs, whereas being swaddled and placed somewhere, the mum is not aware until baby cries out. A baby being worn can move it’s lower legs and can move it’s arms – the arms are also usually raised, rather than tucked in by it’s sides. There are many differences between being swaddled and being worn.

  25. Regardless, I think her point stands that baby wearing restricts movement. As a student of Somatic (Body Oriented) Psychology, and a mom of a now 18 month old who swaddled (at night only while co-sleeping), I have to disagree with Jeanice’s comment about dissociation or shut down. This is obviously unquantifiable, but my intuition about my baby’s experience during swaddling and baby-wearing was that it was calming and relaxing, in effect assisting containment. I never got any sense that it was a negative experience or involving neurological shut down. This is why I continued to use the tool, as I did any parenting tool – in combination with my intuition.

  26. I read somewhere not to swaddle a bed sharing baby as they need to be able to move closer or further from you to regulate their temperature.

    Were you just room sharing? Or actually bed sharing?

  27. My little girl didn’t have colic, she was born in the water after 4 hours of natural labor and I never took any medication nor was she given any, including any immunizations. She was held skin to skin and breastfed immediately. 24 hours after birth she turned into the most difficult baby I’d ever seen. She hated nursing and would NOT sleep. At 2 days old she stayed awake for 12 straight hours crying on and off and I remembered I had taken a class on Happiest Baby on the Block and decided to try swaddling her. Turns out, when she wasn’t swaddled, she was screaming. And if she wasn’t screaming and I tried to get her to nurse, she’d start screaming. If she fell asleep and she wasn’t swaddled, 5 minutes into her nap, she’s get startled and start screaming. Nothing helped except the swaddle. She lived in a swaddle for nearly 5 months and was fine in it. I don’t know what I would have done if I hadn’t used this life saving technique. When my son was born, I may have swaddled him a total of 20 times before he was just annoyed by it.

    If people are looking for a “cure all” swaddling nor anything else will be the answer, however, used with the right infant, it can save your sanity!

  28. I strongly believe that swaddling improved and even saved my breastfeeding relationship with my son. While swaddled he latched more quickly and easily and nursed longer. I did skin-to-skin contact as well, but swaddling was a godsend. I also want to point out that Dr. Karp’s book, video, and methods are what introduced me to and turned me on to attachment parenting. The idea of a fourth trimester really clicked with me, and as a result I felt very comfortable with on-demand breastfeeding, babywearing, and co-sleeping. Contrary to what some people have said, Dr. Karp’s methods felt VERY instinctive to me.

  29. Thank you all for your articulate replies and thank you very much, Dr. Karp, for your response.

    What strikes me as I read your replies is how right you all are about your experiences. What works, works and we adore whatever works with our children. I know that as a mom of four (now grown).

    As a journalist, I want parents to have all the information they can have to consider and hope they will accept or reject on their own terms and based on their own experiences. There is no black and white solution. Swaddling is a helpful too. Like all tools, it can also be overused.

    I’m happy that we’re having such an in-depth conversation here about swaddling, its pros and cons. Thank you for your forthrightness and good humor.

  30. I agree with some of you who said that they think mothering.com is simply trying to point out that not all people are reading The Happiest Baby on the Block, but rather gathering from outside sources that swaddling is “that thing you do”. As a mom of 5 and a former newborn nursery nurse, I can testify that swaddling does work occasionally for a fussy infant, while holding them. However, I didn’t ever swaddle my last two and rarely (on the grand scale of time, in this case) swaddled the others. My 2nd to youngest was very colicky until I removed cow’s milk from my diet and I’ve been cow milk free since then and haven’t had said issues with my youngest. I’d also like to point out, however, that when my oldest was born, doctors were recommending side sleeping (he’s 18 years old now) so I did that, with the help of rolled up blankets on each side of him. I kept this up with the next two, but my last two were always placed on their tummies when they napped without me and its the only reason they stayed asleep for more than five minutes since they can’t thrash around and startle themselves while laying on their stomachs. While I see some of the “back to sleep” research and think it may possibly be somewhat valid, I think there are tons of other factors and know that newborns, especially, have such an active startle reflex that expecting them to not startle, and therefore wake, themselves when laying on their backs is ridiculous and probably leads to way more swaddling than necessary. I also think that we’ve become a society of convenience (or at least the illusion of it) and that children are the victims. We attempt to have our babies at our convenience in a way that is “convenient” to us and then we try and train our babies to be less of an inconvenience. I am a firm believe that there is never a bigger inconvenience to life than that of children and if you aren’t ready for it, don’t have one. I am not saying that anyone who swaddles their child is merely seeking convenience, I am saying that people who parent without first educating themselves (whether by reading and trying it-if it makes sense or be listening to the advice of experienced parents and trying it-again, if it makes sense) are trying to do what least inconveniences them, especially those parents who only seek ways of parenting which others (authors or parents) have touted as those which will make your life easier. I seek out what it best for my children and it is almost always highly inconvenient to what I want or need, but since all of my school aged children are highly gifted academically and all have numerous musical or physical talents as well, I figure, swaddling or not, I am doing something extremely right by placing my kids first.

  31. Dear Peggy,

    Thank you for acknowledging my remarks and for creating this important forum for the exchange of ideas about how we can all do a better job raising our children with the love and nurturing they so deserve. And, thank you to all your readers for their insightful comments and the passion with which they share their hard earned wisdom to benefit others.

    I apologize for showing an entry from another site, but I thought this newly posted note from Amazon.com was on topic for discussion:

    By Paisley’s mom – Review of – The Happiest Baby on the Block DVD.

    The first few nights with our baby were horrible. She would not sleep unless we held her the entire time and there was a lot of screaming where we just could not console her. That is until we remembered someone had given us this DVD. We thought it can’t hurt to watch it. Once we watched this short DVD our entire lives changed. Our baby immediately calmed down and slept in her bassinet. It was like magic. One of the tips was swaddling. We like many people thought our baby did not like to be swaddled because she acted as though we were the worst parents in the world when we would try to restrain her arms. We would swaddle her under her arms but that would do nothing to calm her down. One of the tips this DVD taught us was that babies do not like to be put into a swaddle but they like to be in the swaddle. I am so grateful this was in DVD form because we were in no shape to read a book at this point. I think all the words would have blurred together! I will never know someone pregnant with their first child that I will not buy this DVD for. It was the greatest gift we received. I cannot overstate how wonderful this DVD is. I feel like it saved our sanity and possibly our marriage!

    To be sure, each baby and each set of parents are individuals and there are no

  32. Don’t know how i ended up here. I’ve never heard of this Dr & their methods or this debate before. But we swaddled our 1st son the most & the snuggest of our 4 children. He craved it. He often nursed while swaddled. My husband usually did the wrapping. He didn’t wrap like the nurses did. He would put our son’s feet together & tuck his legs up. This helped so many things. It also made him much more comfortable to carry upright, which he loved. Most every night he slept on my chest (swaddled or naked with the blanket over both of us). I believe the swaddling helped him to feel calm & safe.

  33. I have three kids and never swaddled them, I simply didn’t know how or think of it–didn’t find I “needed” to. They were “swaddled” often in a baby sling–the difference being movement and constant human touch. I wonder now if my first baby who I think was completely overstimulated by an unexperienced mother might have benefited from some moments of being thoughtfully swaddled and kept nearby.

    The most experience I have with swaddling is that in the hospital. It is an absolute essential skill to know when caring for babies who are sent to nurseries! The caregiver in the nursery is often expected to stall for time to let the “parents rest.” Thus the overuse of swaddling and squirts of sugar water, pacifiers. Holding babies is a possibility if the staff-baby ratio is low. It is used to delay the breastfeeding and/or need to be held urges of the baby. I can go into a lengthy discussion the things that influence this practice…the system/institution, parent and staff education, policy/protocol, the way things have always been done, hospital customer satisfaction surveys….yes, I find that swaddling delays breastfeeding and is used as a way to decrease holding time….

    I don’t know if it is documented but this is an experiential observation….in an effort to “hold off” a baby so mom/dad can get rest for a few hours swaddling and the other methods mentioned are used. In hospitals mothers are “not allowed” to keep babies in arms in the beds or bedshare. And the beds, in my opinion, aren’t that safe or conducive for bedsharing. Many nurses seek to “do parents a favor” by taking the baby to the nursery so they can rest–without knowledge, plans, or experience with other ways to achieve this in the hospital. So I am saying that the nursery nurse is then left to figure out how to appease baby for a period of time (usually at least 3 hours). Now 3 hours for a breastfed baby can be a long time depending on day of life and what the baby has experienced that day. Many babies are introduced to celebratory visitors much of the day perhaps with delayed feedings to allow for visiting time. Possibly the baby was in the after birth sleep state/or meds wearing off if mom had medications in labor and now is ready to make up for lost time and cluster feed…so the challenge to hold off the baby is even greater. Now sometimes a nursery nurse will send the baby back to parents even if three hours hasn’t elapsed…or maybe not…it depends. So tight swaddling and pacifiers and sweetened water and when able, holding baby, is used to delay a feeding. Now not to demonize the need to rest for exhausted parents…sometimes a few hours IS desperately needed…and staff are well meaning….I experience an overuse of separation and an underuse of methods which allow mom and baby to stay close and rest together.

  34. I have no affiliation with this company. I’m just trying to suggest something that helped us out. As we left the birth center, our midwife gave us a blue and green Miracle Blanket. The device looks a tad draconian as it has arm flaps that pin the babe’s arms down to his or her side

  35. Actually, to be fair to Dr. Karp who has written here rather graciously, I heard HBOTB described as a panacea from other parents, not from the book itself. And goodness knows, Happiest Baby on the Block is a vast improvement to most of the hundreds of other “sleep systems” or “sleep training” methods out there. It does recognize that babies are sensitive, complicated individuals. The information about the first three months as the fourth trimester were particularly valuable to me.

    I think a Mothering interview of Dr. Karp would be a great read!

  36. As a health care provider, I have seen both the merits and pitfalls of swaddling. The most common difficulty I have found in my practice is when parents overuse swaddling. When done and timed properly, it can be very helpful to parents of high need babies. However, I have seen it contribute to underweight and slow weight gain in babies and consequent suppressed lactation in mothers. In these cases, over-swaddling was the reason for breastfeeding difficulties and premature weaning. Mothers interpreted baby’s hunger cries as gas or fussiness and swaddled them instead of feeding them. Several of these babies had differing degrees of tongue tie so I cannot stress the importance of seeing a lactation consultant if you are having BF problems.

    The most important thing that parents should take away from this is to meet baby’s basic needs first. If they are hungry, feed them. If they are wet, change them. If they are cold, warm, or in pain, remove the source of discomfort. Once baby is refusing food, only then do I recommend swaddling.

    High need or colicky babies should be examined by a breastfeeding-friendly health care professional to rule out hyperlactation (milk oversupply), reflux, allergy or other illness. If your baby is crying all the time, seek out the right health care provider. Swaddling in these cases can no doubt be beneficial but nothing beats a correct diagnosis.

  37. Hi Annie,

    I totally agree. Parents need to be educated to meet their babies needs first….and need access to well trained, breastfeeding friendly professionals.

    No doubt swaddling can be misused. Similarly, nursing can be poorly managed (we’ve all seen nursing babies fail to thrive because the mom is so tired her production is down or has a problem like tongue tie/moms pressured to stop nursing by family members because the baby is crying to much/ have sleepy babies who fail to gain weight because the mom doesnt know she’s supposed to wake the baby up to encourage feeding).

    One of the important characteristics of swaddling, and the 5 S’s in general, is that babies who are ill (or hungry) will not be calmed for very long by these techniques. In fact, many practitioners use the 5 S”s as an intervention to help differentiate well babies from those with a problem and a need for a workup.

    We made the DVD to show parents safe and appropriate swaddling…and how to weave swaddling with the other S’s to give parents the most effective help. And, teaching swaddling – and giving parents a contact number to call if they run into problems with baby calming/sleep – is the reason we started Happiest Baby classes (which I am pleased to say are taught in hundreds of WIC clinics in MA, PA, OK, and other states). Parents need support and guidance. I love working with doulas, IBCLCs, nurses and all parent educators and invite you to find out how to use the 5 S’s approach as an extra clinical tool.

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