Safer With a Swaddle Blanket or Swaddle Garment? Research Says You are Asking the Wrong Question

As a certified Happiest Baby on the Block educator, I am often asked which choice new parents should make.  Swaddling with a blanket is cheaper (babies don’t grow too large for most blankets for months) and blankets can be repurposed after swaddling is finished.  Garments are easier to master; not everyone is willing to learn how to do a firm swaddle.  Parents with physical limitations, and parents of super-wriggly or very strong babies get a more secure swaddle with a garment.  But which is safer? There has been research on this topic.  A Journal of Pediatrics article in January 2014 found that ensuring a wide range of safe sleep practices was more important than method choice for safety.  The question parents should be asking is:  What should we do to make swaddling safe?  Safe swaddling has not been directly connected to very many documented injuries or deaths.  When unsafe sleeping practices are removed from the equation, using swaddling before a child can roll by themselves has a low level of risk.    Here are guidelines to help you make swaddling successful and safer:

  • Many preemies are allowed to sleep on their stomach while in the hospital.  Placing a baby on their stomach without the monitoring and supervision of  a NICU is dangerous.  Safe-to-Sleep recommends only back sleeping at home, swaddled or not.
  • Loose swaddling, soft bedding, rolling over on your child while co-sleeping, or engaging in the use of alcohol or drugs while co-sleeping are huge risks.  Using a co-sleeper next to your bed is much safer than having your baby in your bed.  Avoid having your baby sleep on you in a recliner chair or on the couch.
  • Swaddling your child too warmly is a risk, so learn to “summer swaddle” with muslin or a light cotton swaddle garment, or turn on the A/C.  Child still too warm?  Remove the swaddle until the room is cooler.
  • Not getting a larger swaddle garment once your child has grown is a risk for safety (velcro will not securely attach) and puts him at risk for hip injury if his legs aren’t able to move freely.
  • Once your baby can roll independently, swaddling is riskier. The American Academy of Pediatrics recommends that swaddling should stop when a child is beginning to roll independently.  If you are doing all the other Happiest Baby techniques for the older newborn, then you should have established great sleeping habits without swaddling by the time your baby starts to roll.

By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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