Swaddling Protects against SIDS
By Kimberly Beauchamp, ND
Healthnotes Newswire (September 1, 2005)—According to a study in Pediatrics, swaddled infants may experience more restful sleep than unswaddled babies and awaken more easily in response to noise, a factor that may protect against sudden infant death syndrome (SIDS)(2005;115:1307–11).
Infant swaddling is an ancient practice believed to reduce irritability and crying and to help babies sleep better. Swaddling involves snugly wrapping the baby in a blanket or suit in order to minimize movement of the limbs. A square cotton blanket can be used to swaddle a baby. One corner of the blanket is folded down about six inches, and the baby’s head placed on the fold. Next, one of the sides is drawn across the body and tucked under the arm and back on the opposite side. The middle section is then brought up under the baby’s chin. Finally, the remaining loose corner is brought across the body and tucked under the other arm. Care should be taken to ensure that the chest area is not swaddled too tightly and that the legs can move slightly.
SIDS is the most common cause of death in babies between one month and one year of age, with most deaths occurring before six months. There is some evidence to suggest SIDS may be caused by a brain defect that decreases the infant’s arousability when sleeping. For example, a baby with a brain defect may not awaken if lying facedown in a mattress. Babies who are exposed to cigarette smoke, placed on their stomachs to sleep, overheated due to high room temperature or excessive clothing, and given soft bedding or loose blankets and pillows are at increased risk for SIDS. Babies who have been routinely placed on their backs to sleep and are then switched to the less familiar stomach position are also at a greater risk of SIDS.
Breast-feeding appears to protect against SIDS. Infants who are swaddled and placed on their backs to sleep tend to have a lower risk of SIDS than unswaddled babies who sleep on their backs. This decrease in risk may be due in part to the inability of babies to roll over onto their stomachs. It is also less likely that a back-sleeping baby will suffer obstructed breathing as a result of loose blankets or bedding.
The new study investigated the effect of swaddling on sleep characteristics and arousability among 16 infants whose average age was ten weeks. At bedtime, the babies were placed on their backs. After falling asleep, one half of the infants were swaddled using sheets kept tightly in place with weighted bags, restricting movement of their arms and legs. Four hours later, these babies were unswaddled, and the other babies were swaddled for the remainder of the night. All of the babies were exposed to increasing intensities of white noise (a type of noise produced by combining sounds of all different frequencies) during periods of light sleep to determine the noise threshold at which they were aroused from sleep.
Heart rate, breathing patterns, time spent in light and deep sleep, sleep efficiency (the amount of time spent asleep during a given amount of time in bed), and the level of noise intensity that caused arousal from sleep were recorded for the babies during swaddled and unswaddled conditions.
Swaddled babies experienced significantly greater sleep efficiency and time spent in deep sleep than the unswaddled babies. While swaddled, the babies also spent significantly less time awake than when they were unswaddled. When exposed to noisy conditions, however, the babies were more easily aroused when they were swaddled than when they were unswaddled. There were no differences between the swaddled and unswaddled conditions with respect to heart rate and breathing patterns.
These results suggest that swaddled babies may sleep better and waken more easily in response to noise, potentially decreasing the risk of SIDS.
Kimberly Beauchamp, ND, received her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She is a co-founder and practicing physician at South County Naturopaths, Inc., in Wakefield, RI. Dr. Beauchamp teaches holistic medicine classes and provides consultations focusing on detoxification and whole-foods nutrition.
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