Dr. Sarah Mitchell
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Should I Swaddle my Newborn at Night?

Swaddling your newborn at night can help your baby sleep longer stretches at night. The purpose of swaddling is to help reduce the “startle or Moro” reflex.  Yes, you should swaddle your newborn at night.  

The startle reflex is a primitive reflex that is present and birth and is a protective mechanism.  With any sudden noise or movement, your baby is “startled” and her arms will extend away from her body, she’ll arch her back and neck.  It slowly starts to disappear around 12 weeks and in most babies is completely gone by 6 months of age. References 1,2,3.

Sometimes this startle reflex can be confused with some muscle twitches that happen during REM sleep.  Rapid Eye Movement sleep is also known as “dream” sleep.  In newborns they have less “deep” sleep than babies 6 months and older.  Typically newborns transition from light or into REM sleep. When falling asleep they typically drop into REM sleep. Reference 4. Newborn REM sleep is different from REM sleep in older babies and adults. In adults, in REM sleep a person is dreaming but their voluntary muscles are paralyzed.  You will NOT see any arm or limb movement.  In newborns, it is different. In newborn REM sleep you WILL see vocalizations, smiles, grimaces and twitches or jerks. They are not awake when you see these things.  Remember when your baby was sleeping and she started smiling.  You thought maybe she was passing gas?  She was likely in REM sleep. All good.  All normal.

Why is swaddling important?

Swaddling is important to prevent your baby from startling herself and/or startling herself awake.  It also prevents her from distracting herself with her arms and preventing sleep. 

Do I have to swaddle my newborn to sleep?

You don’t have to swaddle your newborn at night but it absolutely helps.  I’ve worked with lots of parents who say their newborn doesn’t like the swaddle.  That may be true but I would keep trying while changing another variable when you try to swaddle,  such as the time of day.  Then you could also experiment with different types of swaddles.  There are weighted swaddles, arms up to the side swaddles and traditional blanket swaddles.  You’re looking for 100% cotton or natural materials.  Synthetics such as polyester can trap heat and lead to overheating.  

How long can you swaddle a baby at night?

You can swaddle your baby all night long.  I also swaddled for naps.  The only thing to watch out for is that you aren’t swaddling too tight around the hips over for a large portion of your 24 hours for weeks to months.  One tiny study showed the possible increased risk of hip dysplasia. Reference 5.  Newer models of swaddles have tried to be loose around the hips and tight around the upper torso and arms. 

Can babies sleep swaddled overnight?

Yes your baby will likely sleep better swaddled overnight.  Sometimes I didn’t even take her out for the feed once I got really good and efficient at breastfeeding. 

When should I swaddle my newborn?

In my Helping Newborns Sleep Class our number 1 goal is to keep your baby well rested.  When your baby is well rested this actually helps get you MORE sleep and decreases your chance of increased crying and being fussy.  Swaddling helps you keep your baby well rested during sleep periods by eliminating the distraction of the startle reflex and bothering herself with her uncoordinated arms.   You can swaddle for naps and bedtime.   When she’s awake, that’s a great time to work on tummy time to start developing those strong core muscles to help with rolling. 

When Should I Stop Swaddling My Newborn? 

You want to stop swaddling when your child shows that she might be able to roll.  Rolling in a swaddle could pose a risk as your child could get stuck in a position that might compromise her airway.  In addition you would want to stop swaddling when you are working on sleep teaching and having your baby become an independent sleeper.  Independent sleepers can be put in the crib completely awake without feeding, rocking or being drowsy and put themselves to sleep.  She’ll need her hands available to be able to do that so they should not be swaddled in that phase. Until then you will absolutely want to swaddle your newborn at night. 

References cited in this post:

1. Parmelee AH., Jr. A critical evaluation of the Moro reflex. Pediatrics. 1964;33(5):773–788. 

2. Prechtl HFR. Problems of behavioral studies in the newborn infants. In: Lehrman DS, Hinde RA, Shaw E, editors. Advances in the Study of Behavior. London, UK: Elsevier/Academic Press; 1965. pp. 75–98.

3. Rönnqvist L. A critical examination of the Moro response in newborn infants—symmetry, state relation, underlying mechanisms. Neuropsychologia. 1995;33(6):713–726.

4. Sheldon SH. Sleep in infants and children. In: Lee-Chiong TL, Sateia MJ, Carskadon MA, editors. Sleep Medicine. Philadelphia, PA: Hanley and Belfus Inc; 2002.

5. Abd El-Kader Shaheen M. (1989). Mehad: The Saudi tradition of infant wrapping as a possible aetiological factor in congenital dislocation of the hip. Journal of the Royal College of Surgeons of Edinburgh, 34(2), 85-87.

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