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Tip
Sheet: Medical Science & Health Tip sheets highlight timely news and events at Washington University in St. Louis. For more information on any of the stories below or for assistance in arranging interviews, please see the contact information listed with each story. For comments on the Medical Science & Health news tips service, please contact the editor, Jim Dryden at (314) 286-0110 or drydenj@msnotes.wustl.edu. Swaddling may help babies sleep more safely ... and soundly Media assistance: Jim Dryden - (314) 286-0110 Source: Bradley Thach's Web page Related: More information about Dr. Thach Related: Journal of Pediatrics article abstract [St. Louis, Mo., October 2002] - For more than a decade, pediatricians in the United States have been recommending that parents of infants put their babies to sleep on their backs to lower the risk of Sudden Infant Death Syndrome (SIDS). Those recommendations came about partly because of research conducted by Bradley T. Thach, M.D., and colleagues at Washington University School of Medicine and St. Louis Children's Hospital. Since pediatricians in the United States began recommending back sleeping for babies, the SIDS rate has declined.
"Part of the problem in the United States is that about 20 to 30 percent of parents say their babies are fussy when they put them on their backs," he says. "So in spite of the campaign to encourage back sleeping, these parents still place their babies on their stomachs to sleep. We're hoping to learn whether some of those fussy babies may find it more pleasant to be on their backs if they are swaddled." Swaddling is practiced almost universally in hospital nurseries, and various traditional swaddling techniques are practiced in countries such as Turkey, Afghanistan and Albania. But many parents in the United States abandon the practice when their babies are a couple of months old. "That's when babies start kicking their legs enough that they can escape," says Gerard, the lead author of a paper published in the Journal of Pediatrics. "But in other cultures where swaddling is practiced, it's common to continue swaddling babies until they are much older." The rationale behind swaddling is that a baby feels more secure when tightly wrapped in swaddling clothes. That secure feeling can calm babies, making infants less fussy and more amenable to things like sleeping on their backs.
"Over the years, some have suggested that if a child is swaddled too tightly, there may be negative effects on heart rate and respiration," Thach says. "When we tested the effects of very tight swaddling on babies as they napped, we did find some effects on both, but they seemed to be fairly minor." Another potential complication of swaddling is that by restricting the movements of a baby's legs, the practice can contribute to orthopaedic problems such as hip dysplasia. "So we developed a special type of swaddling technique in the lab," Gerard says. "Using cotton, Spandex and Velcro, we tried to swaddle babies in such a way that they could have the benefit of the tightness and warmth without the restrictions on leg movements associated with traditional swaddling." The majority of infants in the study accepted being swaddled and then placed on their backs, and most didn't get too fussy. In fact, nine of the babies in the study normally slept on their stomachs, but when swaddled, seven of those infants were calmed enough to be able to sleep on their backs. "So I think that provides major support for the idea that swaddling babies is a good thing, particularly for those babies whose parents say they won't sleep on their backs," Thach says. They also believe that the particular swaddling technique that they have developed -- providing tightness and security, while keeping the legs free for movement -- may remain useful as babies get older. "The problem with swaddling in the United States is that after a baby gets to be one or two months of age and learns to escape, parents tend to abandon the technique," Gerard says. "On one hand, that's appropriate because we certainly don't want loose blankets in the bed increasing SIDS risk. But two to four months really is the peak risk period for sudden infant death, and we believe that there may be advantages to using an escape-proof swaddling technique for babies in that age group." |
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