SIDS and swaddling: What parents need to know
[4 MIN READ]
In this article:
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Although Sudden Infant Death Syndrome (SIDS) is rare, it’s still important to reduce your child’s risk.
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Swaddling is an effective method for calming your infant during the first two months of life, but once they start rolling over, you should stop swaddling.
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The American Academy of Pediatrics recommends that you lay your infant to sleep on their back, keeping loose blankets and stuffed animals out of the crib. Such extra items in the crib are major risk factors for SIDS.
SIDS and swaddling: What parents need to know
If you’ve ever cared for a newborn, you know just how exhausting it can be. You will do anything to calm them — and swaddling is an important tool in a new parent’s arsenal.
However, swaddling can also carry some risk — particularly for Sudden Infant Death Syndrome (SIDS). Here, Providence explains the link between SIDS and swaddling, and how you can protect your child.
Understanding SIDS
SIDS is the term used to describe the sudden death of an infant younger than one year old with no known cause. According to the Centers for Disease Control and Prevention (CDC), there were 1,529 deaths from SIDS in the United States in 2022.
Although researchers don’t know exactly what causes SIDS, they have developed a theory called the Triple-Risk Model:
- First, the baby has one or more unknown medical conditions.
- Then, as they grow older and develop, their body may be unstable and have unusual reactions to stimuli.
- Finally, they could encounter an outside stressor, such as cigarette smoke or being placed on their stomach to sleep, that could further impact their body.
The role of swaddling in infant sleep
Swaddling is the practice of wrapping a baby in a blanket, usually so that the baby's arms and legs are immobile. Since the beginning of time, mothers and fathers have used swaddling to calm and help their baby sleep.
The reason why swaddling often works well is because it mimics the secure feeling of the womb and reduces startling movements that might wake the infant up. Many babies are able to sleep longer and better because their movements have been restricted.
“I think that swaddling is great for young infants, birth to two months of age,” says Alexander Hamling, M.D., a Providence pediatrician who sees patients at Pacific Medical Centers in Bothell, Washington.
How swaddling may increase SIDS risk
By its very definition, swaddling greatly restricts an infant’s movement. That’s fine for babies who are not yet mobile, says Dr. Hamling, but it could pose a problem if a baby rolls over and is unable to breathe, leading to a higher risk of suffocation.
“They may prefer to roll, and a swaddle may hinder them if they get in an uncomfortable position,” he says. “You should try to know when your child is developmentally ready to not be swaddled. It comes down to the strength of your child to remove an obstacle in their face.”
Dr. Hamling notes that some products for infants, such as sleep sacks or sleep bags, are much less dangerous than swaddling for older babies. They are more of a wearable blanket, and babies can still use their arms to move to a more comfortable position.
The latest safe sleep guidelines for infants
The American Academy of Pediatrics (AAP) provides guidelines to help parents protect their children from Sudden Unexpected Infant Death (SUID), a category that includes SIDS. Those guidelines include:
- Placing infants on their back to sleep.
- Removing loose blankets, pillows, crib bumpers, stuffed toys and other soft items from the crib or other sleep environment.
- Using a crib or bassinet with a firm, flat mattress and a fitted sheet.
- Avoiding smoking.
- Avoiding letting your baby sleep in a swing or car seat (except while they are traveling in the car).
- Avoiding co-sleeping (when a baby sleeps in the same bed during naps or nighttime sleep with another person, such as a parent).
Dr. Hamling notes that while experts do not recommend co-sleeping, studies do show that sleeping in the same room as an infant for the first 6 months of life could reduce the risk of SIDS.
“You don’t need electronic devices that clip on to your baby to reduce the risk of SIDS,” he says. “None of them have been proven to work. All they really do is increase parental anxiety and false alarms. Simply sleeping close to — but not in the same bed — as your young infant can make a difference.”
Prioritizing infant sleep safety
In general, says Dr. Hamling, it’s important to establish a consistent, safe sleep routine for your infant. “Reading a book, taking a bath, developing routines around the same time of day — all of that just helps kids get in the natural rhythm of knowing when it’s time to sleep,” he says. “It helps the whole family plan their day and routine.”
“Thankfully, SIDS is not a common outcome,” adds Dr. Hamling. “When we talk about reducing the risk of this condition, we are looking at making already low percentages even lower.”
Contributing caregiver
Alexander Hamling, M.D., is a Providence pediatrician who sees patients at Pacific Medical Centers in Bothell, Washington.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
