While swaddling provides some babies with a sense of comfort and safety, there is evidence that it can also increase the risk of cot death. There is no clear evidence that swaddling reduces the overall risk for SUDI but if infants are not placed to sleep on their back when swaddled the risk increases.
If a baby is swaddled, they must never be placed for sleep on their side or tummy as this increases the risk of them rolling into an unsafe position and suffocating. They must be positioned fully on their back. It is likely that research which shows swaddling to be protective against SUDI is highlighting the fact that swaddled infants have been placed on their back and it is this position which is the true protective factor.
The most important thing is consistency. If you want to swaddle, swaddle consistently and remember to speak to other caregivers (your partner, parents or nursery) to tell them to swaddle your baby as well. Make sure you (and other caregivers) know how to swaddle safely.
Risks of SUDI are limited swaddling in the supine position ONLY if it is done correctly and routinely from birth or early infancy.
If you have chosen to swaddle your baby please consider the following things:
It is safest to swaddle from birth, rather than deciding to change care practices and begin swaddling at a later age.
It is particularly important not to begin swaddling at around 3 months of age, when the risk of cot death is highest.
Don’t cover your baby’s head when you swaddle. Use thin materials, such as thin cotton or muslin cloth; this helps reduce the risk of overheating.
NEVER place your baby on their tummy to sleep when they are swaddled. By the age of 4 months, most babies naturally start to wriggle; swaddling should be stopped at this age as the risk of a baby rolling increases.
Research on the effect of swaddling on whether babies sleep more or less soundly is unclear. Some research suggests babies sleep more deeply when swaddled, waking less often and have fewer startle reflexes. Another study shows babies respond more easily to noise when swaddled.
Thing to consider:
Different cultures have varying views on swaddling and many cultures use the technique more readily. Swaddling is a practice which many parents use to sooth and calm a baby.
Evidence For Our Message On Swaddling
There is no evidence to suggest that swaddling should be promoted as a practice to reduce the risk of SUDI.
Swaddling can be used to maintain young infants (pre rolling) in a back position for sleep, which is associated with a reduced risk of SUDI. Conversely though, if a baby does roll onto their side or tummy, they will be at an increased risk when swaddled.
Swaddling should stop when infants begin to roll.