Swaddling may increase infant death rate.

A new study that appears in the journal Pediatricshas identified a possible link between swaddling and sudden infant death syndrome (SIDS). Swaddling refers to the practice of wrapping babies up in a light cloth while they sleep, leaving only their head exposed. The researchers behind the study are urging parents to exercise caution when swaddling their young.

The popularity of swaddling lies in the fact that it is reported to encourage more peaceful sleep among babies – especially those less than two months old – while also reducing excessive crying. However, results of this latest research point to the fact that swaddled infants should only be placed on their backs, as lying them on their side or front carries a statistically significant increase in the risk of SIDS.

To conduct their research, the study authors searched through several online databases in order to review all available literature on the subject of swaddling, some of which dates back to the 1950s. However, after examining almost 400 previous studies on the issue, they found only four that investigated the connection between swaddling and SIDS.

Taking all four of these studies into account, the researchers were left with information regarding 760 SIDS cases, as well as 1,759 further babies who were swaddled but did not suffer this tragic outcome. However, given the fact that these four papers were produced in different eras and geographical locations – ranging from Tasmania to the U.K. – the study authors note that any judgements drawn from their analysis are far from conclusive, as swaddling practices can vary greatly between cultures.

Swaddling is reported to help babies sleep and prevent excessive crying. Katrina Elena/Shutterstock

Nonetheless, it is significant that, when considering all the available data, certain clear patterns stand out. For instance, the risk of SIDS among infants placed on their side or front was found to double when they are swaddled. Additionally, this risk appears to increase with the age of the infant, suggesting that, while swaddling may be relatively safe during the first weeks of a baby’s life, it should not be continued beyond the first four to six months.

The reason for this is that around this age babies develop the ability to roll over on their own, so some that are initially placed on their backs may end up on their side or front – two positions that are generally associated with a higher risk of SIDS, even when swaddling is not involved.

It is therefore unsurprising that, of those swaddled babies who died lying on their front, the majority had been placed on their backs and later rolled over.

For this reason, official guidelines in the Netherlands encourage parents to swaddle their newborns in order to prevent excessive crying, but to cease swaddling as soon as the baby shows signs of being able to roll over.

Though the study authors concede that more research is needed in order to corroborate these findings and identify a more robust connection between swaddling and SIDS, they do insist that “current advice to avoid front or side positions for sleep especially applies to infants who are swaddled.” In addition, they claim that “consideration should be given to an age after which swaddling should be discouraged.”