From time to time, we see infant providers who swaddle babies as a way to calm them and to help them sleep. In the most recent notes for clarification in the ITERS-R and FCCERS-R (9-2013), if we find children are being swaddled in center-based or family child care homes, it is considered inadequate care for nap practices. The guidelines come from the 2011 edition of Caring for Our Children (3rd edition). They state the swaddling is not necessary or recommended in child care settings. Some states (Minnesota, Pennsylvania, and Texas) are even starting to address this issue in their licensing standards by banning the practice in child care settings.
Although the American Academy has not taken an official stance on this issue, we know that in the first days and weeks of life, swaddling can help sooth newborns and it mimics the close comfort of the womb. But Dr. Rachel Moon, chair of the task force that authored the American Academy of Pediatrics safe sleep recommendations, recommends that swaddling should be stopped by the time a child reaches 2 months of age and before a baby intentionally starts to roll. This is about the same time that parents who need care outside the home will enroll their children in family or center-based care.
What are some of the concerns associated with swaddling?
- In center-based care, there can be multiple providers and some may not know the correct swaddling technique.
- Tight swaddling can lead to hip dysplasia in babies because there is not enough room for the baby to bend her legs up and out from her body.
- Dr. Moon states that swaddling may decrease a baby’s arousal making it harder for her to wake up which can be a risk factor for SIDS (Sudden Infant Death Syndrome).
- Older infants who are swaddled may roll over and not be able to roll back which can cause suffocation.
- Swaddling can also lead to overheating, which is another risk factor for SIDS (Sudden Infant Death Syndrome).
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