Swaddling or swaddling the baby is a technique of intercultural use that has centuries of history. In fact, it was very common in the eighteenth century, although the truth is that its use has decreased significantly since then. Today, it continues to be prevalent in some parts of the Middle East and begins to gain popularity again in the United States and in some areas of Europe.
Babies wrapped in diapers sleep more, have reduced levels of motor activity in response to stimulation, fewer startles, and less heart rate variability. Therefore, it is a technique that is being used again to calm excessive crying in newborns and improve their quality of sleep.
Besides, also additional benefits have been observed, which include improvements in neuromuscular development for very low-birth-weight newborns, reduction of physiological and behavioral distress among premature babies, and improved calmness and sleep for newborns with neonatal withdrawal syndrome.
Basically, this technique consists of wrapping the baby in a blanket smooth by following a series of steps:
First, the blanket should be fully stretched and one corner folded, then the baby is placed on the blanket on his back, with his head on the folded corner, his left arm is straightened and the left corner of the arm is wrapped. blanket over your body, tucking it between your right arm and your right side. The lower part of the blanket is loosely folded and placed under one side. Then the right arm is straightened next to your body and the right corner is bent of the blanket, tucking it under your left side. Make sure that you can move your hips and that the blanket is not too tight.
Generally, this technique of swaddling the baby was used to curb excessive crying. In fact, babies are said to be swaddled overnight they wake up less and sleep longerAlthough there is little data on the physiological effects of Swaddling on sleep-wake characteristics, this technique has been shown to promote sleep and reduce crying.
Precisely because to the palliative effect on excessive crying, colic and the promotion of sleep, there has been a resurgence of this technique. Furthermore, regarding sudden infant death it has been shown that to reduce the risk it is important to place the baby in a supine position, and, precisely, the Swaddle technique can help in the adherence to the supine position of babies.
On the other hand, it has also been shown that premature babies wrapped with this technique have better neuromuscular development, fewer levels of physiological distress, better motor organization and greater self-regulation. Swaddling has also achieved calmer sleep in premature babies by reducing crying and spontaneous excitement. In addition, it can be useful for regulate the temperatureAs babies born preterm cannot regulate body temperature properly, it can also cause hyperthermia if applied incorrectly.
Neonates admitted to an intensive care unit undergo various invasive procedures such as endotracheal suctioning or cannulation of a peripheral venous line. In this sense, research has shown that preterm infants respond intensely to pain compared to term infants.
Pain in newborns can be controlled by pharmacological and non-pharmacological means. Pharmacological means have side effects which deters from their habitual use. Therefore, research is important and the use of non-pharmacological procedures, among which is the Swaddling.
Adverse effects of Swaddling
Respiratory infections. An increase in respiratory infections has been observed related to the stiffness to which the baby is exposed when being swaddled. In swaddled newborns, respiratory morbidity is increased, respiratory rate and oxygen saturation are decreased while swaddled.
In addition, another study has observed that the prevalence of pneumonia or upper respiratory infections can be increased by up to 4 times in swaddled babies during the first 3 months of life, compared to non-swaddled ones.
Less weight gain. Swaddling the baby immediately after delivery can cause a delay in postnatal weight gain.
Sudden infant death. Swaddling babies favors the supine position, which initially reduces the risk of sudden death, but in the case of babies swaddled on their stomachs, this risk increases significantly, so swaddling should be stopped when try to turn around.
The inability to awaken from sleep in response to cardiovascular stress has been described as a mechanism that leads to sudden infant death. Swaddled babies have fewer spontaneous sleep arousals and longer sleep time, which is a state of reduced stretchability.
Hip dysplasia. It is one of the main concerns in the use of Swaddling, as it is the main adverse effect. Hip dysplasia is one of the most common congenital disorders and has considerable socioeconomic implications.
The most common risk factors are breech presentation and family history, but postnatal mechanical factors should also be considered. The early diagnosis of hip dysplasia leads to a simpler and more successful treatment, so it is especially important to take into account all risk factors, in order to make the diagnosis as soon as possible.
Swaddling forces the hips to extension and adduction and predisposes to dysplasia. Hip dislocation predominantly occurs if swaddling at birth, prolonged swaddling also results in a higher rate of dislocation. In cases where wrapping began later after birth, dysplasia occurs but not dislocation.