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Saturday, December 4, 2010

Rethinking Swaddling

It seems that every time you see a "birth" on TV the baby is immediately mummified in blankets and hats and handed to the fully clothed mother to smile and coo at.  Wrapping babies up tightly in a blanket is known as "Swaddling", and until recently was considered the normal way to keep babies warm after birth and it is still the generally accepted practice in most hospitals.

While considered the norm, many doctors are speaking out against swaddling and studies are proving over and over that swaddling is not only NOT helpful in warming the baby, it also negatively effects the baby's ability to breastfeed naturally and properly, and can increase risks of SIDs.

Babies are meant to be with their mothers, and the best way of nurturing a baby is to maintain skin-to-skin contact between the baby and it's mother.  This is known as "Kangaroo Care" . The baby, wearing only a diaper, is held upright against the parent’s bare chest. The term kangaroo care is used because the method is similar to how a baby kangaroo is nurtured by its mother - from the safe environment of the womb to the safe environment of the pouch where further maturation of the baby occurs. Skin-to-skin contact promotes more consistent heart and respiratory rates; it stabilizes oxygen needs; it aids in stabilizing blood sugar levels; it regulates body temperature; and improves weight gain and helps increase breast milk supply.

Dr. Nils Bergman, the father of modern "Kangaroo Care"  developed and implemented Kangaroo Mother Care (KMC) for premature infants right from birth. This resulted in a five-fold improvement in survival of Very Low Birth Weight babies raising the survival rate of these tiny preterm infants from 10% to 50%.

But Kangaroo Care isn't just for preemies. Skin to Skin contact is vitally important for all infants.

"The very best environment for a baby to grow and thrive, is the mother's body," says Dr Nils Bergman, "When placed skin-to-skin on the mother's chest, the baby receives warmth, protection and food, and its brain can develop optimally. Not feeding the baby often enough and leaving it to sleep alone after a feed can result in the baby getting colic", he adds. "The mother's skin is the baby's natural environment, and both physically and emotionally the healthiest place for the baby to be".

Dr. Jack Newman of the Newman Breastfeeding Clinic & Institute in Toronto is a huge supporter of mother & baby skin to skin contact and strongly promotes it in his clinic and when training and working with medical professionals in the birthing industry.

"To appreciate the importance of keeping mother and baby skin to skin for as long as possible in these first few weeks of life (not just at feedings) it might help to understand that a human baby, like any mammal, has a natural habitat: in close contact with the mother (or father). When a baby or any mammal is taken out of this natural habitat, it shows all the physiologic signs of being under significant stress. A baby not in close contact with his mother (or father) by distance (under a heat lamp or in an incubator) or swaddled in a blanket, may become too sleepy or lethargic or becomes disassociated altogether or cry and protest in despair. When a baby is swaddled it cannot interact with his mother, the way nature intended. With skin to skin contact, the mother and the baby exchange sensory information that stimulates and elicits “baby” behaviour: rooting and searching the breast, staying calm, breathing more naturally, staying warm, maintaining his body temperature and maintaining his blood sugar."
Nancy Mohrbacher in her blog  writes an excellent article that outlines the many reasons why the tradition of Swaddling babies is dangerous and needs to come to an end:

Rethinking Swaddling

There’s no doubt that babies seem calmer and sleep more when swaddled.  But is this a positive or a negative?  The research provides some surprising answers, starting with the first days after birth.
Swaddled babies arouse less and sleep longer.1 That may sound good, but in the early hours and days after birth this can lead to less breastfeeding, which is associated with greater weight loss, more jaundice, and a delay in milk production.2
Swaddling delays the first breastfeeding and leads to less effective suckling.  In a study of 21 babies after a vaginal birth,3 researchers divided them into two groups.  One group was laid skin-to-skin on mother’s body, examined briefly, then returned to skin-to-skin contact for two hours.  The other group was shown to the mother, examined, and swaddled with hands free and then returned to mother.  The swaddled group showed delayed feeding behaviors, suckled less competently at their first breastfeeding, and established effective breastfeeding later.

But what about after hospital discharge?  Once a baby is breastfeeding well, is there any reason to avoid swaddling?  While swaddling may be helpful when used occasionally, routine swaddling during the first months associated with greater risk of:
  • Respiratory illness10 
  • Hip dysplasia11
  • SIDS in prone sleeping positions12
  • Overheating13
Evidence is also growing that babies’ hand movements aid them in finding the breast and latching. 14 Swaddling during breastfeeding to restrict babies’ hands may contribute to breastfeeding problems.
After reading the research, my own opinion of swaddling has changed.  In most cases a mother’s body is her newborn’s best “baby warmer.”  When babies get fussy, it may be best to limit swaddling and suggest instead parents consider alternatives, such as skin-to-skin contact and baby carriers.

 HERE to read Nancy's entire article

For more information about swaddling please read my article "In the Pouch"