Swaddling and Sensory Self-Soothing
We love to empower and guide parents to help make your new role easier.
We see new moms and dads go through the motions of learning so many new things everyday. We want to share what we see over and over to help build your confidence.
Parenting advice and information is often passed down through generations and most new parents do not question certain things because they seem common place.
As you raise your child, there may be times when you feel that something isn’t quite right for your child. We encourage you to always trust your parental intuition.
Any advice, medical or healthcare theory can be debunked and we like to give you the most up-to-date, evidence-based information.
Swaddling has been a common practice in parenthood for generations. Let’s explore the history, benefits, how-tos, and the neurological implications.
The History of Swaddling
Before modern times swaddling was primarily done for safety reasons while a child was basically neglected. Many household environments had fires out in the open, they were out working in the field and there were sharp dangerous objects around. Instead of baby proofing the house – many parents would swaddle up their little ones to keep them safe and secure.
Another common practice back in the day was wet nursing. It is hard to believe, but there was a time when it was not considered okay for women of higher status to nurse their own babies. Instead, a woman servant would nurse their children for them. One servant would have upwards of 4 or 5 babies to nurse and she would swaddle them up to keep them safe and calm.
It was also a common belief in past times that it was important to keep babies arms and legs straight and tight or else child would grow up with bent limbs. Obviously, we know today that this is certainly not true.
Starting in the 1700’s there were pediatricians who spoke out and no longer encouraged swaddling. However, the practice continued to be passed down in families and within the medical community.
Fast forward to the 1990s. In 1994 the American Academy of Pediatrics promoted the Back to Sleep Campaign to prevent SIDS. It was encouraged to only put your child to sleep on their backs swaddled.
During the start of the Back to Sleep campaign, it was found that many babies were being swaddled too tightly and it led to many cases of hip dysplasia. Hip dysplasia is a serious concern and can lead to growth and developmental issues.
When swaddling, you never want a baby’s hips and knees to be straight down and held tightly. You always want them to be able to bend their little legs and have their knees come up towards their hips. You also want babies to be able to move their legs while swaddled.
The National Institute of Hip Dysplasia is a non-profit organization with more information regarding this on their website.
During this the beginning of this campaign, labor and delivery nurses would swaddle newborns right after birth and then mom would attempt to breastfeed, often unsuccessfully.
Since the early 2000s, it has become a common practice in hospital birthing centers to allow for and promote skin-to-skin contact of mom and baby immediately after birth, for the many understood benefits for bonding, nursing, temperature regulation, and immune system support.
Tummy When Awake
Many people have never heard of the 2nd part of the Back to Sleep Campaign slogan – “Tummy when awake.”
Many infants have daily struggles simply because they spend too much time on their backs when they are awake. Whether at home or in their car seat, this constant back time puts a lot of stress on their neck and head. This leads to torticollis (tilt & turn of their head) and plagiocephaly (abnormal head shape) — two issues we see daily in our practice.
Tummy time is vitally important developmentally. The position helps them to explore their new world. During tummy time they are stretching, reaching, looking and unfolding from the fetal position.
Swaddling for Sleep
When it comes to sleeping, swaddling is certainly a tool in a parent’s toolbox to help their infants sleep on their backs without being held.
Parents today are often being told to swaddle, but not really being taught why, how, what swaddles to use, or any guidelines on how to transition out of swaddling.
The 4th Trimester and Beyond
We are big proponents of the concept that during the 4th trimester it is important to recreate feelings of safety and comfort for baby. That is typically the idea of swaddling in modern times — to remind baby of being held closely and safely in the womb.
Yes — while we want to mimic the womblike environment, we also want to help them slowly adapt to their new world.
We encourage you to plan for a gentle transition phase. As the parent you can help facilitate your baby’s adaptability by allowing them to experience their environment and swaddling lightly and only short-term.
We encourage you to plan on being finished swaddling by 4 to 8 weeks old. A baby should definitely be done swaddling by 12 weeks of age. Basically, you want to be done swaddling by the end of the 4th trimester.
Another element to timing is the fact that rolling over while swaddled is a suffocation hazard. Many babies can roll over between 3 to 4 months. Some will not until 5 or 6 months — which is still developmentally normal — but you need to be prepared.
Types of Swaddles
Muslin blankets or receiving blankets are very common new baby items. They are often found in beautiful patterns and they are soft and comforting. There are also a number of different ways to swaddle with a blanket. The diamond wrap is the most common and easy way to wrap but there are many others too.
The danger of using muslin blankets for swaddling is that many babies learn to ‘break out’ of them and pull the swaddle over their face with their hands. This is another safety hazard and a baby should never be swaddled in a blanket and then put down to sleep.
Velcro swaddles or sleep sacs with a zipper are a safer way to swaddle for sleeping. They also allow for baby to have their hands up by their face and to even break their hands out if they have to.
It is important that baby still has room to move their arms and legs while in a swaddle or sleep sac. You want them to have movement because it is also important for development, it is important for growth.
Developmentally by 5 or 6 weeks you will start to see baby show more lateral outward movements. Baby needs to stretch and have space to expand their body. This allows them to open up their nervous system and learn how to move.
Neurodevelopment and Swaddling
There are neurological and developmental reasons why we want babies to be able to move, even while being swaddled. Motion and all other sensory information works through our nervous system as signals that go directly to the brain. The brain then regulates all of this input and tells the body what to do.
There are two types of sensory feedback to the brain in our nervous system: proprioception and nociception. It is important to note that these two types of sensory input to the brain work inversely – when one is up and the other is down.
To understand proprioception, think movement. Motion is soothing to a baby. Swaying and rocking calms a baby down. It is like Mozart playing in their nervous system. When a baby is able to move while being swaddled it is very soothing for them.
To understand nociception, think anything that is irritating, noisy or startling. Basically, anything that would make baby cry. Nociceptive input is like Metallica playing in the background of their nervous system. When a baby is swaddled too tightly and too often, it stresses out their nervous system because they cannot move and receive the proper proprioceptive input.
BUT THEY SLEEP BETTER?
This understanding of sensory input to the brain with swaddling makes sense when we are talking about neurotypical kiddos. If your baby needs the input of a tight swaddle just to be calm, that is a red flag that they are overwhelmed and overstimulated constantly. Their nervous system is likely stuck in a nociceptive state and they are in a repetitive stress response. Metallica is playing in their brain constantly. This stress could have begun in utero, from fetal positioning or from a traumatic birth.
Parents will often say that a tight swaddle is the only thing that calms their baby down and helps them sleep longer. When a baby’s nervous system is stuck in a nociceptive state – it is overwhelming for their system. It causes their autonomic nervous system to be dominant in sympathetics – or fight-or-flight mode. This is not a sustainable state and leads to sleep challenges, health challenges and developmental delays.
When an infant’s nervous system is in this constant state of stress, it also inhibits them from integrating the moro (or startle) reflex. This reflex should be extinguished between 4 and 6 months. They are able to slowly integrate this reflex through experiencing motion, by lots of tummy time and baby wearing. This ability to move and feel motion gives them the nourishing proprioceptive input their brain crave.
Other signs of this constant stressed internal environment are if baby hates tummy time, hates the car seat, is always tense and uncomfortable, is experiencing nursing issues that won’t resolve, experiencing reflux, colic and/or constipation. These are all signs that baby is not adapting well to the world and not coping appropriately to stress. If these issues are not addressed, they will not “outgrow them,” rather they often manifest as other sensory and health issues as the child grows.
Maybe tightly wrapping up your baby helps to calm them now, but what is that doing for their neurodevelopment in the long term? Many sleep training books recommend a tight “straight jacket” swaddle for sleeping through the night. While sleep is very important, you must to remember that it is not developmentally normal for babies to sleep long stretches during infancy.
Benefits of Pediatric Chiropractic Care
If a child needs to be tightly swaddled or cannot transition easily out of swaddling that is a red flag that they have stress in their neurospinal system. It is important to see a brain-based pediatric chiropractor as soon as possible to help them regulate their stress. Chiropractic is all about stress adaptation. Babies can learn to work through the overwhelm and regulate sensory stimulation from the inside out.
At Pure Light Family Chiropractic, the doctors utilize advanced neurological scans to measure the stress in the neurospinal system as well as measure the stress response in the body. We specialize in helping babies and children adapt, thrive and reach their full potential. We are happy to help answer questions and offer guidance at anytime.