Gina Mydlo, PT, DPT
- Mar 13, 2021
- 7 min read

How to Swaddle Safely and Choose a Store-bought Swaddle

Updated: Nov 22, 2021

First of all, do you NEED to swaddle your newborn baby?

Let me first start by saying, it is absolutely not necessary to swaddle your infant for sleep.

Many parents choose to do so, because they see their baby sleeps more comfortable that way. However, many parents report that their baby "fights it", or even "hates it" from an early age.

Our babies are born with a primitive reflex, called the Moro reflex, or startling reflex. What swaddling does, is gives babies input when they startle which suppresses that reflex. But letting babies sleep freely will actually allow the child to work through and integrate that startling reflex sooner, which may lead to that child sleeping more comfortably on their own sooner than an infant who has been swaddled. For this to happen efficiently, the startling reflex must be met and completed with a cuddle from a caregiver, thus completing the "fight or flight" response.

The infant who is not swaddled will arouse frequently throughout the night, seeking that protection from their parent to meet their needs. If an infant is co-sleeping, that parent will respond promptly, which essentially completes the cycle of the Moro reflex.

However, what about the parents that chooses not to co-sleep? The AAP recommends that infants sleep separately from parents on a firm, flat surface to prevent the risk of SIDS.

So in my opinion, we need to give these parents who choose to sleep separately a realistic option to help their babies calm.

As more information comes out about the effects of swaddling, more professionals are actually recommending against it. Like I said before, if your baby is sleeping soundly and you have no concerns, then don't start to swaddle just because someone else did.

But if you are having significant sleeping issues and your baby is not meeting his or her sleep needs, then we certainly need a tool to help us address those issues. Lack of sleep can have a profound effect on development in all areas.

Swaddling can help keep baby's arms and legs in midline (the middle of their body) which is actually calming to the nervous system and can help baby fall asleep. Many parents report (although there is no conclusive research based evidence of this) that their baby who is swaddled sleeps longer and more soundly. While this sounds great, our ultimate goal should not be to get baby to sleep 12 hours straight without waking up. That is not how infant sleep cycles work. BUT, we can use swaddles short term to help teach baby to love to sleep, and then wean out of them as soon as possible. (And I can teach you all of that in my online course!)

If we choose to swaddle, what swaddles are best to use, and how can we use them as safely as possible?

Many parents choose to use store-bought swaddles to wrap their precious baby for sleep. Picking out a swaddle seems like an easy enough task - right?!

Have you SEEN the swaddle blanket aisle at the store? There are so many different kinds! And it seems like every time I turn around, there's a new one out on the market! (If you haven't downloaded our FREE guide, do it now to get more expert information on swaddles and tons of other baby gear).

One of the most important factors when picking out a swaddle is to make sure that the swaddle promotes a HIP HEALTHY position. What does this mean?

When babies are born, the cartilage in their hip socket is not completely formed. It takes appropriate positioning and alignment of the leg bone in the hip joint to form the cartilage to keep the hip joint stable. By ensuring our babies have enough room in the swaddle to move their hips freely, we are allowing their hip joints to develop appropriately.

What's the best position for baby's hips?

We want babies to be able to bend their hips fully, spread their hips wide, and rotate their hips freely.

Figure 1. Effect of Tight Swaddling the Soft Hips of Newborns. (Keri Caffrey, Inc., 2018).

What position do we want to avoid?

We want to avoid putting baby's hips in a locked, straight, narrowed position.

Figure 2. Effect of Tight Swaddling the Soft Hips of Newborns. (Keri Caffrey, Inc., 2018).

So how does that all factor in to picking out a swaddle? Well, you need to make sure that whatever swaddle you choose has PLENTY of room from baby's hips downward for baby to move his legs freely.

Let's talk about a couple of my favorite swaddles and a couple that I'd avoid. I'll tell you why I like them or not and when they may be appropriate to use on your baby.

I'm going to break these down into two categories: Velcro swaddles, and Non-Velcro swaddles.

Velcro swaddles

SwaddleMe® Original Swaddle

About: You place baby in this sack that only covers the legs, then you wrap the velcro wings around baby's arms to swaddle.

Pros: These are hip healthy, and allow plenty of room for baby's legs to move freely. It is pretty easy to use. The lightweight fabric is nice to prevent overheating.

Cons: In general, I don't love the veclro swaddles. Baby's arms are usually stuck in one position which is not a natural sleeping position. This leaves baby able to move their legs and neck from side to side, but not their arms at all. It is also possible to overtighten these since it is a velcro swaddle.

HALO® SleepSack® Swaddles

About: You first place baby in the zippered sack that goes up above the shoulders. Then, you cross the velcro wings over baby's arm to swaddle.

Pros: These are hip healthy, and allow plenty of room for baby's hips to move freely. These are easy to use. The velcro appears to stick better and last longer than other velcro swaddles. They have multiple fabric options for winter and summer months.

Cons: Again, it velcros the arms into one spot so this is not a very natural sleeping position for babies. Since it is velcro, you need to be cautious not to overtighten. And you need to make sure you are using the correct size. If you use too big of a swaddle sack on baby, the velcro will cross the hip joint, so when you go to tighten the velcro, it will tighten across the hips.

* You can use these as a regular sleep sack. You just put the baby in them, then loosely velcro the wings under baby's armpits (not swaddling their arms inside.)

Non-Velcro Swaddles

Woombie®

About: This is a zippered swaddle blanket. You place baby in it, then zip it up - it's that easy!

Pros: This is my favorite swaddle blanket, so in my opinion it has a lot of pros!

It is so easy to use, any caregiver can do it.
It is hip healthy, and allows for free movement of the hips.
Since there is no velcro, baby's arms are able to move more freely within the confines of the sack, allowing baby to find a more natural sleeping position.
There is no chance of baby "escaping", or getting his hands out of the sack.
It has double zippers to allow for easy nighttime diaper changes without getting baby completely out of the sack.
It is available in many options, including a convertible option that allows you to unzip an arm hole when you want to transition baby from a swaddled position.

Cons: If your baby wants to sleep with his or her arms up above the head, this won't allow it.

*SwaddleMe® also makes a similar swaddle called the SwaddleMe® Pod. I have not tried it so I don't want to review it. While the SwaddleMe® Pod appears to allow for free movement at the hips, the fabric does look narrower at the hips than the Woombie®, which makes me lean more toward using the Woombie® for extra hip wiggle room.

Swaddle UP™

About: This is also a zippered swaddle blanket, and it is tailored to keep the arms up at chest level, and out to the side with hands above shoulders.

Pros: This allows baby's arms to move in some directions, allowing for a more natural sleeping position. Since it is a zippered sack, it is easy to use for any caregiver. It has a double zipper for easy nighttime diaper changes. It is hip healthy, allowing for plenty of free movement of the hips. There are also transitional sacks that you can unzip the arm holes to transition baby away from being swaddled.

Cons: While some babies respond well to sleeping with arms in this position, not all babies find this to be a comfortable or natural position for sleep. Baby can't extend their arms downward, which some babies like to do during sleep.

Figure 3. SwaddleUP™ Original.

I am aware that this by no means is an exhausted list of swaddles! There are many more out there. But these are the ones you will typically see in store, and other swaddles may be very similar to these.

Ultimately as the parent, you are the one to decide whether you will swaddle your infant or not. But the important thing is, now you can make a more educated decision on if you will swaddle or not, what swaddles are available to you, and how to use them safely.

For a list of Hip-Healthy swaddles and carriers backed by the International Hip Dysplasia Institute, go to:

Hip Health Products

For a video on how to swaddle safely using just a blanket, go to:

Hip Healthy Swaddling

Are swaddles just for sleeping?

When most of you hear 'swaddle', you immediately think 'sleep'. But have you ever considered the need to swaddle your newborn for feedings? While it is certainly not necessary or recommended for every baby (baby pushes on mom's breast while nursing for a reason), it CAN be used as a technique to help calm baby prior to a feed, or to be organized enough to feed, as well as support her body so that she can latch more efficiently.

Learn more on how to support your infant's feeding and sleeping development, and if swaddling is right for your infant in our online course, Baby's Best Start.

Parent confidently,

Gina Mydlo, PT, DPT

References:

1. Caffrey, K. [animation] International Hip Dysplasia Institute. (2018). Effect of Tight Swaddling The Soft Hips of Newborns. Retrieved

February 24th, 2020 from https://hipdysplasia.org/developmental-dysplasia-of-the-hip/hip-healthy-swaddling/

2. Caffrey, K. [animation] International Hip Dysplasia Institute. (2018). Effect of Tight Swaddling The Soft Hips of Newborns. Retrieved