To Swaddle or Not To Swaddle? What Parents Need To Know About Swaddling

Swaddling newborns has been practiced for centuries, and today it remains one of the most common ways parents comfort their babies. Wrapping a baby snugly in a lightweight blanket can help some infants sleep longer and feel calm and secure. At the same time, safe sleep experts emphasize that swaddling should be done with care.

In this article, we’ll explore the benefits of swaddling, the potential risks, and what the American Academy of Pediatrics (AAP) recommends, so you can decide what works best for your baby.

Swaddling isn’t unique to modern American parenting - it has been practiced around the world for thousands of years. A systematic review published in Pediatrics (the journal of the American Academy of Pediatrics) found that swaddling was nearly universal in many societies before the 18th century and is still common in parts of the Middle East, Eastern Europe, and South America today (1).

In contrast, some Northern European countries, such as Sweden and Norway, rarely practice swaddling (2), instead favoring sleep sacks or layering. In Scotland, parents are advised not to swaddle, but rather to tuck babies in with a light blanket, illustrating how recommendations can vary widely across the world (3). In Japan, in recent years public health initiatives have focused on safer swaddling, as traditional leg-straightening methods were once linked to higher rates of hip dysplasia. When practices shifted to allow for natural hip flexion, rates declined significantly (4).

To learn more about sleep in children, read these articles: 

• Sleep Essentials For Kids
• Butter Before Bed for Babies: Helpful Sleep Hack or Internet Myth?

The AAP does not specifically recommend in favor of or against swaddling. Instead, they acknowledge that swaddling can be a helpful soothing technique for some infants but emphasize that it must always be practiced safely (5,6):

• Babies should always be placed on their backs to sleep, even when swaddled.

• Swaddling should be stopped as soon as a baby shows signs of rolling, usually around 2-3 months.

• Swaddles must allow for hip and leg movement to prevent hip dysplasia.

• Care should be taken to avoid overheating.

• Loose blankets, weighted swaddles, blankets, or soft bedding should be avoided.

One of the biggest concerns is sudden infant death syndrome (SIDS). Research shows that swaddled babies who roll onto their stomachs are at a higher risk (6). Overheating and using loose blankets can also raise risk (6).

This is why safe swaddling means:

• Back to sleep only,

• Lightweight, breathable fabrics,

• Monitoring your baby for signs of overheating,

• Transitioning to a sleep sack once the first signs of rolling begin.

Swaddling should be avoided if you are co-sleeping because a swaddled baby has limited ability to move or alert when their airway is blocked. If your family chooses bedsharing, a safer alternative is a wearable sleep sack that leaves the arms free.

To learn more about safe co-sleeping, read this article: Co-Sleeping 101: Benefits, Risk Factors, & Safety Guidelines

Babies are born with reflexes, such as the startle reflex, that play an important role in brain and body development. Research shows that swaddling can temporarily quiet the startle reflex (7), helping babies sleep more soundly.

Recently, some pediatric physical therapists and developmental specialists have raised valid concerns that prolonged swaddling may limit opportunities for reflex integration and slow the natural progression of motor skills. These cautions are grounded in professional experience rather than robust clinical studies, yet they highlight an important perspective: infants need plenty of time to move freely and practice the reflexes that support healthy development.

The general recommendation is to stop swaddling as soon as your baby shows signs of rolling, often between 2 and 3 months of age (5,6). While this is an important safety step, it’s also one of the trickier transitions in early parenting. Many babies love the snug, womb-like feeling of the swaddle, so it’s normal for sleep to get a little rocky once their arms are free.

One way to make the change gentler is to transition gradually:

• Start by swaddling with one arm out for naps, then both arms out, and then implement the change for night sleep as well.

• As you leave the swaddle behind, transition into a sleep sack.

During this stage, babies may need more soothing than usual. Rocking, white noise, or a consistent bedtime routine can help signal that it’s time for rest, even without the swaddle. Some parents also find that offering contact naps or motion naps in the stroller or carrier during the day helps babies catch up on sleep while they learn this new skill at night.

It can be discouraging when your baby’s sleep seems to take a step backward, but remember, it’s only temporary. More restful nights are on the way! Meanwhile, this article may help: How To Manage Sleepless Nights As A Parent: Science-Backed Strategies For Surviving Sleep Deprivation

Swaddling can be a wonderful tool for helping newborns feel calm and secure. The AAP encourages parents who swaddle to do so safely by placing babies on their backs, using breathable fabrics, keeping their hips free to move, and stopping once rolling begins. Swaddling isn’t recommended when co-sleeping. Some parents are concerned about swaddling affecting the integration of the startle reflex, and while there is not large-scale research on this, it does highlight the importance of giving babies plenty of time unswaddled to move freely and practice their natural reflexes.

Ultimately, whether or not you swaddle is a personal choice. With safe practices and mindful observation, swaddling can be one of many tools parents use to comfort their newborns and support healthy sleep in the early months.

1. American Academy of Pediatrics. (2024). Aap.org. https://publications.aap.org/pediatrics/article-abstract/120/4/e1097/71284/Swaddling-A-Systematic-Review

2. Wennergren, G., Nordstrand, K., Alm, B., Möllborg, P., Öhman, A., Berlin, A., Katz-Salamon, M., & Lagercrantz, H. (2015). Updated Swedish advice on reducing the risk of sudden infant death syndrome. Acta Paediatrica, 104(5), 444–448. https://doi.org/10.1111/apa.12966

3. Safe Sleep Scotland. (n.d.). Reduce The Risks: Tuck me in with blankets under my arms and place me “feet to foot.” Safe Sleep Scotland. https://safesleepscotland.org/reduce-the-risks-tuck-me-in-with-blankets-under-my-arms-and-place-me-feet-to-foot/

4. Yamamuro T, Ishida K. Recent advances in the prevention, early diagnosis, and treatment of congenital dislocation of the hip in Japan. Clin Orthop Relat Res. 1984 Apr;(184):34-40. PMID: 6705362.

5. Moon, R. (2023). How to Keep Your Sleeping Baby Safe: AAP Policy Explained. HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

6. Moon, R. Y., Carlin, R. F., & Hand, I. (2022). Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics, 150(1). https://doi.org/10.1542/peds.2022-057990

7. Gerard CM, Harris KA, Thach BT. Spontaneous arousals in supine infants while swaddled and unswaddled during rapid eye movement and quiet sleep. Pediatrics. 2002 Dec;110(6):e70. doi: 10.1542/peds.110.6.e70. PMID: 12456937.