Physiologic studies show that swaddling decreases arousals and awakenings and increases sleep duration. This can be good (baby sleeps longer) or bad (baby doesn’t wake as easily).

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Tight swaddling can make it more difficult for the baby to breathe, and some babies have increased respiratory rates when swaddled. Tight swaddling can make hip dysplasia worse if the legs are kept straight down. Swaddling may increase overheating especially if the head is covered or the baby is sick, but if the baby is swaddled in a light cotton blankets from the shoulders down there should be no rise in skin temperature.

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Some studies suggest a decrease in SIDS rate with swaddling if the infant is supine but there is increased risk of SIDS if the infant is swaddled and placed prone. Swaddling may encourage supine positioning and may help with the “retraining” process for usual prone or side sleepers. Swaddling may be helpful as a strategy to calm the infant.

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A light receiving blanket should be used and the infant should not be overdressed to avoid overheating. Swaddling should not cover baby’s head or face. Swaddling probably should not be used if the baby is sick and has a fever. The swaddle should be tight enough that it does not become loose, but not too tight as to restrict respiration and hip movements.

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Swaddled infants should NEVER be placed in the side or prone position and swaddling should be discontinued after the infants is 3 months of age or after the infant begins to roll, whichever occurs earlier. If the swaddle becomes too loose, the blanket should be removed from the sleep area.