Swaddling or wrapping the baby is a technique of intercultural use that has centuries of history. In fact, it was very common in the 18th century, although the truth is that its use has decreased significantly since then. Today, it continues to be common in parts of the Middle East and is beginning to gain popularity again in the United States and parts of Europe.
Swaddled babies sleep more; have reduced levels of motor activity in response to stimulation, less startle, and less heart rate variability. Therefore, it is a technique that is being used again to calm excessive crying in newborns and improve their sleep quality.
In addition, additional benefits have also been observed, including improvements in neuromuscular development for very low birth weight infants, reduction in physiological and behavioral distress among preterm infants, and improvement in infant calm and sleep with neonatal abstinence syndrome.
Basically, this technique consists of wrapping the baby in a soft blanket following a series of steps:
• First, the blanket must be fully stretched and one of its corners folded.
• The baby is then placed on the blanket on its back, with its head over the folded corner.
• Her left arm is straightened and the left corner of the blanket is wrapped over her body, tucking it between her right arm and her right side.
• The lower part of the blanket is folded loosely and placed under one of the sides.
• Then the right arm is straightened along her body and the right corner of the blanket is tucked under her left side.
• Make sure that you can move her hips and that the blanket is not too tight.
BENEFITS OF SWADDLING
Generally, this technique of swaddling the baby was used to stop excessive crying. In fact, babies swaddled overnight are said to wake up less and sleep longer, although there are a few data on the physiological effects of swaddling on sleep-wake characteristics, this technique has been found to promote sleep and reduce crying.
Precisely due to the palliative effect on excessive crying, colic and sleep promotion, there has been a resurgence of this technique. In addition, regarding sudden infant death, it has been shown that to reduce the risk it is important to place the baby in the supine position, and, precisely, the Swaddle technique can help babies adhere to the supine position.
On the other hand, it has also been shown that premature babies wrapped with this technique have better neuromuscular development, less levels of physiological distress, better motor organization and greater self-regulation. The Swaddle has also achieved a calmer sleep in premature babies by reducing crying and spontaneous arousals. In addition, it can be useful for temperature regulation, since preterm babies cannot regulate body temperature properly, but it can also cause hyperthermia if applied incorrectly.
Neonates admitted to an intensive care unit undergo various invasive procedures such as endotracheal suctioning or peripheral venous catheterization. In this regard, research has shown that preterm infants are strongly responsive to pain compared to term infants.
Pain in newborns can be controlled by pharmacological and non-pharmacological means. Pharmacological means have side effects which discourage their regular use. For this reason, research and the use of non-pharmacological procedures are important, among which is Swaddling.
ADVERSE EFFECTS OF SWADDLING
Respiratory infections- An increase in respiratory infections related to the stiffness to which the baby is exposed when swaddled has been observed. In swaddled newborns, respiratory morbidity is increased; respiratory rate and oxygen saturation are decreased while swaddled.
In addition, another study has observed that the prevalence of pneumonia or upper respiratory tract infections can increase up to 4 times in swaddled babies during the first 3 months of life, compared to those not swaddled.
Less weight gain- Swaddling the baby immediately after delivery may cause a delay in postnatal weight gain.
Sudden infant death- Swaddling babies favors the supine position, which initially decreases the risk of sudden death, but in the case of babies swaddled upside down, this risk is significantly increased, so you should stop swaddling babies when try to turn around.
The inability to awaken from sleep in response to cardiovascular stress has been described as a mechanism leading to sudden infant death. Swaddled babies have fewer sleep arousals and longer sleep times, which is a state of reduced stretchability.
Hip dysplasia- It is one of the main concerns in the use of Swaddling, since it is the main adverse effect. Hip dysplasia is one of the most common congenital disorders and has considerable socioeconomic implications.
The most common risk factors are breech presentation and family history, but postnatal mechanical factors must also be considered. The early diagnosis of hip dysplasia leads to an easier and more successful treatment, which is why it is especially important to take into account all the risk factors, in order to make the diagnosis as soon as possible.
Swaddling forces the hips into extension and adduction and predisposes to dysplasia. Hip dislocation occurs predominantly if swaddled at birth, prolonged swaddling also results in a higher rate of dislocation. In cases where wrapping was started later after birth, dysplasia occurs but not dislocation.