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Why Swaddling and When To Stop Swaddling

Maria with baby Jesus in swaddling clothesHow does swaddling work? Why, in order to be effective, should it be tight? Why are light cotton swaddling blankets better than thick and warm ones, if swaddling makes babies feel warm and snug, as many medical sources claim? Mainstream medicine still cannot provide answers to these questions (see a recent medical review below - van Sleuwen et al, 2007), but leading Soviet physiologist Dr. Konstantin Buteyko, while working in the Institute of Experimental Medicine and Physiology (Novosibirsk, USSR), provided a simple and sensible explanations. Swaddling prevents and stop hyperventilation and upper chest breathing. In other words, they breathe slower and less air, but using mainly the tummy (diaphragm) for better blood, brain and body oxygenation. These factors improve cell oxygenation, sleep, digestion, and other quality of life factors, stopping and preventing SIDS (sudden infant death syndrome), rashes, digestive symptoms, and many other health problems.

Before the baby is born, the fetus gets all its blood supply from the mother through the umbilical cord. This includes CO2 and O2. Because of this, the breathing of the fetus depends solely on the mother’s breathing. Birth itself is a severe shock for the baby. Probably, the central part of this shock is a drastic change in air composition: a drop (about 30%) in blood CO2 concentrations. The process of delivery and new environmental conditions cause severe stress and make their breathing heavy. In order to make the transition more gradual, all primitive and recent cultures used swaddling (or tight wrapping) of babies to stop their hyperventilation. 

When meeting people born and raised on different continents, I was reassured that swaddling was the norm in Africa, America, Europe and Asia. In Asia, due to hot climate, they used, instead of clothes, wooden sticks, which were applied along the trunk and tightly tied using ropes. In Scotland, swaddling blankets were passed from generation to generation.

"But the cells of animals and humans need about 7 % CO2 and only 2% O2 in the surrounding environment. This is the way our cells live: cells of the heart, brain, and kidneys. But now air has 10 times more oxygen and 250 less carbon dioxide, i.e., it is not suitable for our cells and is poisonous in its composition. This is confirmed by embryology. During recent years detailed studies of gas blood exchange in embryos of humans and animals were done. It was found that during 9 months we live in an environment, which has 3-4 times less oxygen and 1.5 times more CO2 (both as partial pressures) in comparison with adults. Obviously, the organism of the mother creates such conditions for the embryo, as they were billions of years ago. This supports the Law of Gekkel-Severtsev: the embryon, in its development, repeats the filogeneses.
After birth, during the first breaths, there is a sudden increase in blood oxygenation and a sudden drop in CO2. It is known that the child is virtually disease-free in the womb of the mother. Only after the birth, do diateses and all other abnormalities of metabolism appear. Why? There is a sudden change in air. The wisdom of East surprises us: the just-born infant is tightly swaddled, and in some places even tightened to a wooden plate. The chest is covered by layers of heavy material [voilok]. Our grandmothers covered the cradle with the infant using material covering [leaving a small hole for air exchange], and used swaddling too… Folk wisdom understood, that this air, so poisonous for the newborn, requires gradual adaptation." Dr. Buteyko lecture in the Moscow State University on 9 December 1969"

When to Stop Swaddling

The answer depends on physical exercise and breathing patterns of the baby. If the baby is involved in large amount of daily physical exercise with strictly nose breathing (for effects of mouth breathing in children, see Mouth Breathing in Children), and if the baby's body oxygen level remains high, swaddling is not necessary.

Bear in mind that unswaddled babies will hyperventilate if they sleep in a supine position. If you notice that the baby tries to turn and sleep in a prone position (on the tummy), it can be used as a natural sigh to stop swaddling.

Covering a cradle with a blanket and leaving only a small hole for gas exchange (e.g., about square inch in size for small and medium cradles) is another technique to ensure high body oxygenation and excellent health in babies. Note that even older children, when conditions are not hot or warm, like to hide under a blanket. It is not just a feeling of safety, but higher CO2 that makes this method effective. Puppets of wild dogs and many other animals also grow for many months in dens and borrows at very high CO2 levels (up to 5-7% and even more).

To measure the body oxygen level, one needs to observe how long time the baby can easily remain under water (diving). Diving is the best therapy and in excellent form of exercise to improve body-oxygen levels in babies in order to slow down their automatic breathing at rest.

One may also measure the respiratory rate of the baby during sleep. While respiratory rates is babies are normally high, healthy babies with higher body-oxygen content have slower breathing. Ideally, it should be near the minimum normal breathing rates for babies.

Respiratory Rate Chart for Babies, Newborn, Infants, and Toddlers
Groups and ages Normal respiratory rates
Newborns to 6 months old 30-60 breaths/min
6 to 12 months old 24–30 breaths/min
1 to 5 years old 20–30 breaths/min

References
Buteyko KP, Lecture in the Moscow State University, Soviet national journal Nauka i zshizn'; [Science and life], Moscow, issue 10, October 1977.

Van Sleuwen BE, Engelberts AC, Boere-Boonekamp MM, Kuis W, Schulpen TW, L'Hoir MP, Swaddling: a systematic review, Pediatrics. 2007 Oct;120(4):e1097-106.
Department of Medical Psychology, Wilhelmina Children's Hospital, University Medical Center Utrecht, KA.00.004.0, PO Box 85090, 3508 AB Utrecht, The Netherlands.
Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and The Netherlands to curb excessive crying. We have systematically reviewed all articles on swaddling to evaluate its possible benefits and disadvantages. In general, swaddled infants arouse less and sleep longer. Preterm infants have shown improved neuromuscular development, less physiologic distress, better motor organization, and more self-regulatory ability when they are swaddled. When compared with massage, excessively crying infants cried less when swaddled, and swaddling can soothe pain in infants. It is supportive in cases of neonatal abstinence syndrome and infants with neonatal cerebral lesions. It can be helpful in regulating temperature but can also cause hyperthermia when misapplied. Another possible adverse effect is an increased risk of the development of hip dysplasia, which is related to swaddling with the legs in extension and adduction. Although swaddling promotes the favorable supine position, the combination of swaddling with prone position increases the risk of sudden infant death syndrome, which makes it necessary to warn parents to stop swaddling if infants attempt to turn. There is some evidence that there is a higher risk of respiratory infections related to the tightness of swaddling. Furthermore, swaddling does not influence rickets onset or bone properties. Swaddling immediately after birth can cause delayed postnatal weight gain under certain conditions, but does not seem to influence breastfeeding parameters.

References

  1. Swaddling (From Wikipedia.org)
  2. How to Swaddle a Baby (From Parenting.com)
  3. Swaddling: Is it Safe? (From HealthyChildren.org)

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