The risk of sudden infant death syndrome doubled for children sleeping on their stomach or side when they were swaddled.
Babies who are swaddled and placed on their stomachs or sides may have an increased risk of dying from sudden infant death syndrome, according to an analysis of four studies.
Researchers found that babies who were swaddled, or wrapped tightly in a blanket or cloth, were twice as likely to die from SIDS, if they were laid on their stomachs or sides, according to the report, published in the journal Pediatrics. The likelihood of SIDS was low for those placed on their backs.
While the study in no ways says parents should stop swaddling all together, it did find that swaddling could be dangerous for older children who can move from their backs into a dangerous position while sleeping, Anna Pease, lead study author and research associate at the University of Bristol in England, said in a statement.
“On a practical level what parents should take away from this is that if they choose to swaddle their babies for sleep, always place them on their back, and think about when to stop swaddling for sleep as their babies get older and more able to move,” Pease said.
In 1992, the American Academy of Pediatrics recommended that parents should place babies on their backs, instead of their stomachs, while they sleep. According to the academy, the recommendation resulted in a dramatic decrease in SIDS. But in 2014, about 1,500 infants died from SIDS in the United States, according to the CDC.
An infant that is unable to flip from his or her back to their side or stomach can safely be swaddled, according to Chris Colby, division chair of neonatology at Mayo Clinic, who is not associated with the study. He notes that swaddling is used to mirror the constricted nature of the womb and promotes the baby falling asleep more quickly.
“The concern is that as babies get older – even tho swaddled — they could wiggle around and end up in a prone position, face-down, looking at the mattress,” Colby said. “You have to be mindful as your baby gets older, and assess if swaddling your baby tight at 2-3 months if still a safe practice.”
He notes that further research will likely be needed to assess whether there is a general rule on when parents should stop swaddling their children.
To find out the connection between swaddling a child and SIDS, researchers pored over data from four studies which spanned over two decades and covered areas in England, Tasmania and Chicago, Ill. The studies included 760 infant deaths which were attributed to SIDS, out of a total group of 2,519 babies.
One of the biggest limitations of the study was that none of the studies gave the same definition of swaddling, Pease said in a statement.
“We only found four studies and they were quite different, and none gave a precise definition for swaddling making it difficult to pool the results,” Pease said. “We did find, however, that the risk of SIDS when placing infants on the side or front for sleep increased when infants were swaddled.”
Colby notes the main takeaway is to reemphasize that a baby should always be placed on their back to sleep and never face down.