It is common that swaddling is outdated and even dangerous for a newborn practice. We decided to check if such a belief is confirmed by scientific data.

About unsafe, possible or even proven harm of swaddling is described in set articles in Media, Blogs, on sites children's clinics and profile resources For parents. Authors alone publications excites The influence of swaddling on the risk of sudden children's death syndrome (SVDS), others -On the musculoskeletal system. Some protrude exclusively against tight swaddling, but do not urge to completely abandon this practice (with them Solidarity, for example, the Ministry of Health of the Krasnoyarsk Territory), other - Against the swaddling as such, third They insist that swaddling can even be useful.

Swinging is a very ancient practice. Wrapping a newborn in strips of fabric, probably Practically Already in the 4th millennium BC. e. Information about this has reached this day, for example, in the form of vouchers - special gifts to deities. Thus, the ancient Romans created votivs of babies in diapers and used them for prayers for successful pregnancy and childbirth.

The spitting baby from the sanctuary is in the sanctuary near Cortona, the 3rd - II century BC. e. Source: Wikimedia Commons

Antique doctors explained the benefits of swaddling by the fact that it gives the baby’s body the correct shape. Greek doctor Soran Ephesian (98 - c. 138) He wrote: “You need to tie each part of the body in accordance with its natural form, and if something was shifted during childbirth, you need to fix it and bring it into a natural form.” Galen echoed to him (129 - c. 210): “When the baby is born, he necessarily comes into contact with the cold and heat and with many bodies that firmly than himself. Therefore, it is appropriate that its natural cover is best prepared by us for [different] effects. ” Later, in the 15th century, the Italian doctor Paolo Bajellardo gave instructions on how to swaddle the newborns: “Cover the baby’s head with a thin linen fabric in the form of a hood, take another piece of fabric and stretch the hands of the baby directly forward to the knees and hips, evenly giving them the form not to get pitching ... The stomach and, holding his legs, make his soles touch the buttocks to the end so that his knees can be correctly laid. "

Probably the first against swaddling He performed The Swiss physician Felix Würz, who lived in the 16th century: “I saw children born straight, but became chrome and crooked; Their mothers or nurse did not leave newborns as God created them, they wanted to make their children even more beautifully, swaddling them. But when children are swaddled with a tight fabric, they usually grow crooked; And no one will grow up more direct in their body than those that are free and whose arms and legs are free. ” The British doctor William Kadogan in the 18th century associated the swaddling with the appearance of edema in infants and the weak development of muscles in more adulthood. His compatriot and contemporary William Smelli wrote that the swaddling prevents children from breathing and eating normally, and the French philosopher Jean-Jacques Rousseau-that it causes psychological harm to newborn: “The child barely left his mother’s womb, he barely began to move and stretch his limbs when he was condemned to new bonds. <...> Where does this unreasonable custom come from? <...> This is one of the vain rationalizations of our false wisdom, which experience has never confirmed. "

The restriction of the freedom of the newborn, in which Russo saw the main danger of swaddling, is now, on the contrary, it is considered the main argument in favor of this practice. Pediatrician from the Boston Children's Hospital Claire McCarthy in the Harvard School of Medicine Explains: "Squering ... makes the child feel as if he had returned to his mother’s womb or as if he was hugged tightly." This calms the newborn and helps him fall asleep. Particularly well swaddling acts on children with neurological problems or experiencing a period of colic, as well as those born among mothers with drug addiction. A similar point of view adheres to And the American Academy of Pediatricians.

However, Australian scientists Spent An experiment showing that, although swaddling contributes to strong sleep, it itself carries certain risks. The study was attended by 27 healthy full-term babies aged three to four weeks. Parents 15 of them regularly swaddowed their children before bedtime, and 12 others slept without diaper. During the experiment, all children were swaddled, and then appreciated their sleep The method of polysonography. The study was repeated when the babies turned three months old. It turned out that in children accustomed to swaddling, the thresholds of excitement during sleep corresponded to the average in the population, but for those who were in the diaper, these thresholds increased significantly. In other words, the former did not wake up from the slightest noise, but their dream did not differ in a special strength, but the latter slept almost unbearable. The authors of the study emphasize that the increased threshold of excitement increases the risk of SVDS - sudden death from stopping the breath of a healthy baby. This is the most common The reason for the death of children aged one month to one year. Based on the data obtained, scientists concluded that the swaddling of this child who is not accustomed to this can increase the risk of such a pathology, but there is no harm to the children who are accustomed to.

However, not the entire scientific community agreed with this position. Pediatrician Bradley Tach from the University of Washington Noticethat his Australian colleagues did not experimentally prove the relationship between the increased threshold of excitement and the increased risk of the SVDS. In addition, Tach notes, in their study, scientists did not divide children into groups depending on the pose of sleep - on the side or on the back. Sleep on the side and even more so on the stomach - the main factor The risk of the SVDS, so swaddling, the pediatrician pays attention, will help to fix the child in a safe position and thereby reduce the risk of pathology. By the sum of the arguments, the Tach makes the opposite conclusion: swaddling for a while is more useful than dangerous.

At the same time, one of the risk factors of the SVDS - overheat bodies. Both Australian scientists, and Tach ignore in their reasoning the fact that the diaper is an additional layer of clothing for the baby. Neonatologist and infant sleep expert Michael Goodstein warnsthat overheating is extremely dangerous, therefore, when swaddling, it should be checked from time to time if the child has become too hot.

Finally, they note Specialists, swaddling It becomes More and more unsafe As the child learns to turn over from side to side and from the back to the stomach. If a spanned baby turns from a position on his back, it will be difficult for him to turn back without support on his hands. As mentioned above, with a dream on the side or on the stomach, the risk of child death is up to a year higher.

As for fears, related to the influence of swaddling on the development of the musculoskeletal system, here the recommendations of experts are more unambiguous. Tight swaddling with straightened legs and fixed hips, really increases the risk of developing dysplasia The hip joint - pathology caused by the insufficient development of the upper part of the femur or the wrong shape of the acetabulum of the pelvic bone. With such a disease, the thigh head does not correspond to the shape and size of the hollow, which leads to instability in the joint and in the future is fraught with restrictions in mobility, pain and lameness. Children's orthopedist Emily Dodvell Offers Consider the hip joint as a design of the ball and nest - the first should perfectly fit into the second. However, the constant restriction of the movement delays the growth of the “ball”, and he risks starting to fall out of the “nest”. At the same time, the orthopedist explains, the swaddling itself does not cause dysplasia, but only increases the risk of its appearance in those children that are already predisposed to pathology due to other factors (for example, genetics or pelvic presentation of the fetus in the third trimester, in which the legs are significantly limited in movements). About every hundredth child faces it - when examining a newborn, the pediatrician should notice the problem and send it to ultrasound diagnostics. International Institute of Hip Distribution Institute Writesthat incorrect swaddling with elongated legs can contribute to the development of pathology, but if a sledged child can bend his knees and pull them up to his stomach, there is nothing dangerous in such practice.

In 2007, scientists from the University Medical Center Utrecht in the Netherlands Published Meta analysis dedicated to various aspects of swaddling. They were interested in the influence of this practice on the behavior of the child, his physical condition and development, the risk of SVDS and some diseases. Scientists have found that swaddling did not affect the two aspects under consideration - the success of breastfeeding and the risk of rickets. This practice had a positive impact on the duration and depth of sleep, reduced the level of pain and crying rate, improved the development of motor skills in premature babies, contributed to thermoregulation and reduced the risk of SVDS in a dream in the position of lying on the back. At the same time, experts expressed concern about overheating due to swaddling, increasing the risk of SVDS in a dream in a stomach position, increased risk of hip dysplasia during a tight-risk of respiratory infections due to restriction of air circulation. Apparently, scientists noted, the swaddling is somewhat slowed down, but there is nothing dangerous in this, in their opinion,. The authors of the meta -analysis emphasized that in general, swaddling is safe and even useful if parents follow the four rules: the baby should only sleep on his back, the diaper should not close his head, his legs should be freely bend, and the child himself should not overheat.

Similar work after a year and a half Spent Scientists from the University of Daremsk in the UK who concentrated in touch between the swaddling and the quality of infant sleep. Their conclusions were similar: this practice increases the duration of calm sleep in children who are familiar to diapers, but children who have not been swaddled from birth can be susceptible to a slightly higher risk of SVDS, especially with a dream of lying on the stomach. In other words, it is safe to practice swaddling from the moment the child is born, but it can be risky for those who have already accustomed to sleep freely.

The British non -profit organization National Childbirth Trust, specializing in the popularization of an evidence -based approach to pregnancy, childbirth and parental Gives More clear terms: swaddling is safe if it is practiced from birth to the moment when the child is already able to turn over (usually this happens between the fourth and seventh months of life). At the same time, experts advise, starting to swaddle a child who has already reached the age of two to three months. National Childbirth Trust emphasizes that in any case, the legs of a sled baby should move freely, and his body should not overheat.

Thus, a unambiguous answer is, the swaddling is useful or harmful, not. On the one hand, it soothes the child and improves his sleep, and also fixes it in a safe position. On the other hand, if the child already knows how to turn over, then in the diaper he will be able to roll over from the back to his side or even his stomach, but not back, and this is fraught with an increased risk of SVDS. Therefore, with the advent of such a skill, experts advise stopping swaddling and not at all swaddling children who are not used to this from birth. From the point of view of orthopedics, more and more clearly: swaddling does not harm if the baby can bend the legs in the knees and press them to the stomach. To comply with this recommendation, it is enough to swaddle the upper limbs tightly, but freely - the lower ones.

Image on the cover: Engin Akyurt from Pixabay