Many medical experts were consulted during the development of the Ultimate Swaddling Blanket - Infant Researchers, Orthopedic Physicians, Pediatricians, Nurses, and Infant Developmental Specialist. We also consulted Lactation Consultants and Breastfeeding Experts. Nearly all felt it was important that babies - especially very young babies and preemies - have their hands up on their chest, midline inside the swaddle. However, not all experts agree about hand position. Dr. Karp believes hands placed down by sides is the best way to calm baby, promote sleep, and to keep the wrap secure. The babies in Dr. Bradley Thach's 2002 study were all 3 months old (give or take a week) and for his study, they were swaddled with hands by sides.
We have gathered the following information for your decision making when swaddling your baby.
Hand to Mouth is a Natural Reflex
- The normal infant has been observed post delivery to get hands to his mouth within 30 minutes.
- Infants are equipped with the hand-to-mouth reflex also known as the Babkin reflex.
- Many babies suck their thumbs or fingers inutero.
Baby able to Self-Soothe by Sucking
- Sucking is the most organizing behavior of the newborn.
- Provides for state (sleep/wake) control.
- Enhances the maturity of the baby including hand movements and gastrointestinal function.
Early Communication
- Baby cues caregiver when hungry by rooting (sucking vigorously) on hands or fingers.
When your baby is brand new, you may want to consider swaddling baby with hands up on chest until breastfeeding is well established. After about 2 weeks or so, or when your baby grows stronger and more active, you may want to consider swaddling with hands down inside the swaddle by the sides and with elbows gently flexed. Remember to always keep baby's hips and knees flexed in the swaddle for proper joint development.
Every baby is unique. Ask your pediatrician about swaddling your baby. Different techniques work for different babies. If your baby happens to get his or her arms(s) out of the swaddle and is unhappy that way (some babies are content with arms out), you may want to try another technique. You may want to try swaddling with one hand up by face and the other down across the tummy or down by leg with elbow fixed, alternating arms each time you swaddle. The third choice is to swaddle with both arms down, keeping the elbow joint flexed and allowing more time out of the swaddle.
Infant researchers state it's in baby's best interest to have the baby's hands accessible to face, however it is your decision as a parent to choose how and if to swaddle your baby.
"Infants need access to their hands for self-soothing. Sucking is the most orientating behavior for a newborn, and the normal newborn has been observed post delivery to get his hand to his mouth within thirty minutes of birth. By vigorously sucking on his hands, a baby can communicate with a caregiver that he is hungry, and as such, sucking is one of the first baby cues or early forms of communication."
Dr. Kathryn Barnard, PhD, FAAN,
Winner of the Gustav O. Lienhard award and leading infant researcher
"Thumb sucking is a healthy self-comforting pattern. A fetus sucks his thumb. A newborn is equipped with the hand-to-mouth, or Babkin reflex. When he is upset or trying to settle down, he will resort to this as a way of controlling himself. The pattern seems built in. Babies who make use of it are easier to live with."
Dr. T. Berry Brazelton, MD, author of "Touchpoints – The Essential Reference"
"A new baby's natural position is with her arms bent at the elbow and her legs flexed. Wrap her like this, making no attempt to straighten her out before you start. Above all, leave her hands where she can suck them if she wants and is able to do so."
Penelope Leach, PhD, author of "Your Baby and Child"
"As founder of the Becoming Parents Program, I am a strong advocate of educating both the practicing medical community and new parents using the latest research. It is common for the practicing medical community to be unaware of the recent research with a lag of 10-15 years. I am a hearty supporter of SwaddleDesigns because their blanket is helping nurses, doctors, parents and caregivers learn how to swaddle using the hands up by face technique. Parents have so much to learn as they make the transition to parenthood. It can be overwhelming for both the new mother and the father. Our Becoming Parents Program is designed to help the hospital education and community service professionals to deliver effective courses with up-to-date information to help young men and women become parents - and I strongly advocate that parents use the SwaddleDesigns blanket because it is the optimum size and shape for swaddling and as an educational aid - it truly makes swaddling easy to learn.
Pamela Jordan, RN, PhD, Founder of Becoming Parents Program
"As an Orthopedic physician, I am happy to see your blanket's 123 SwaddleTM Tip Tag shows the hands up by face swaddling technique. Orthopedists have a strong bias that baby's hips, knees and elbow joints be in a flexed position when swaddled for proper joint development. We become concerned with over extension of the elbow joint when it is straight down by baby's side."
Dr. Larry Holland, Orthopedic Physician
"I definitely recommend that a baby be swaddled in a natural position with elbows bent, hips and knees flexed for proper joint development."
Dr. Bill Wagner, Orthopedic Physician
Theresa Kledzik, RN, Infant Developmental Nurse Specialist
What is the purpose of swaddling?
To assist the infant in achieving and maintaining motor control, which in turn has a regulatory effect on autonomic and state function. In other words, breathing, heart rate, and color will normalize, as well as the infant's ability to transition from a fussy or crying state to a quiet awake or sleep state.
How should I swaddle a baby?
The baby should be swaddled with the arms bent, brought to midline, and accessible to his (or her) face. With this positioning, the infant is supported in his ability to self-console by bringing hands to face and mouth. A caregiver's dual purpose is immediate consoling as well as long-term support of the infant to achieve his own goals of self-regulation and self-calming. The palms of the hands and the area around the mouth are very sensitive and potent sources of stimulation. Rather than deprive the infant of this access, support it.
How tight should the developmental swaddle be?
The developmental swaddle is intended to support the infant's efforts to achieve and maintain regulation. It is not intended to be a restraint. The blanket wrap should be snug, but not too snug to allow the infant to move.
How can I maximize the effects of a developmental swaddle?
Hold the baby. Be attentive to cues of over stimulation and stress while offering stimulation. These subtle infant behaviors, such as looking away, sneezing, hiccoughing, and color changes, are early indicators of an infant reaching his threshold of sensory stimulation. Reducing the stimulation at this point may help the infant maintain regulation. If the threshold has been exceeded, reduce the stimulation and console the baby (while swaddled) to restore regulation.
The information contained on this website is intended to complement, not substitute for, the advice of your child’s pediatrician. Consult with your own pediatrician who can discuss your individual needs and counsel you.