I've worked in a small hospital birthing center for going on 11 years. I've  
been teaching parents how to calm babies for quite a while.  And the nurses  
at our hospital all swaddle babies fairly firmly.
 
But I've noticed that often in the first few days parents often ignore a  
baby who is swaddled and either in one of those plastic cribs, or in someone's  
arms.  The baby comes up into light sleep with small motions of the face  and 
extremities.  The baby often sinks back down into a deeper sleep.   And the 
parents pretty much ignore this change in state.  If the baby has  not been to 
the breast in two or more hours I point it out to the parents this  change as a  
time that they can unwrap the baby and help the  baby to a more alert state 
so that the baby can feed.  
 
I can't tell you how many parents seem content to let that baby  continue to 
sleep and not eat.  I have noticed over the years that if you  try to wake the 
baby from a deep sleep, even using the doll's eyes technique I  learned in 
the 80's (baby supine on your lap/thighs brought up to sitting  position, down 
to supine, up again until the eyes stay open and the baby is  alert) babies who 
are awoken from deep sleep might get all the way to  mouth-open-on-the-breast 
and then just fall back to sleep.  Often 15 - 20  minutes later the baby has 
awoken and then will nurse fine.  
 
So I've made a point of teaching the parents to look for a light sleep  stage 
and then to unwrap and wake the baby by laying him supine on a flat  surface 
(like the bed) talking to him, touching her, or changing the  diaper.  So I 
guess I have issues with the suggestion to wake the baby  every two hours as a 
way to counsel  that the baby be fed so that the baby  sleeps more during the 
night time hours.  Those every two hours might not  coincide with the baby's 
light sleep stages and cause the parents to become  concerned and demoralized. 
Parents can get desperate trying to wake a baby  from deep sleep to get them on 
the breast especially when they've been told by a  physician or nurse that 
the baby needs to feed more often.  I'd  seen that in my earlier years when I 
didn't know what I know now.
 
I've read that often newborns might sleep one 4 -5 hour stretch in a 24  hour 
period.  So if a baby has done this -- and it's often from 7 or 8  Am to 11 
AM or 12 PM  -- I strongly suggest that they watch the baby  carefully the rest 
of the day for that active sleep stage and help them  wake.  In these early 
days swaddling can appear to work against  breastfeeding adequately especially 
if no one tells the parents what to watch  for and how to help a baby awaken 
and actively feed. Even after working hard to  waken a baby some babies drift 
of quickly. As I know it's been suggested on  Lactnet  rubbing the baby's palm 
or foot seems to keep that jaw moving  rhythmically.  When a baby is kept 
skin-to-skin its been shown that they  seek the breast more often, not less. 
 
I think after the initial days after the milk is abundant and the baby  
thriving it might be fine to swaddle the baby who appears to have a very active  
sleep stage where his own movements awaken him.
 
Mardrey Swenson


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