Dear Naomi, Gonneke, Barbara, Susan, Dr. Jay, and all fellow Lacnetters,


>It is my VERY strongly held opinion that babies should not be swaddled
while
>they sleep and are supposed to wake up several times each night for the
first
>six to eighteen months of life.

>Sleeping long intervals is not safe nor physiologically sound.

>Doctors and others who lead parents to believe that
"sleepingthroughthenight"
>  (all one word) is the sine qua non of successful parenting are
potentially
>creating unsafe situations for babies.

Jay,
 Thank you, thank you! I couldn't have said it better or more concisely
myself,
though I keep trying.

  Naomi Bar-Yam


I completely agree that babies should not be expected to sleep through the
night.  To be sure, breastfed babies need nourishment during the night and
their moms need the stimulation to continue a robust milk flow.

However, I am a little shocked by the inflexible sound of your comments.
Helping a baby go from waking every 2 hours at night to waking every 4 hours
(and eventually even 5-6 hours)is the hope of many parents.  And, it does
not interfere with breastfeeding...the babies just feed more frequently
during the day.  In fact, many new moms develop breastfeeding problems
because of exhaustion-induced inhibitition of milk production (to say
nothing of exhaustion-induced depression, more marital problems...and even
abuse).

Snug wrapping is physiologically NORMAL for new babies.  It is one component
of the "4th trimester" as is frequent breastfeeding, rhythmic white noise,
and calming motion.  Swaddling is very similar to the tight embrace they
experience for many weeks before birth.  In fact, in many ways the world is
"too big" for our new babies.  Thant's why all native cultures around the
world "swaddle" their babies for several months (depending on the climate,
some wrap in blankets and others in confining slings...and of course, we all
"swaddle" babies with our arms when we hold them).

Help with sleeping has become especially pertinent to new parents since the
introduction of the very important "Back to Sleep" campaign.  Babies tend to
wake more frequently when they are on the back (they startle more and miss
the soothing tummy touching provided by the prone position).  Swaddled
babies sleeping on the back, however, are still treated to the cozy and
soothing feel of having their tummies embraced.  Also, the swaddling helps
to inhibit their waking because of accidental startling...all the while,
still receiving the benefit of the back position.

Swaddling also helps keep co-sleeping babies from scooting around in your
bed and lodging on a pillow or falling off.  Additionally, wrapping keeps
babies from accidentally flipping over onto their tummies (there is reliable
evidence that back sleeping babies who roll themselves over are at increased
risk of SIDS). (see the recent article in September Journal of Pediatrics
about the safety of swaddling -

Objective: The calming effects of swaddling may help infants accept back
sleeping and so reduce the risk of sudden infant death syndrome. We
hypothesized that swaddling, with minimal leg restraint, would be accepted
by postneonatal infants with minimal respiratory effects.

Conclusions: Older infants including usual prone sleepers generally accept a
form of swaddling that has minimal respiratory effects. The reintroduction
of swaddling, without restricting hip movement or chest wall excursion,
combined with supine sleeping, may promote further sudden infant death
syndrome reduction. (J Pediatr 2002;141:398-404)


Of course, a mother always has the choice of nursing her baby through the
night.  In one well studied culture, the Kung San in Botswana, moms
traditionally nurse their babies through the night (on average 4 times an
hour).

It's a parent's choice.  But, moms who are driving INTO stop signs instead
of just halting at them, or are just plain exhausted, should be given the
tools to help them get more sleep.

Harvey Karp, MD

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