This subject is as logical as it is difficult to deal with!

1. Babies have been "swaddled" (limited motion of all body parts) in utero
- but the uterus also massages them and provides stimulation, and allows
the baby to touch himself - often hands are near the face and many babies
suck their fingers, thumbs, wrists, arms, even the cord if it is nearby.

2. After birth, babies do startle when left on their backs, in bed, with
little support.  Some babies deal with this feeling of reaching out and not
finding the comfort of the uterus better than others.

3. One of the best ways to deal with this experience is to offer babies
comfort in mom's or dad's arms using Kangaroo care.

Dr. Karp is trying to offer other alternatives - and we fear that giving
parents these options will reduce the amount of time spent in interaction
with babies.  It's not that his suggestions are wrong - as much as that we
know that his endorsing swaddling and the publicity that this suggestion is
getting will lead to "sound bites" that ignore the FIRST steps a parent
should take BEFORE resorting to swaddling.

Those of us who make home visits often see the extremes of many other
suggestions:
1. Car seats are the safest place for baby ... so now babies are carried in
those hard shells instead of in parents' arms - I've even found babies in
car seats at home where they are in the car seat for many hours a day.
2. Back to sleep - so now babies are NEVER left on their tummies and don't
develop upper arm strength.
3. Babies should never be cold...so now I find babies wrapped in 2 - 3
blankets, with hats and gloves on - with a high temperature because it's
Summer or the house is very hot due to setting the thermostat at a very
high temperature "so the baby won't get cold".

Yes, I have also found swaddling very useful in specific situations - as
Dr. Karp himself stated in his note to Lactnet.  The message I believe we
are hoping to get to him and asking him to clearly communicate to his
audience is that there are OTHER steps that should be followed FIRST.

Jeanette Panchula, BSW, RN, PHN, IBCLC
NEW e-mail address: [log in to unmask]

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