Soothing and Safe: How to Swaddle a Newborn
There's a moment in the maternity ward when a nurse folds a square of muslin around your baby in four unhurried movements, and the crying simply stops, and you look at her as though she's done a card trick.
It isn't a trick. It's a good piece of fabric and a few folds that your own hands will learn much faster than you expect. I've taught it to all five of my children when their babies came, and to a Swedish son-in-law who was sure he'd never manage it.
Muslin is the usual fabric for it. It's thin, as the safe-sleep guidance says it should be, and in a climate like ours a thin cloth over a light layer is most of the skill. A thin cloth isn't a safety feature on its own, though. Anything that reaches her face is a risk whatever it's made of, so the rules further down count for more than the fabric does.
What do you need before you start?
Very little: a surface she can't roll or fall off, with one of your hands on her the whole time, a baby who's fed and drowsy (not furious), and one large square of thin muslin. Our full-size bamboo swaddles are cut big enough to tuck in properly, so you can start with a single one in a print you like before you buy a set.
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Wrap her after a feed and a clean nappy, just before she drifts off. If she's a spitter and you'd like to hold her upright for a little while first, do that while she's awake, and then lay her down to sleep flat on her back as always. Do it the same way each night and the wrap becomes part of the bedtime routine, and babies pick up routines like that very early.
How do you swaddle a newborn step by step?
This is the diamond wrap, the one taught in maternity wards the world over, and the one my mother used. Words are a poor way to learn a fold, so look at the AAP's swaddling page alongside this, or better still ask the nurse or midwife to watch you do it once before you go home. Read it through by daylight, and keep it open beside the cot for the first few evenings, because nobody remembers step three at midnight.
- Lay the swaddle flat as a diamond and fold the top corner down to make a straight edge.
- Place your baby on her back, shoulders just below the fold, head clear of the fabric entirely.
- Ease her left arm straight, draw the left corner across her body and tuck it beneath her right side.
- Bring the bottom corner up over her feet, leaving it loose around the hips so her legs can bend and fall open.
- Draw the right corner across her body and tuck it snugly under her left side: firm over the arms, loose at the hips.
Snug at the chest, loose at the hips. Two or three of your fingers should slide easily between muslin and chest.
How tight should a swaddle be
Firm enough to stay in place through a night of wriggling, but never so tight that it presses her legs straight or makes her work to breathe. Her hips need room to fall open into a little frog shape. A swaddled baby always sleeps on her back, in a cot with nothing else in it.
Warmth is the other thing to watch. On our warm nights, one layer of muslin over a nappy or a light onesie is enough. Feel the back of her neck: if it's damp, she's too warm, so take a layer off. And stop swaddling altogether at her first attempt to roll, whatever her age, since the AAP notes some babies try from about two months.
If the folding beats you at three in the morning, there's no shame in that, because it has beaten me too. A velcro swaddle wrap holds the arms gently, leaves plenty of room at the hips, and needs nothing from you but two soft fastenings.
Swaddling is considered safe for a newborn when a few rules are followed, and they count for more than how neat your folding is. They come from the AAP and The Lullaby Trust, so read the whole list once, carefully.
Why the hips matter
A newborn's hip joints are still forming, and the way they're held affects how they form. Wrapping the legs straight and pressed together, which a tight wrap does if you aren't thinking about it, raises the risk of developmental dysplasia of the hip, where the joint doesn't sit properly in its socket. That's the one thing the old way of wrapping got wrong. I'm told it got other things wrong too, though I never noticed them.
This isn't folklore. In 2007 van Sleuwen and colleagues reviewed the swaddling research for the journal Pediatrics. They found the hip risk comes from wrapping with the legs straight and pressed together, not from swaddling itself, and the International Hip Dysplasia Institute's guidance makes the same point.
That's the good news. You don't have to choose between a settled baby and healthy hips: a wrap that's firm over the arms and chest and loose below the waist gives you both, and it costs nothing.
So leave her legs free to bend into that little frog shape and kick. If you only remember one thing about swaddling safety, make it this: snug at the top, loose at the bottom.
If the wrap will not hold, or she objects to it
When not to swaddle
Don't swaddle in any of these cases, whatever anybody's aunt tells you.
- Once she's tried to roll, or once she keeps fighting her way out.
- During skin-to-skin time, which works best with her unwrapped against you.
- While feeding, especially in the early weeks, because babies use their arms and hands to latch and to show you what they want.
- When she's unwell or has a temperature, because the last thing she needs is extra heat.
- When she clearly dislikes it. Some babies settle better with their arms free from the start. That's a preference, not a problem to fix.
When the swaddle alone isn't enough
A wrap calms the startle reflex, and for many babies that's most of the battle. When it isn't enough, the instinct is to wrap tighter. That's the wrong instinct, and I had it for years. Adding one or two other kinds of comfort usually does more.
- Hold her on her side or over your shoulder to settle her, then lay her in the cot on her back to sleep.
- Steady, low sound: not silence and not loud, more like the household hum she heard before birth.
- Movement. Slow and rhythmic works better than fast and bouncy: walking, rocking, or pushing the pram up and down a corridor.
- Something to suck on, once feeding is going well and a dummy won't interfere with it.
- Sometimes less, not more. An overstimulated baby needs a dim room and quiet, not another technique.
- Check the simple things first: hungry, wind, nappy, too warm. In that order, most evenings.
If the crying pushes you past your limit, put the baby down somewhere safe and leave the room for a few minutes. That's the right thing to do, not a failure. Decide now, in daylight, that you'll do it, before you ever need to.
Once swaddling is part of your evenings, a set of two or three means there's always a clean one in the drawer while another dries. Practise a few times in daylight first, and soon your hands will know the folds without you having to think.
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What I read before I wrote
- van Sleuwen et al. (2007), Pediatrics 120(4):e1097-e1106: Swaddling: A Systematic Review
- International Hip Dysplasia Institute: Hip-Healthy Swaddling
- The Lullaby Trust: Swaddling and slings
- American Academy of Pediatrics (HealthyChildren.org): Swaddling: Is it Safe for Your Baby?
- The Lullaby Trust: Swaddling
- NHS: Reducing the risk of sudden infant death syndrome
This guide is general information, written to help you understand a topic and ask better questions. It is not medical advice and does not replace your own doctor, midwife or paediatrician. Anything that worries you about your baby belongs with them.
Read next: What Is Swaddling? The Complete Guide · Why Some Families Swaddle, and When Not To
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