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Swaddling: Unexpected Deaths Are Uncommon but Safe Sleep Precautions Still Vital

February 07, 2014

Washington, DC – A study from Children’s National Health System is breaking ground in trying to understand the safety of wearable blankets and swaddle wraps, an area where there is currently minimal data.

Published online in The Journal of Pediatrics, the study found that the reporting of sudden unexpected deaths among swaddled infants is rare but that swaddling should not take away from creating a safe sleep environment, such as having their babies sleep on their backs.

Study details
The team, consisting of Children’s pediatric resident Emily McDonnell, MD, and pediatrician and Sudden Infant Death Syndrome (SIDS) researcher Rachel Moon, MD, reviewed incidents reported to the Consumer Product Safety Commission from 2004-2012. Although an estimated 5 million swaddle wraps have been sold in the United States, reports of injury and death associated with wearable blankets, swaddle wraps, and ordinary blankets are rare.

Overall, only 36 incidents were registered and reviewed. Of those cases, 10 infants died while wearing swaddle wraps and wearable blankets and 12 infants died while swaddled in an ordinary blanket. Eighty percent of the deaths were in infants who had been placed onto or who rolled onto their stomachs. Seventy percent of the cases had additional risk factors like soft bedding.

For parents: be cautious and maintain a safe environment
 “Our preliminary conclusions about infant safety, wearable blankets and swaddling still reinforce the idea that parents should continue to place their infants to sleep on their backs,” said Dr. Moon.

She advises parents to:

  • Be cautious when swaddling, ensure that all fasteners are secure
  • Never place a swaddled (or unswaddled) infant on the baby’s side or stomach for sleep
  • Stop swaddling when the infant tries to roll
  • Keep baby’s sleep environment safe by using approved cribs or bassinets that are free from soft bedding or other objects that could lead to suffocation

Currently the American Academy of Pediatrics recommends against the use of bedding in an infant’s sleep space but wearable blankets may be used.

Contact: Emily Hartman or Caitlyn Camacho, 202-476-4500.

About Children's National Health System

Children’s National Health System, based in Washington, D.C., has served the nation’s children since 1870. Children’s National is one of the nation’s Top 5 pediatric hospitals and, for a second straight year, is ranked No. 1 in newborn care, as well as ranked in all specialties evaluated by U.S. News & World Report. It has been designated two times as a Magnet® hospital, a designation given to hospitals that demonstrate the highest standards of nursing and patient care delivery. This pediatric academic health system offers expert care through a convenient, community-based primary care network and specialty outpatient centers in the D.C. Metropolitan area, including the Maryland suburbs and Northern Virginia. Home to the Children’s Research Institute and the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is the seventh-highest NIH-funded pediatric institution in the nation. Children’s National is recognized for its expertise and innovation in pediatric care and as a strong voice for children through advocacy at the local, regional and national levels. 

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