Sudden infant death syndrome (SIDS) is the unexpected death of an infant less than 1 year old. It is rare during the first month of life, then it peaks at 2-4 months of age and gradually decreases. Experts do not know the exact cause of SIDS.
Swaddling is a practice used to wrap infants in cloth to mimic the mother's womb and promote calm and sleep. Researchers wanted to conduct an individual meta-analysis of SIDS risk for infants swaddled for sleep. The study, published in the journal Pediatrics, found that current advice to avoid front or side positions for sleep especially applies to infants who are swaddled. Consideration should also be given to an age after which swaddling should be discouraged.
The systematic review included 4 observational studies evaluating the association between swaddling and risk of SIDS in 2,519 infants. Swaddling in all groups peaked at 2 months of age and dropped off steeply between 4 and 6 months of age. SIDS was reported in 760 infants.
A meta-analysis revealed that the risk of SIDS from swaddling varied according to position placed for sleep:
The risk also increased with age with the highest risk associated with infants aged 6 months or older.
A meta-analysis is a mathematical method that combines the results of several smaller studies in order to improve the reliability of the results. Studies chosen for inclusion in a meta-analysis must be similar in a number characteristics in order to accurately combine their results. In this analysis, the observational studies were not similar enough to be combined and compared, making the end result less reliable. For example, none of the studies gave a precise definition of swaddling. The trials were also observational studies which can show some potential link between 2 factors but cannot show cause and effect. So while this study showed a potential connection between swaddling and SIDS in infants 6 months and older, it can not confirm that swaddling was the cause.
If you have a newborn, talk to your child's doctor about swaddling your child. The American Academy of Pediatrics recommends that parents do not put any loose blankets in a baby's crib. It could become unwrapped and increase the risk of suffocation. Swaddling should also stop once an infant can roll over. Furthermore, infants should only be put to sleep on his or her back.
Healthy Children—American Academy of Pediatrics
Kids Health—Nemours Foundation
Pease AS, Fleming PJ, et al. Swaddling and the risk of sudden infant death syndrome: a meta-analysis. Pediatrics. 2016 Jun;137(6). Available at: http://pediatrics.aappublications.org/content/137/6/e20153275.long. Accessed July 24, 2017.
Sudden infant death syndrome (SIDS). EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T113764/Sudden-infant-death-syndrome-SIDS. Updated June 16, 2017. Accessed July 24, 2017.
Last reviewed July 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP