The Impact of Swaddling Upon Breastfeeding: A Critical Review

Overview

Journal Am J Hum Biol

Specialty Biology

Date 2023 Feb 14

PMID 36787374

Authors

Allison Dixley

Helen L Ball

Affiliations

Soon will be listed here.

Abstract

Introduction: Many parents swaddle their infants to promote sleep and reduce night-waking, however lack of definitive evidence about the pros and cons of swaddling when breastfeeding hinders postnatal recommendations regarding this infant care practice. This review critically examines research conducted on the impact of swaddling upon breastfeeding.

Methods: Only two recent studies on swaddling outcomes have reported infant feed-type, therefore the purpose of this paper is to consider the known effects of swaddling on breastfeeding babies and their mothers. We interpret the existing literature on swaddling in terms of impact on breastfeeding physiology and behaviour during the immediate post-natal period, and as infancy progresses.

Results: Infants swaddled immediately after birth show a delay in initial breastfeeding, less successful suckling at the breast, reduced intake of breastmilk and greater weight loss compared to un-swaddled babies. Swaddling visually obscures feeding cues and reduces crying, thereby eliminating two key feeding prompts typically used by parents/carers.

Conclusions: As swaddled babies cry less, and are fed less frequently than un-swaddled babies some clinical trials position swaddling as a 'novel weight regulation tool' to combat obesity. However, in the case of breastfed babies, by reducing feed frequency swaddling may impede maternal milk production and thereby infant growth.

Citing Articles

The impact of swaddling upon breastfeeding: A critical review.

Dixley A, Ball H Am J Hum Biol. 2023; 35(6):e23878.

PMID: 36787374 PMC: 10909524. DOI: 10.1002/ajhb.23878.

References

Hewlett B, Lamb M, Shannon D, Leyendecker B, Scholmerich A . Culture and early infancy among central African foragers and farmers. Dev Psychol. 1998; 34(4):653-61. DOI: 10.1037//0012-1649.34.4.653. View

Lavner J, Stansfield B, Beach S, Brody G, Birch L . Sleep SAAF: a responsive parenting intervention to prevent excessive weight gain and obesity among African American infants. BMC Pediatr. 2019; 19(1):224. PMC: 6610994. DOI: 10.1186/s12887-019-1583-7. View

Gross R, Mendelsohn A, Gross M, Scheinmann R, Messito M . Randomized Controlled Trial of a Primary Care-Based Child Obesity Prevention Intervention on Infant Feeding Practices. J Pediatr. 2016; 174:171-177.e2. PMC: 4925185. DOI: 10.1016/j.jpeds.2016.03.060. View

Anderson G, Moore E, Hepworth J, Bergman N . Early skin-to-skin contact for mothers and their healthy newborn infants. Birth. 2003; 30(3):206-7. DOI: 10.1046/j.1523-536x.2003.00247.x. View

Harris H, Anzman-Frasca S, Marini M, Paul I, Birch L, Savage J . Effect of a responsive parenting intervention on child emotional overeating is mediated by reduced maternal use of food to soothe: The INSIGHT RCT. Pediatr Obes. 2020; 15(10):e12645. PMC: 7729434. DOI: 10.1111/ijpo.12645. View

Hodges E, Hughes S, Hopkinson J, Fisher J . Maternal decisions about the initiation and termination of infant feeding. Appetite. 2007; 50(2-3):333-9. PMC: 6609089. DOI: 10.1016/j.appet.2007.08.010. View

Anzman-Frasca S, Liu S, Gates K, Paul I, Rovine M, Birch L . Infants' Transitions out of a Fussing/Crying State Are Modifiable and Are Related to Weight Status. Infancy. 2014; 18(5):662-686. PMC: 4188402. DOI: 10.1111/infa.12002. View

Guleroglu F, Mucuk S, Ozgurluk I . The effect of mother-infant skin-to-skin contact on the involution process and maternal postpartum fatigue during the early postpartum period. Women Health. 2019; 60(6):707-718. DOI: 10.1080/03630242.2019.1707747. View

Ball H, Ward-Platt M, Heslop E, Leech S, Brown K . Randomised trial of infant sleep location on the postnatal ward. Arch Dis Child. 2006; 91(12):1005-10. PMC: 2083001. DOI: 10.1136/adc.2006.099416. View

10.

van Sleuwen B, Engelberts A, Boere-Boonekamp M, Kuis W, Schulpen T, LHoir M . Swaddling: a systematic review. Pediatrics. 2007; 120(4):e1097-106. DOI: 10.1542/peds.2006-2083. View

11.

Moore E, Anderson G . Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status. J Midwifery Womens Health. 2007; 52(2):116-125. DOI: 10.1016/j.jmwh.2006.12.002. View

12.

Bystrova K, Matthiesen A, Widstrom A, Ransjo-Arvidson A, Welles-Nystrom B, Vorontsov I . The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling. Early Hum Dev. 2006; 83(1):29-39. DOI: 10.1016/j.earlhumdev.2006.03.016. View

13.

Franco P, Seret N, Van Hees J, Scaillet S, Groswasser J, Kahn A . Influence of swaddling on sleep and arousal characteristics of healthy infants. Pediatrics. 2005; 115(5):1307-11. DOI: 10.1542/peds.2004-1460. View

14.

Scarborough D, Boyce S, McCain G, Oppenheimer S, August A, Strinjas J . Abnormal physiological responses to touch among children with persistent feeding difficulties. Dev Med Child Neurol. 2006; 48(6):460-4. DOI: 10.1017/S0012162206000995. View

15.

Wen L, Baur L, Simpson J, Rissel C, Wardle K, Flood V . Effectiveness of home based early intervention on children's BMI at age 2: randomised controlled trial. BMJ. 2012; 344:e3732. PMC: 3383864. DOI: 10.1136/bmj.e3732. View

16.

McKenna J, Mosko S, Richard C . Bedsharing promotes breastfeeding. Pediatrics. 1997; 100(2 Pt 1):214-9. DOI: 10.1542/peds.100.2.214. View

17.

Tennekoon K, Arulambalam P, Karunanayake E, Seneviratne H . Prolactin response to suckling in a group of fully breast feeding women during the early postpartum period. Asia Oceania J Obstet Gynaecol. 1994; 20(3):311-9. DOI: 10.1111/j.1447-0756.1994.tb00476.x. View

18.

Shloim N, Vereijken C, Blundell P, Hetherington M . Looking for cues - infant communication of hunger and satiation during milk feeding. Appetite. 2016; 108:74-82. DOI: 10.1016/j.appet.2016.09.020. View

19.

Edstedt Bonamy A . Breastsleeping or not?. Acta Paediatr. 2015; 105(1):23. DOI: 10.1111/apa.13263. View

20.

Bailey C, Tawia S, McGuire E . Breastfeeding Duration and Infant Sleep Location in a Cohort of Volunteer Breastfeeding Counselors. J Hum Lact. 2019; 36(2):354-364. DOI: 10.1177/0890334419851801. View