CLAIM:
Tightly swaddling a baby to 'straighten' their hands and feet is harmful and unnecessary. Swaddling should be done loosely to manage reflexive movements, not to forcefully shape a baby’s limbs.
FACT:
Swaddling can help newborns sleep better by reducing their startle reflex, but it must be done safely. Studies show that improper swaddling, especially when babies sleep on their stomach or when the legs are wrapped too tightly, can increase the risk of SIDS and hip problems. Always swaddle loosely around the hips, keep the baby on their back, and stop once they begin to roll.
In a viral reel posted by Dr Imran Patel, a paediatrician, the doctor addresses a common parenting practice — swaddling, and whether it should be done tightly. The reel opens with Dr Imran introducing a 2-and-a-half-month-old baby, as he explains to viewers and the child’s mother why certain traditional methods of tying or wrapping infants can be harmful.
In the video, Dr Imran says, “Hello everybody, this is 2 and a half months hero.” He then shares what the mother was told at home, that the baby should be wrapped tightly so that her hands and feet “stay straight” and do not become crooked. Demonstrating the common technique, he adds, “It is tied in such a way that the hands and feet are pulled tight and then the cloth is tied.”
He immediately clarifies why this approach is incorrect, shifting into an explanatory mode for the audience. Dr Imran tells the mother that babies naturally exhibit primitive reflexes, especially the Moro reflex, which causes their hands to suddenly open even with slight movement. “This is why babies sometimes wake up suddenly,” he explains, emphasising that swaddling is meant to gently control reflexive movements, not to forcefully straighten limbs.
Setting the record straight, he adds, “As children grow, their legs automatically become straight. Tying them tightly will not make them straight; that is an illusion.”
The reel has managed to gain massive traction, amassing 2.47 crore views, over 11.7 lakh likes, and nearly 3 lakh shares, sparking widespread discussion among parents about safe swaddling practices.
What is swaddling?
Swaddling is the practice of wrapping a baby snugly in a cloth or blanket so that their body is wrapped securely while the head remains free. The gentle pressure created by the wrap mimics the cosy environment of the womb, which is why many newborns find it calming.
This soothing technique has been used across cultures for thousands of years, and researchers have studied its effects on infant sleep and behaviour for decades.
The effectiveness of a swaddle comes from how it gently limits a baby’s movements. In scientific terms, some studies describe this as a form of “motor restraint” — essentially, restricting sudden limb movements that can trigger the Moro reflex, also known as the startle reflex. This reflex is present from birth and typically lasts until around 3–6 months of age. It causes babies to abruptly extend their arms or legs in response to loud sounds or unexpected movements.
Is swaddling safe?
One study titled ‘Influence of swaddling on sleep and arousal characteristics of healthy infants’, conducted on 16 healthy infants aged 6–16 weeks, investigated how swaddling affects sleep patterns and responsiveness to environmental stress. Using overnight polygraphic recordings, researchers found that swaddling increased sleep efficiency, encouraged more non-REM sleep, and reduced spontaneous awakenings.
However, the study also noted that “significantly less-intense auditory stimuli were needed during rapid eye movement sleep to induce cortical arousals when swaddled than when not swaddled”, meaning infants woke up or reacted more easily to even softer or quieter sounds when they were swaddled.
The authors concluded that “swaddling promotes more sustained sleep and reduces the frequency of spontaneous awakenings, whereas induced cortical arousals are elicited by less-intense stimuli. These findings could indicate that, although swaddling favours sleep continuity, it is associated with increased responsiveness to environmental auditory stress.”
While this study highlighted the calming effects of proper swaddling, another piece of research focused on safety risks, especially in relation to sudden infant death syndrome (SIDS). A 2016 individual-level meta-analysis examined four observational studies assessing whether swaddling increased SIDS risk. The pooled analysis found an age-adjusted 1.58 times higher risk of SIDS in swaddled infants, though results varied by sleeping position.
Crucially, the risk was highest when swaddled infants slept prone (on the stomach) with an odds ratio (OR) of 12.99, followed by side sleeping (OR 3.16) and supine sleeping (on the back) (OR 1.93). Limited evidence also suggested that swaddling became riskier as babies grew older, especially beyond six months.
The authors warned that “current advice to avoid front or side positions for sleep especially applies to infants who are swaddled. Consideration should be given to an age after which swaddling should be discouraged.”
While the study doesn’t clearly explain why the risk increases, experts suggest that a tightly swaddled baby may struggle to lift their head if they experience breathing difficulty. And, if the swaddle becomes loose while the baby is lying face down, it could raise the chances of accidental smothering.
Beyond SIDS concerns, experts have also raised alarms about the impact of tight leg binding on hip development. Traditional swaddling, especially when the legs are wrapped straight, has long been associated with developmental dysplasia of the hip (DDH), a condition where the hip joint does not form properly.
A 2020 Indian study surveyed 364 participants, including paediatricians, nurses, and caregivers. It found that 90 pc of caregivers practised traditional tight swaddling, often for more than 10 hours a day, starting from birth. Many believed the practice helped keep the baby’s legs straight. However, awareness of hip-safe swaddling was extremely low — only 6.6 pc of paediatricians, 4 pc of caregivers, and none of the nurses had heard of it.
The study concluded that “traditional swaddling of infants is a practice deeply rooted in India, born out of misbeliefs, and propagated by lack of awareness. Training in hip-safe swaddling targeted at nurses and Paediatricians would be an effective initial step in creating awareness among mothers and changing their practices.” In short, swaddling is generally safe when done correctly.
What is the right way to swaddle the baby?
Swaddling can be soothing for some infants, but it’s important for parents to follow safe practices. Babies do not need to be swaddled, and if your child sleeps comfortably without it, you can skip it altogether.
If you choose to swaddle, always place your baby on their back to sleep, as this is especially crucial when they are wrapped. The swaddle should be snug enough to stay in place but not so tight that it restricts breathing or movement; loose fabric can be hazardous. Parents should also avoid overheating by not layering too many warm clothes or blankets.
Additionally, the baby’s hips and legs should have enough room to bend and move, since overly tight wrapping around the lower body can affect healthy hip development. For longer periods of swaddling, such as both day and night, using a swaddle-style sleep sack that allows freer leg movement is a safer option. Finally, swaddling should stop once the baby shows any signs of rolling over, as this significantly increases the risk of suffocation.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS.
