Swaddling — the age-old practice of wrapping infants snugly in cloth — is still commonly seen among new parents today. My students and patients often ask about it, wondering whether it helps babies sleep, whether it’s safe, and how it affects breastfeeding. It’s a practice that feels comforting and intuitive to many families, but it also carries physiological implications that need to be better understood.

Here are some key things every lactation professional should know about how swaddling influences breastfeeding, sleep, and newborn outcomes — and what the evidence really tells us.

Swaddling and Early Breastfeeding Success

The evidence consistently shows that swaddling in the immediate postnatal period can interfere with early breastfeeding behaviors. In a landmark randomized trial from Russia, Bystrova and colleagues (2007) found that babies who were swaddled and separated from their mothers after birth showed delayed initiation of breastfeeding, less effective suckling, reduced milk intake, and greater early weight loss than unswaddled infants. The combination of swaddling and mother–infant separation was particularly detrimental — even brief separation after birth was enough to delay recovery from physiologic weight loss.

Helen Ball and Allison Dixley (2023) reinforce this in their critical review, noting that swaddling physically blocks the sensory cues — like rooting movements, crying, and hand-to-mouth behavior — that help mothers recognize feeding readiness. They write that “swaddling obscures feeding cues and reduces crying, eliminating two key feeding prompts.” This, in turn, reduces feeding frequency and may impede milk production.

In contrast, infants who experience skin-to-skin contact immediately after birth are more likely to latch effectively, breastfeed longer, and gain weight more steadily. Skin-to-skin supports what Lupton (2013) called “skinship” — the relational and physiological synchrony between mother and baby that facilitates milk ejection, regulation of temperature and heart rate, and secure attachment.

Swaddling, Sleep, and Arousal

Swaddling is often promoted as a way to improve infant sleep — and research does show it has measurable effects on sleep states.
In their 2022 systematic review, Dixley and Ball found that swaddling increases the duration of quiet sleep and reduces the number of sleep-state transitions among infants who are new to swaddling. While this might sound positive, the authors caution that reduced arousability may also increase the risk of sudden unexpected death in infancy (SUDI), especially when other unsafe sleep conditions are present (e.g., prone position, overheating, or loose bedding).

Earlier reviews echo this concern. Nelson (2017) notes that swaddled infants have fewer spontaneous awakenings and may have increased arousal thresholds, which could impair their ability to respond to airway obstruction. Importantly, this effect is most pronounced in infants who are swaddled for the first time — suggesting that naïve swaddlers face greater risk than babies who are regularly wrapped.

This diminished arousal, combined with overheating or rolling to prone, may contribute to the observed increase in SIDS risk among older swaddled infants.

Cultural Context and Risk–Benefit Tradeoffs

Anthropological perspectives remind us that swaddling is not just a physiological intervention but a cultural practice shaped by maternal needs and social environments. Ball and Volpe (2013) observed that mothers use nighttime parenting strategies — including swaddling — to manage fatigue and balance their infants’ needs with their own physical and emotional limits. In this light, swaddling can be understood as a maternal coping tool rather than a purely infant-focused practice.

However, the same research cautions that public health guidance often fails to account for these tradeoffs. Campaigns that simply advise against “risky” behaviors may overlook why parents swaddle or co-sleep in the first place — and thus fail to promote safer, realistic alternatives.

Safety Considerations and Clinical Implications

Modern evidence provides a nuanced picture:

• Potential benefits: Swaddling may help calm fussy infants, improve sleep efficiency, and support supine sleep (which itself reduces SIDS risk)

• Risks: Overheating, impaired arousal, hip dysplasia (from tight leg wrapping), and breastfeeding interference remain significant concerns
• Safe swaddling guidelines: Infants should always be placed on their backs, swaddles must allow hip flexion and movement, and swaddling should stop once the baby shows signs of rolling.

Nelson (2017) summarizes it best: “If precautions are taken — avoiding overheating, ensuring supine sleep, and discontinuing when rolling begins — swaddling presents minimal risk”.

Bottom Line

Swaddling can be both soothing and risky. While it may promote sleep, it can also delay breastfeeding initiation and reduce feeding frequency. The safest, most supportive approach for newborns remains clear: close contact, frequent feeding, and responsive care over restraint.

As Helen Ball and Allison Dixley emphasize, “Swaddling may calm babies — but it also quiets the very cues that keep breastfeeding on track.”

References

Ball, H. L., & Volpe, L. E. (2013). Nighttime parenting strategies and sleep-related risks to infants. Social Science & Medicine, 79, 92–100.

Bystrova, K., et al. (2007). The effect of Russian maternity home routines on breastfeeding and neonatal weight loss with special reference to swaddling. Early Human Development, 83(1), 29–39.

Dixley, A., & Ball, H. L. (2022). The effect of swaddling on infant sleep and arousal: A systematic review and narrative synthesis. Frontiers in Pediatrics, 10, 1000180.

Dixley, A., & Ball, H. L. (2023). The impact of swaddling upon breastfeeding: A critical review. American Journal of Human Biology, 35, e23878.

Nelson, A. M. (2017). Risks and benefits of swaddling healthy infants: An integrative review. MCN: The American Journal of Maternal/Child Nursing, 42(4), 216–223.

van Sleuwen, B. E., et al. (2007). Swaddling: A systematic review. Pediatrics, 120(4), e1097–e1106.

Kelly, B. A., et al. (2016). Swaddling and infant sleeping practices. Journal of Community Health, 42(1), 10–14.