The impact of swaddling upon breastfeeding: A critical review.

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.