baby straight jackets?

October 12, 2007 4:42 PM

Our itchy baby can only sleep if we swaddle her securely. By securely, I mean we have to wrap her quite snuggly, safety-pinning the stretchy cloth to prevent her from wriggling out and scratching herself awake. It took some trial-and-error to find a wrapping method that could contain her. Can snug swaddling harm babies orthopedically?

It is hard to describe the wrapping pattern: We lay her on a 4-foot long strip of cloth that goes around each arm and back around to the front. There is a 6-inch-wide-by-12-inch-long flap sewn to perpendicularly to the middle of one long edge of the main cloth. This smaller strip is then brought to the front between her legs and pinned in place to prevent her hiking the bottom edge up.

We have not found any fold-down cuffed sleeves to be secure enough to keep her hands inside, and now that she has grown a little they don't seem to offer fold-down cuffs in her size anyway.

We survived the hot summer by running the air-conditioner in her room at night which allowed her to not overheat while wrapped in several layers of restraint.

She spends about 10 hours swaddled each night. And sometimes we have to swaddle her for naps or feedings during the day. She has learned to crawl well, and seems on her way to walking soon, so maybe I shouldn't worry.

Please don't ask, "have you tried lotion?" We have tried many different lotions, creams and oils, and been to a dermatologist who simply prescribed topical steroids. We try to avoid steroids because the side-effects compound her other challenges such as digestive sensitivity and slow weight gain. She is now 15 months old (adjusted), and quite small for her age: in the 5th percentile or less. She is a little over 16 pounds, and about 28 inches long. She did start off small as a 2lb-12oz preemie born 8 weeks early.

I've never heard of baby straight-jackets, but it seems the only way to keep her from scratching the skin off her face, arms, neck, chest, hips, ankles, and behind the knees.

posted by markhu to health & fitness (27 comments total)

Can snug swaddling harm babies orthopedically?

Provided they're getting an otherwise normal amount of baby-appropriate activity, no. And it sounds like you're hitting all the walking-crawling milestones right on schedule.

I've never heard of baby straight-jackets

Not really a straight-jacket. More of a baby burrito -- the Miracle Blanket.
posted by Cool Papa Bell at 4:48 PM on October 12, 2007

I don't think so, but you should know as she gets older and stronger and able to turn over, there is a higher risk for sids, as she could flip over and then not be able to flip back over. However, I don't think that is a concern until she's older.
posted by whoaali at 4:59 PM on October 12, 2007

I don't know anything about swaddling, but whoaali, that isn't right -- babies are at risk for SIDS when they are younger -- by definition, younger than one. By the time a child can crawl, as this one can, she should be able to roll back over.
posted by dpx.mfx at 5:02 PM on October 12, 2007

(Derail, sorry: Cool_Papa_Bell, thank you for that blanket link! The how-to video is amazing. As soon as the mom tucks the short flap, the baby relaxes. Adorable.)
posted by thehmsbeagle at 5:07 PM on October 12, 2007

Not an direct answer to your question, but a friend of mine stitched the sleeves closed on her itchy infant's PJs when he outgrew his swaddling blankets.
posted by jamaro at 5:18 PM on October 12, 2007

Well, this website (selling swaddling blankets) suggests that swaddling legs too tightly can lead to orthopedic problems. Don't know what they base that on.

Here's an article that also links swaddling to hip dysplasia in infants.

One more, suggesting that swaddling with the legs in an extended position can cause dysplasia, based on a study in Qatar.

That was just me googling "orthopedic problems from swaddling"; there's more, a lot of it based on indigenous people who swaddle babies with extended legs tightly bound. I don't know how worried I'd be about it; we're big fans of swaddling at our house. We used a two-blanket "baby straitjacket" with our second son, and right now we have a baby who is being duct-taped into her swaddling blanket at night because she's otherwise such an effective wiggler that she will get loose even from the strait-jacket and wake herself up (disclaimer: no duct-tape touches the baby; it's wrapped in a band around her upper arms outside the blanket. So chill). She usually is swaddled with her legs out, and looking at this stuff has got me thinking about that; maybe we'll try to find a way that tucks her legs or leaves her legs more free (that Miracle Blanket with the leg pouch seems good for that).

The crawling and walking are good signs; also, presumably she's been to the doctor and been checked for hip dysplasia many times. I'd be inclined not to worry, were I you, and even if I were inclined to worry a bit, I'd weigh my worries against the consequences, for her and for the whole family, of stopping the swaddling.
posted by not that girl at 5:24 PM on October 12, 2007

We used the "miracle blanket" linked above with our son. We did actually call it the baby-straightjacket around our house. And it worked fantastically well. A++++ would use again.
posted by u2604ab at 5:41 PM on October 12, 2007

Please forgive the derail but now that I know about an uncomfortable baby, well, I can't just let it go. A quick FYI: some people get relief from eczema symptoms by supplementing their diet with Omega 3 Essential Fatty Acids. There's lots of info on the web about this topic so I'll leave it at that.
posted by Soda-Da at 5:56 PM on October 12, 2007

My midwife suggested adding a little olive oil to my baby's diet and that worked for us.
posted by cda at 6:48 PM on October 12, 2007

I don't know anything about swaddling, but whoaali, that isn't right -- babies are at risk for SIDS when they are younger -- by definition, younger than one. By the time a child can crawl, as this one can, she should be able to roll back over.

Well it may not officially be "SIDS", but babies are at risk when they get bigger and stronger to flip over and suffocate themselves. They can't roll back over as easily if they can't move their arms or legs. I have at least two friends with babies who use swaddling and both have been warned by their doctors that as they get older (and you'll have to ask your Dr. for the age, because I can't remember) that you need to phase it out. One friend's baby couldn't sleep unless swaddled and I know they were really worried about it when the baby was older. So just something to ask your Dr about.
posted by whoaali at 7:02 PM on October 12, 2007

Are you certain that your baby will scratch herself in her sleep? Have you witnessed this anytime lately? I understand your baby was a preemie, and I also can certainly empathize with the need for swaddling. But you can't swaddle her forever.

I swaddled my babies longer than what was recommended and I think that was around 4 or 5 months. I would discuss the swaddling with her pediatrician and keep looking for alternatives. From the description it seems like a long time to be swaddled at this age.

Good luck.
posted by LoriFLA at 7:47 PM on October 12, 2007

how about sewing mittens (or even thick socks) to her pajama tops? that way she can move around more normally.

if she outgrows the tops before the mittens, you can just rip the stitches out and resew the mittens to her new top.
posted by thinkingwoman at 8:04 PM on October 12, 2007

I don't know if her scratching will wake her so much as it prevents her from getting to [back to] sleep.
Just tonight, she wriggled out of the swaddling and was digging at her ears and cheeks.
posted by markhu at 9:14 PM on October 12, 2007

about 28 inches long

Off topic question, but when, during the course of human development, do we stop referring to an individual's length and begin referring to their height? Is it about the same time they transition from being, say, 28 months old to simply being 2 years old?
posted by ChasFile at 9:27 PM on October 12, 2007

Also, we only swaddle her upper body, so her legs are totally free, and she can roll over with ease.
posted by markhu at 9:30 PM on October 12, 2007

Also, I'm not too sure about this swaddling thing. It looks to me like the whole thing is designed as way to quickly dispose of - for a few hours, at least - a child that's become inconvenient or annoying. This, especially, from the Miracle Blanket site, raised alarm bells:

It's normal for her to fuss when first wrapped - especially the first few times. But don't worry, after a week or two most babies begin to relax at the mere sight of the blanket.

That sounds alot like learned helplessness to me, and I don't think you should be teaching that to infants.
posted by ChasFile at 9:38 PM on October 12, 2007 [1 favorite]

Off topic question, but when, during the course of human development, do we stop referring to an individual's length and begin referring to their height?

Anecdotally only, but I'd say it coincides with when they learn to walk, and thus actually spend their time upright.
posted by jacquilynne at 9:50 PM on October 12, 2007

ChasFile, sort of like the hug machines and weighted blankets some autism-spectrum kids use, I think that the deep pressure of swaddling helps calm (an in this case not yet fully-developed, I imagine?) nervous system.

I understand that it's alarming to look at a baby burrito as an adult and think about how terrible it would be if someone swaddled up us in blankets, but you have to remember that a newborn just came out of the womb, where things were dim, pretty quiet, and extremely snug. Being swaddled probably mimics part of that in a pleasantly soothing way.
posted by thehmsbeagle at 10:15 PM on October 12, 2007

Oops! Misphrase! Misphrase! I didn't mean to say that the OP's daughter's nervous system isn't fully developed, but that the nervous systems of newborns aren't.
posted by thehmsbeagle at 10:17 PM on October 12, 2007

we swaddle our one year old...... and intend to do so for a long time to come. she loves the sleep cue. "he who must obey" swaddles much more firmly than i do...but "she who must be fed" settles either way. but we don't do it for itchies.

apparently indigenous cultures have been known to swadddle till up to two and those kids walk at the same age.

swaddling rocks. apparently you progress to a single bed sheet when they get bigger. we're still able to use a flat cot sheet.

don't fret possum, there are plenty of us out there doing it!
posted by taff at 12:45 AM on October 13, 2007

We swaddle our 4.5 month daughter because if we didn't, she'd flail her arms in her sleep and wake herself up every 30 minutes. She sleeps better & is much happier swaddled than she is the nights we let her sleep without the blanket (because it's still in the wash or something like that). When we wrap her up she gets a huge grin on her face. It's certainly *not* a case of learned helplessness.
posted by belladonna at 7:41 AM on October 13, 2007

Why aren't you using the gloves available to prevent this? I know that 15 months is absolutely old enough to tear them off (I have a 16 month old), but if you put them on soon after she falls asleep, you could be ok. You could also make your own full sleeves with capped ends.

I assume you are keeping her nails trimmed close.

We also swaddled because we have an extremely active baby...she never stops moving and when she was younger she kept herself awake.

In any case, we were advised to stop swaddling around 9 months to ensure there were no development issues. I think that any pediatrician would be concerned about swaddling at 15 months, as you obviously are.
posted by Kickstart70 at 9:34 AM on October 13, 2007

Ok...we also used the Miracle Blanket...it was a lifesaver.
posted by Kickstart70 at 9:35 AM on October 13, 2007

Not that you asked, but I'd be spending some time with more holistic doctors, like maybe a DO, to see if they have better answers than steroids. In the meantime, I wouldn't worry too much about swaddling, as long as the little chica is meeting her other developmental milestones. 16-20 months is fine for walking.
posted by pomegranate at 3:33 PM on October 13, 2007

I don't think the miracle blanket does a large size that will fit your daughter, but the Kiddopotamus SwaddleMe does come in a large size, which is marked on their site for 15-22lbs. Honestly, it is not quite as good as the Miracle Blanket, but I preferred it because it was way easier to use. If you decide to try one out, don't bother with any fabric options except the microfleece, the cottons are too stretchy and therefore too easy to escape from.

Chasfile - swaddling recreates the snug environment of the womb, which generally calms babies. It also prevents them from jerking themselves awake every few minutes, since their nervous system is not fully mature yet - they cannot control their bodies properly. It is not intended as a way to dispose of children, it is intended as a way to help babies sleep soundly and feel secure and calm. Hospitals do it as standard practice, and they have no interest in "disposing" of babies.
posted by Joh at 9:49 PM on October 13, 2007

Please be on the alert for food allergies. My daughter had a milk allergy when she was smaller, and it took us forever to work out what was going on. She had eczema, very red cheeks, and she always had self-inflicted scratches on her face no matter how we tried to keep up with her fingernails.

Interestingly, the allergy didn't show up in blood testing (only the peanut allergy did) - but after we eliminated dairy from her diet, she got so much better. And if we let her eat yogurt or have a bottle of cow milk, her cheeks would turn bright red again, and she'd break out in hives. The doctor said the evidence was more important than the test result was, and yeah, she was allergic...
posted by Andrhia at 9:38 AM on October 14, 2007

an update from me, the OP: My daughter is now 2 years old, though no longer swaddled, she still doesn't sleep through the night. The itchiness is one factor, but the socks on her hands seem to mitigate that somewhat. We tape them on every night and she has learned to accept that as part of the evening routine. Also, she is mildly allergic to soy (and majorly to dairy) so we theorize that when she finally weaned off the soy-formula that helped the itchiness a bit. When she wakes up around 1 or 2 AM, she either says she is hungry, or just generically calls for mommy/daddy. She is still very small for her age: just under 20 pounds at 24 months. Anyway, I'll post another question about how to deal with a midnight snacker.
posted by markhu at 6:25 PM on June 6, 2008