The effect of swaddling on infant sleep and arousal: A systematic review and narrative synthesis

M, N. SS, P. JR, G. DP. Impact of swaddling techniques in enhancing sleep patterns among newborns

Swaddling is a traditional technique used to improve sleep quality among newborns by providing a secure, womb-like environment that may enhance relaxation and reduce arousals. This quasi-experimental study evaluated the effectiveness of swaddling in promoting sleep patterns in a sample of 60 full-term newborns in a hospital setting. Participants were divided into an experimental group (n=30), who received swaddling and a control group (n=30), who received routine care. Sleep patterns were assessed using the Anders and Chalemian Sleep Scoring Tool, categorizing sleep into mild, moderate and deep. Findings revealed that swaddled newborns experienced significantly longer durations of deep sleep and fewer spontaneous arousals compared to the control group.

A Systematic Review of the Efficacy of Compression Wraps as an Anxiolytic in Domesticated Dogs

Many domesticated dogs show signs of anxiety, negatively impacting their own and their owner's mental and physical health. A systematic review evaluating whether pressure wraps decrease clinical signs of anxiety in dogs was completed to identify relevant studies. The main outcomes of interest included behavioral and physiological measures. A total of 229 studies were identified, of which four met the inclusion criteria. Commercially available pressure wraps and a telemetry vest were used in the reviewed studies. Three experimental studies included brief exposure to recorded firecracker or thunderstorm sounds or separation from their owner as anxiety-invoking stimuli. A non-experimental study evaluated the use of pressure wraps for dogs with thunderstorm phobia living in their home environment exposed to naturally occurring thunderstorms. The risk of bias in domains related to the blinding of investigators or study participants was generally high. Domains with moderate risk of bias often reflected incomplete reporting of research methods and imprecision due to small sample sizes. Most studies reported minimal benefits on behavior or heart rate in the absence of adverse side effects. Our review suggests there is weak and limited evidence to support the beneficial effect of pressure wraps in reducing physiological or behavioral signs of anxiety. Confidence in the available literature is low due to the moderate-to-high risks of bias and inconsistent findings. Further studies are needed regarding the efficacy of these products.

Sleep characteristics and changes in sleep patterns among infants in Bhaktapur, Nepal

OBJECTIVE

Sleep undergoes major changes during the first year of life, but the characteristics of sleep among infants in low and middle-income countries are not well documented. This study describes sleep characteristics and changes in sleep patterns in infants at 6 and 12months of age from Bhaktapur, Nepal.

METHODS

This was a community-based longitudinal study comprising 735 infants. Sleep characteristics were obtained by interview with the mother using the Brief Infant Sleep Questionnaires. The stability of sleep duration and night awakenings were estimated by logistic regression analysis.

RESULTS

Cosleeping in the parent's bed at 6 and 12months of age was almost universal (>97%). At 6months of age, 254 (35%) and at 12months of age, 341 (46%) infants had a total 24-hour sleep duration <12 hours. Night awakenings >3 times per night were common (65%) both at 6 and 12months of age. Infants with frequent nightly awakenings at 6months had increased odds of frequent nightly awakenings at 12months (OR=2.2; 95% CI: 1.6, 2.9). Very few (<3%) mothers reported sleep problems in their infants at 6 and 12months of age.

CONCLUSIONS

Cosleeping was almost universal among Nepalese infants, and very few of the mothers reported sleep problems in their infants. Infants at 6 and 12months had similar patterns for both sleep duration and nocturnal awakenings. For infants, there were increased odds of having similar sleep duration and nocturnal awakening at 6 and 12months.

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.