Swaddling a baby: how to wrap safely and when to stop

Swaddling, called wrapping in Australia, means snugly wrapping a young baby in a thin cloth so their arms and body feel held. It can help some babies settle, but it does not lower the risk of SIDS, so it is only worth doing if you can do it safely every time: baby on their back, a thin breathable wrap, firm at the chest, loose at the hips, nothing above the shoulders. The most important rule is when to stop. The AAP, NICHD, Red Nose and the Lullaby Trust all say to stop wrapping with the arms in once your baby shows signs of rolling, and Red Nose in Australia adds an upper limit of 3 months, whichever comes first.

Does swaddling help babies sleep, and does it reduce SIDS?

The NICHD Safe to Sleep FAQ puts it plainly: swaddling does not reduce SIDS risk, but some babies are calmer and sleep better when they are swaddled. Red Nose in Australia says wrapping can help a baby settle and stay asleep, and may help keep them in the recommended back position.

The AAP's swaddling guidance explains the trade-off. Swaddling may reduce how easily a baby rouses, and some studies have found a higher risk of SIDS and suffocation when a swaddled baby is placed on their tummy or rolls onto it. That is why back sleeping and stopping on time matter so much.

Swaddling is optional. If your baby settles well without it, or hates being wrapped, an arms-free sleeping bag is a safe alternative from birth, according to Australia's Red Nose's sleeping bag guide. For other ways to calm a young baby, see soothing a crying baby and the 5 S's.

How do you swaddle a baby safely, step by step?

Before you start

• Choose the fabric. Use a thin muslin or light cotton wrap or a thin cot sheet. The Lullaby Trust and Australia's Red Nose both say not to use blankets or bunny rugs, because they can cause overheating.
• Dress lightly underneath. Australia's Red Nose suggests only a nappy and vest in warmer weather and a lightweight grow suit in cooler weather.
• Take off any hat. The Lullaby Trust says babies don't need hats indoors, and the head must stay uncovered.

The diamond method (AAP)

These steps follow the AAP's instructions:

1. Spread the wrap flat in a diamond shape and fold the top corner down.
2. Lay your baby face-up with their head above the folded edge.
3. Straighten your baby's left arm, bring the left corner across their body and tuck it between their right arm and right side.
4. Tuck the right arm down, bring the right corner across and tuck it under their left side.
5. Fold or twist the bottom of the wrap loosely and tuck it under one side, leaving room for the hips and legs to move.
6. Place your baby on their back in their own cot or bassinet, with nothing else in the sleep space.

Australia's Red Nose's version

The Australia's Red Nose safe wrapping guide places the baby slightly off-centre with the top of the wrap level with the shoulders. One arm is folded across the chest and the short side of the wrap is tucked firmly under the baby, then the long side comes across, and the bottom is brought up and folded under. Either way, the finishing checks are the same: chest snug but not tight, hips loose, face and head uncovered.

How tight should a swaddle be, and what about the hips?

Aim for firm, not tight. The AAP says you should be able to fit at least two or three fingers between your baby's chest and the swaddle. Australia's Red Nose warns that tight wraps can restrict chest movement, while loose wraps are hazardous because they can come undone and cover the head and face.

The hips need extra care. The AAP says that straightening and tightly wrapping a baby's legs can lead to hip dislocation or hip dysplasia, and recommends hip-healthy swaddling that lets the legs bend up and out. The Lullaby Trust says to keep swaddles looser around the hips, because a wrap that is too tight there can cause developmental dysplasia of the hip.

Which wraps and swaddle products are safest?

A plain, thin muslin or cotton wrap is the option all three countries' sources describe. Products are where advice differs:

The AAP says not to use weighted swaddles or weighted blankets because they can press on a baby's chest and lungs, and the NICHD FAQ says there isn't enough evidence that they are safe at home. The Lullaby Trust says it can't comment on individual swaddle products, but suggests choosing one that meets safety standards, fits well and has a lower tog to reduce overheating. Our guide to sleep products to avoid covers weighted and positioning products in more detail.

When should you stop swaddling?

Stop wrapping with the arms in as soon as your baby shows signs of trying to roll. The sources agree on that trigger but word the timing differently:

Australia's Red Nose's stopping guidance is the strictest, because it sets a cut-off even for babies who aren't showing signs yet. Its older printable guide gives a later age for rolling, so follow the current web page. Whatever your country, the cautious approach is to act on the earliest cue you notice rather than waiting for a full roll.

Signs that rolling is on the way can be subtle. Parents often notice their baby rocking onto one side, swinging a leg across, or getting partway onto their side during floor play. Every baby is different, so watch your own baby rather than the calendar. The rolling over guide covers what to expect.

How do you transition out of a swaddle?

How gradual you can be depends on timing.

1. Before any signs of rolling, you can ease out slowly. Australia's Red Nose says you can leave the arms free once the startle reflex disappears if your baby likes being wrapped, and the AAP says there's no evidence that SIDS risk depends on whether the arms are in or out. Many families try one arm out for a few sleeps, then both.
2. Once rolling signs appear, there is no gradual phase. Australia's Red Nose says the arms must be free or wrapping must stop altogether, and the AAP and Lullaby Trust say to stop swaddling.
3. Move to an arms-free sleeping bag if your baby needs something to replace the wrap. Australia's Red Nose says a safe bag has fitted neck and armholes, no hood, is the right size, and is never combined with a wrap or extra blankets. The AAP says sleep sacks that don't swaddle can be used for as long as you like.
4. Expect a few unsettled nights. Keep the rest of the bedtime routine the same and offer extra comfort while your baby gets used to having their hands free. Responsive settling has ideas.

For what to wear under the bag in different weather, see dressing your baby for sleep.

When should you never swaddle?

• When sharing a sleep surface. Australia's Red Nose, the Lullaby Trust and the NHS all say not to swaddle a baby who is sharing a bed, and the NHS adds that sleeping bags are safer. See bed-sharing.
• On the front or side. The Lullaby Trust says never to put a swaddled baby to sleep on their front or side.
• Inside a sleeping bag. Australia's Red Nose says babies must not be wrapped if you are using a sleeping bag.
• With bedding on top. The Lullaby Trust says never to put extra bedding over a swaddled baby.
• When your baby has an infection or fever. The Lullaby Trust lists this as a time not to swaddle. A fever in a baby under 3 months needs urgent medical help (see below).
• With a weighted product. No weighted swaddles, blankets or sleepers.

The Lullaby Trust also notes that babies in hospital are supervised and may be swaddled in a particular way for medical reasons, so home wrapping should follow standard safe-sleep advice.

When to get help

These signs come from the NHS list of signs that need urgent help. The same NHS page says a temperature of 38°C (100.4°F) or higher in a baby under 3 months also needs emergency care, so don't wait for a routine appointment. Read more in fever in babies.

Mention at the next check: any questions about how your baby's hips or legs sit or move, and any worries about settling once you stop wrapping. Your GP or health visitor can check the hips and help with a plan.