swaddling tips

written by Linda Hawley

with Leslie BrogdenFebruary 2010

Linda Hawley, Freelance Writer Website: http://HawleyWords.com

Leslie Brogden, President, SwaddleBaby© Website: www.SwaddleBaby.com Website: www.SwaddlingTips.comEmail: [email protected]

Swaddling TipsTM

Swaddling TipsTM

written by Linda Hawleywith Leslie Brogden

February 2010

”The vast majority of new babies stay calmer and sleep longer when swaddled.”Dr. Harvey Karp, author of The Happiest Baby On the Block

Swaddling is an important calming tool that new mothers can add to their parenting “toolkit.”

Swaddling can be a lifesaver for the over-tired parent who needs to find an effective way to

calm baby. Use swaddling judiciously and never to replace mom’s own arms. Hold, carry,

and nurture your baby skin-to-skin whenever possible.

5 Reasons to Swaddle

1. Swaddling simulates the womb, offering warmth and security.

2. Swaddling minimizes baby’s involuntary flailing of limbs. These uncontrolled jerky movements can

cause baby’s arms to fly to baby’s face, causing newborns to hit or scratch themselves. Or, baby

can experience a sudden and uncomfortable experience of falling (called the Moro reflex). Imag-

ine yourself (as an adult) falling asleep while sitting up, only to have your head jerk up as you start

to doze off. Each of these uncomfortable jerky movements can upset baby. Swaddling helps to

prevent these upsets.

3. Swaddling calms baby, and is ideal for the “colicky” (upset) baby.

4. Swaddling focuses baby. Without baby’s limbs flailing, a swaddled baby can concentrate on other

tasks, such as nursing. Swaddling can also help baby transition better from breastfeeding to sleep.

5. Swaddling requires baby to be put to sleep on her back and helps to keep baby on her back. This

© 2010 The Bottom Line Marketing Service Corp. 2

back-sleeping position is recognized as an effective step in helping reduce the incidence of SIDS.

For literally centuries, the human race has been swaddling their babies. The American Academy of Pe-

diatrics insignia even depicts an infant swaddled. Some of the greatest men in history, from Alexander

the Great—to Julius Caesar—to Jesus, were all swaddled as babies. The book of Luke in the Bible ex-

plains, “And she brought forth her firstborn son, and wrapped him in swaddling clothes, and laid him

in a manger; because there was no room for them in the inn.” i For centuries—until modern day—we

have nurtured our babies through swaddling. Doctor Harvey Karp—a well known Pediatrician trained

by Dr. Brazelton—calls swaddling “wrap-ture.” What is swaddling? Why swaddle now? How is it done?

What type of blanket should be used? How long should a baby be swaddled? You will find the answers

to these questions and more here.

Swaddling History

Swaddling is a method of snugly

wrapping a baby in a light blanket. It

is often done by a nurse right after a

baby is born. It’s been going on for

centuries over most of Europe, Asia,

and North and South America.

Archaeological evidence confirmed this

when large numbers of swaddled infant

figurines were unearthed from ancient Greece.

There have been terracotta figurines portraying swaddled twins found at Olympia.ii Even in ancient

Egypt, swaddling was used, and Egyptian figurines show swaddling clothes iii In the writings of

Aristotle, Hippocrates, and Plutarch, swaddling is discussed. In the second century, the Greek physi-

cian Soranus of Ephesus—who practiced in Alexandria and Rome—recommended the practice of

© 2010 The Bottom Line Marketing Service Corp. 3

cian Soranus of Ephesus—who practiced in Alexan-

dria and Rome—recommended the practice of swad-

dling. In the 15th century, his writings were found in

European medical and midwifery books.iv In America,

Native American women historically carried their in-

fants on their backs in a papoose cradle board, which

was a type of swaddling. Before the 18th century,

swaddling became a nearly universal practice around

the world. In the Middle East, it is still a tradition. In

modern times, swaddling is gaining popularity in

the United States, the United Kingdom, and the

Netherlands.v

Why swaddle now?

”Swaddling is the cornerstone of calming. It gives nurturing touch, stops flailing,and focuses your baby’s attention…the essential first step in soothing

the fussy baby and keeping him soothed.”Dr. Harvey Karp, author of The Happiest Baby On the Block

Most adults would dislike living in a womb. However, it’s contrary to think that babies want the same

things that we do. Newborns love being restricted, and when they’re frantic, they need help confining

their flailing legs and arms. vi A baby’s skin is their largest organ, and of all the human senses, touch is

the most calming. When a baby is swaddled, she receives a continuous soft caress. To a baby, touch is

as vital as milk, and swaddling is a good substitute when your baby is not in your arms. In the womb,

baby’s arms are confined within the uterus, which prevents her arms from flailing about. After birth,

baby can experience a falling reflex (called the Moro reflex), which upsets her, starting a crying and

thrashing cycle. By swaddling baby, she feels cozy and calm.

4© 2010 The Bottom Line Marketing Service Corp.

Doctor Harvey Karp, an expert in the study of crying and colic, explains in The Happiest Baby on the

Block the baby’s experience when crying severely:

...she experiences a sensation similar to ten radios playing in her head—at the

same time. Each jerk and startle shoots another alarm message to her brain,

and together those signals make such a racket that your crying infant may hardly

notice you’re there! vii

When baby is in this crying state, the caretaker takes over, swaddles the baby, beginning the end of

the conflicting radio signals, thereby entering the baby soothing cycle. There are babies with very spe-

cific needs that will benefit from swaddling. These are discussed below.

Soothing Sensitive and Colic Babies

Hypersensitive babies are especially sensitive to light,

noise, touch, massage, and feeding.viii The word “colic”

is defined as severe abdominal pain of the intestines; it

is more simply explained as a gassy intestine. A “colicky

baby” is one who has regular crying spells that can last

for hours for no apparent

reason.ix With each sobbing air intake, baby gulps down

air which intensifies her reaction.x Parents and care-

takers can spend endless hours attempting to sooth a

sensitive or colic baby by bouncing, walking, or strolling

themselves into exhaustion. Alternatively, swaddling

can help sooth these babies by recreating the snugness of being in the womb.

As stated above, swaddling also helps decrease the frequency of the startle reflex. A scientific study

was conducted in 2009 on health care interventions for excessive crying in infants. The physicians

published their results in the Journal of Child Health Care, and their research proved that swaddling


helps babies cry less, feed adequately, fall asleep independently, and sleep sufficiently. These find-

ings resulted in a decrease in the overtired baby, which reduced parental stress. The deduction is

that the quality of interaction between the child and the parents is therefore improved.xi

Improving Baby’s Sleep

Thousands of parents and caretakers experience babies who do not

sleep long, or sleep fitfully. In the womb, baby enjoyed a perfect

temperature and nutrients, snuggled within her mother. Swaddling

recreates some of the womb environment, and this sleeping tight

can lend security to improve baby’s sleep. In fact, swaddling can

help baby sleep longer.xii

Improving Development of Preterm Infants

Swaddling has been found to aid in the development of Very

Low Birth Weight (VLBW) infants. A scientific study published

in Neonatal Network concluded that swaddling can enhance

neuromuscular development of VLBW infants.xiii Additionally,

these babies can be inefficient in regulating their body tempera-

ture, and swaddling helps keep babies warm at a steady tem-

perature. A research article called, “Swaddling: A Systematic

Review,” published in the Official Journal of the American Acad-

emy of Pediatrics, October 2007, concluded that:

Preterm infants show improved neuromuscular development when swaddled and less

physiologic distress, better motor organization, and more self-regulatory ability when

swaddled during weighing. In VLBW infants in a double-walled incubator, abdominal

temperature is higher when swaddled. In excessively crying infants with cerebral dam-

age, swaddling decreases significantly the amount of crying compared with massage.

Swaddling during heel sticks makes premature infants return to their baselines...more


quickly, and it can soothe preterm infants after pain.xiv

Improving Breastfeeding

The book, The Natural Baby – An Instinctive Approach to Nurturing Your Infant, was written by the

renowned pioneer of natural childbirth, Janet Balaskas. In this book, she states that swaddling can

improve a baby’s ability to position and latch onto the breast.xv

By swaddling before feeding, mothers have also found that their babies are calmer and squirm less.

Furthermore, swaddling while breastfeeding can help infants transition easier to sleep at the end of a

feeding. A swaddled baby can also be unwrapped if baby is very drowsy and needs to be awakened to

feed. The cool air on baby will help to arouse her in order to feed.

Decreasing Risk of Sudden Infant Death Syndrome

One of the foremost experts on child development, Dr. T. Berry Brazelton has written about sleeping

as it relates to the incidents of Sudden Infant Death Syndrome (SIDS). Dr. Brazelton explains SIDS in

this way:

When babies can get bedclothes bunched up around their faces, they tend to rebreathe

their own carbon dioxide exhalation. This makes them weak. They may then not be able

to fight to clear their airways. And they may stop breathing. This can lead to SIDS. We

now know that babies sleeping on their backs are more likely to be safe.

He recommends that loose blankets or wrappings be removed from the crib, to help decrease the risk

of SIDS.xvi This is another reason to ensure that baby’s swaddle is snug and tucked in—so the blanket

doesn’t become loose to move about the crib. In most countries, putting babies to sleep on their back

has reduced SIDS by around 50 percent. Doctor William Sears, the respected Harvard pediatrician, has

stated in The Baby Sleep Book, that SIDS risk can further be reduced by insuring that babies are not too

warm at night. He states that overheating can reduce sleep arousal.xvii Swaddling with the right mate-

rial, size, and technique can help decrease an infant’s risk of SIDS, by helping keep the baby in a back


sleeping position, avoiding overheating, and decreasing the chance of an infant re-breathing their own

carbon dioxide.

Soothing Drug-Addicted Babies

Babies born addicted to drugs or alcohol unfortunately occurs regularly throughout the world. Nursing

staff, caretakers, and adoptive parents are often the ones who care for these babies. Neonatal drug

withdrawal (NAS) is when a baby has been exposed to illegal drugs, alcohol, or medicines while in the

womb, and when born the infant develops withdrawal symptoms. The withdrawal occurs because she

is no longer receiving the drug that the mother was taking.xviii Children’s Hospital Boston (the pediat-

ric teaching hospital of Harvard Medical School) treats many drug-addicted babies with NAS, and has

stated:

“It is estimated that 3 to 50 percent of newborn babies have been exposed to maternal

drug use, depending on the population and area of the country.”

One aspect of treatment by Children’s Hospital Boston is for NAS babies to be swaddled. In their words:

Babies suffering from withdrawal are irritable and often have a difficult time being com-

forted. Swaddling, or snugly wrapping the baby in a blanket, may help comfort the babyxix

A drug-addicted baby feels safer when swaddled, and her hypersensitive body is protected from direct

touch, which is often painful to the infant.

How is swaddling done?

The steps to baby swaddling are easy to learn.

Step 1

Because of its patented shape, you don’t need to pre-fold

the top corner of the SwaddleBaby® blanket down (as

other square-shaped swaddling blankets require) Swad-

dleBaby® is the ideal shape without pre-folding. Lay the

SwaddleBaby® blanket flat with long end at the top. Place

baby with the back of her head on the stitched line in8© 2010 The Bottom Line Marketing Service Corp.

the middle top border of the blanket. This is your starting line. Don’t worry that the blanket seems too

high, as the blanket will be pulled down into the proper position as the swaddle is completed.

Step 2

Bring baby’s arms to rest on her tummy with elbows

flexed. Then pull right flap of blanket down and across

baby’s chest and arms.

Step 3

Tuck right flap under baby’s back snugly.

Step 4

Ensure baby’s first shoulder is completely covered so that

baby’s arms stay inside the,swaddling.

Step 5

Lift the bottom edge of the blanket up towards baby’s

face, being careful that the blanket edge doesn’t touch

or cover baby’s face.


Step 6

While holding the bottom blanket edge on baby’s torso

and arms, take the left flap of the blanket and pull down

across baby’s torso.

Step 7

Notice the V-shape that the two flaps have formed under

baby’s chin.

Step 8

With your left hand, keep the blanket Vshape in place on

baby’s torso. With your right hand, wrap the left flap up

and over baby’s left shoulder.

Step 9

Wrap flap behind her neck.


Step 10

Tuck the end of the blanket into the blanket

swaddle, like tucking in a dinner napkin.

Step 11

Baby is snugly and effectively swaddled. Be sure that

all wraps are done snugly, ensuring that baby can still

breathe easily and her legs are able to move freely within

the swaddle.

What type of blanket should be used?

The most effective swaddling blanket is specially designed for this purpose and does not contain

scratchy self-closure tabs, snaps, zippers, or cords. Velcro® can even induce a startle effect from baby

because of the noise it can create during removal. Ordinary square or oblong receiving blankets are

simply too small to swaddle effectively. A SwaddleBaby® blanket or Nurture Blanket™ does not con-

tain any of these closures, is sized right to help keep babies from pulling out of the blanket, the shape

makes it easier to swaddle, is made with high quality, 100% organic cotton flannel or 100% cotton muslin,

both soft to the touch, breathable, machine washable, and dryable.


How should baby’s arms be positioned while swaddled?

Different medical professionals have varying recommenda-

tions about ideal placement of baby’s arms

while swaddled.

1. Both arms in the swaddle, positioned with elbows

bent, palms down and wrists on tummy. This is the

preferred position of many physical therapists who

believe this positioning is the most natural and com-

fortable for baby.

2. Arms straight down at baby’s side. This is especially recommended because the posi-

tioning makes it more difficult to wiggle baby’s arms up and out of the swaddling. Dr.

Harvey Karp is a proponent of swaddling with arms straight down at sides.

3. Arms out. Some medical professionals recommend keeping baby’s arms unswaddled

to allow baby to self-soothe, by sucking on fingers. The possible downside of this ap-

proach is that the Moro reflex cannot be soothed, which can upset baby.

4. One arm in. This is the compromise position of the above two approaches. Baby still

has one hand available for sucking, while the Moro reflex and involuntary flailing are less-

ened by having one arm swaddled. It’s a good idea to consider trying these positions, to

discover which best satisfies baby.

How long should baby be swaddled?

According to Dr. Harvey Karp, when the baby is able to push up, roll over, and grab, she no longer needs

to be swaddled. For most babies, this is when they are about four months old. Swaddling can be a com-


fort until then.xx However, Dr. Karp states that some babies sleep better when wrapped, even up to

one year of age.xxi Elizabeth Pantly, author of the bestselling book, The No-Cry Sleep Solution, states

that swaddling works well for babies through four months of age, however, some babies may enjoy it

even longer.xxii If you choose to continue swaddling after baby can roll over, be sure to discuss with

your pediatrician and keep baby’s arms out while swaddling.

Why won’t my baby stay swaddled?

According to Susan Orr, a baby expert, professional lactation consultant, and childbirth educator,

there are three main reasons a baby won’t stay swaddled:

1. Your swaddling blanket is too small. If the blanket is too small, there just isn’t enough

fabric to adequately wrap, fold and tuck.

2. You’re swaddling baby too loosely. Many parents are nervous about making the swaddle

too tight, so they mistakenly wrap too loosely. A loose wrap will irritate baby, because it

isn’t doing its job of hugging and containing her. Also, when the wrap is loose, baby can

too easily wiggle her arms and legs out of the swaddle. Then the subsequent flailing can

potentially upset baby. A good swaddle is snug on baby, but she can still breathe easily.

3. The swaddle doesn’t capture baby’s shoulders. Most professionals agree that baby’s

hands should be held inside the swaddle to effectively calm baby. That can only be

achieved and maintained by wrapping the blanket over baby’s shoulders as the swad-

dling is done. Be sure the size, shape, and wrapping method of your swaddling blanket

ensures that baby’s shoulders are contained. If the swaddle is low on baby’s shoulders

or arms, baby will quickly wiggle her arms free.

Considerations when Swaddling

1. Swaddling is not a substitute for immediate and responsive parental care and intimacy.

Whenever possible, hold baby and even keep baby skin-to-skin on mom or dad’s chest.


Kangaroo care or baby wearing (with wraps, slings, and special garments) and skin-to-

skin contact are considered by many to be the gold standard of infant care. This type of

care calms baby, and regulates baby’s body temperature.

2. Use sound judgment when swaddling, allowing baby the time to touch and explore her

world.

3. Baby can be weaned from swaddling (even though she may seem dependent on the

technique) when you and she are ready. Baby may even communicate that she has out-

grown the need for swaddling and wean herself. You and your baby should enjoy swad-

dling for the wonderful calming and sleeping tool that it is.

4. Some are concerned over possible development of hip dysplasia from swaddling; this

concern makes it even more important to correctly swaddle your baby as described in

this booklet. Baby’s legs should be loosely wrapped with plenty of room for her to freely

move her legs. Research seems to point to the issue of hip dysplasia as it relates to very

tight swaddling (like on a cradle board in traditional native cultures), that keeps baby’s

legs from moving freely, and restrains baby’s legs so they are completely straight against

the board. Take care to swaddle baby correctly, and discuss any concerns about hip dys-

plasia with a pediatrician.

Common Swaddling Concerns

There are safety guidelines for swaddling babies. When wrapping the baby, ensure that it’s snug, but

not so tight that baby’s breathing is restricted. Ensure that the room temperature is moderate, the

baby does not appear too hot, or sweaty. Always put baby to sleep on her back. When baby is able to

roll over, swaddle with her arms out. Beyond these simple safety rules, some caretakers have other

questions. Below are typical frequently asked questions answered by Dr. Karp in The Happiest Baby on

the Block:


Question: How many hours per day should I swaddle?

Answer: Often infants are calmer initially by swaddling 12 to 20 hours per day. After one to two months,

observe baby to see how calm she is without swaddling.

Question: How can I tell if I’m swaddling too tightly?

Answer: Babies wiggle, and this will loosen the blanket a little. It is more often that caretakers wrap

too loose, instead of too tight, however, there is a test to ensure the wrap is not too tight. Simply slide

a hand between your baby’s chest and the swaddling blanket; it should feel as snug as a pregnant belly

and the pant’s elastic waistband at the end of the ninth month.

Question: How can I tell if my baby is overheated?

Answer: Full term babies do fine in a room temperature of 65 to 70 degrees, when dressed in light

clothing and bundled. If the room is hotter than that, the baby can be wrapped wearing only a diaper.

To check baby for overheating, feel her ears and fingers; if they are sweaty, hot, or red, then she is

likely over-wrapped.xxiii

Recommended by the American Academy of Pediatrics

The American Academy of Pediatrics (AAP) website,

called HealthyChildren.org, is dedicated to the attain-

ment of optimal physical, mental, and social health

and wellbeing for all infants, children, adolescents, and

young adults. HealthyChildren.org informs pediatricians,

parents, and caretakers of AAP recommendations that

are backed by scientific research. The AAP recommends

the swaddling of infants:

...[baby] may be comforted if you...swaddle her

tightly in a blanket. There are even special blankets for swaddling small babies who are


particularly difficult to console....xxiv

Wrapping it Up

1. Remember, consult with a pediatrician about all aspects of parenting, and questions that

arise in the day to day care of baby.

2. Pay attention to baby’s cues when determining how to most effectively care for her.

Baby’s cries, facial expressions and hand motions are all communication cues to the con-

cerned parents or caregivers.

3. Respond to all of baby’s needs quickly.

4. Always put baby to sleep on her back, unless otherwise specifically recommended by

Swaddling Tips™ is not a medical recommendation, but rather a discussion and presentation of the topic of swaddling. Please discuss with your pediatrician.

Note: This is a free publication courtesy of SwaddleBaby®. If it is reprinted or distributed it must be printed and distributed in its entirety. Portions of the publication may not be reproduced or distrib-uted without prior written permission from SwaddleBaby®.

Linda Hawley, Freelance Writer

Website: http://HawleyWords.com/

Leslie Brogden, President, SwaddleBaby®

Website: http://www.SwaddleBaby.com/

Website: http://www.SwaddlingTips.com/

Email: [email protected]


Images:

1. Terracotta figurines of swaddled infants. Image from Winter 1903, vol. 3.2, p. 271 nos. 12

and 13.

2. Native American Baby of the Nez Perce Tribe in a Papoose Cradle Board, photographed by

Edward S. Curtis, 1911.

References:

1. The Holy Bible: Containing the Old and New Testaments, Authorized King James Version.

1996.

2. Wise S. Childbirth votives and rituals in ancient Greece [doctorate thesis]. Cincinnati, Ohio:

University of Cincinnati, 2005.

3, Demause L. Foundations of Psychohistory. Creative Roots Publishing; 1982.

4. Linde K. Encyclopedia of children and childhood in history and society. Topic: Swaddling.

Available at: http://www.faqs.org/childhood/So-Th/Swaddling.html. Accessed: January 30,

2010.

5. Van Sleuwen BE, Engelberts AC, Boere-Boonekamp MM, Kuis W, Schulpen TWJ, L’Hoir MP.

Swaddling: a systematic review. Pediatrics. 2007;120(no 4).

6. Karp H. The Happiest Baby On the Block: The New Way to Calm Crying and Help Your Baby

Sleep Longer. New York: Bantam Books; 2002.

7. Brazelton TB, Sparrow JD. Calming Your Fussy Baby the Brazelton Way: Advice from Amer-

ica’s Favorite Pediatrician. Perseus Publishing; 2003.

8. Jana LA, Shu J. Heading Home with Your Newborn: From Birth to Reality. American Acad-

emy of Pediatrics; 2005.

9. Blom MA, van Sleuwen BE, de Vries H, Engelberts AC, l’Hoir MP. Health care interventions

for excessive crying in infants: regularity with and without swaddling. Journal of Child Health

Care. 2009;13(2):161-76.

10. Sears W, Sears R, Sears J, Sears M. The Baby Sleep Book: The Complete Guide to a Good

Night’s Rest for the Whole Family. New York. Little, Brown and Company;


2005.

11. Short MA, Brooks-Brunn JA, Reeves DS, Yeager J, Thorpe JA. The effects of

swaddling versus standard positioning on neuromuscular development in very low birth

weight infants. Neonatal Network. 1996;15(4).

12. Kellicker, PG. Neonatal drug withdrawal (Neonatal Abstinence Syndrome). Beth Israel

Deaconess Medical Center (Teaching Hospital of Harvard Medical School). 2009.

Available at: http://www.bidmc.org/YourHealth/ConditionsAZ.aspx?ChunkID=535598.

Accessed: January 30, 2010.

13. Neonatal Abstinence Syndrome. Children’s Hospital Boston (Primary Pediatric Teaching

Hospital of Harvard Medical School). Available at:

http://www.childrenshospital.org/az/Site1338/mainpageS1338P0.html. Accessed: January

30, 2010.

14. Balaskas J. The Natural Baby: An Instinctive Approach to Nurturing Your Infant. Minne-

sota: Creative Publishing International; 2002.

15. Pantley E. Gentle Baby Care: No-Cry, No-Fuss, No-Worry—Essential Tips for Raising Your

Baby. New York: McGraw-Hill; 2004.

16. Shelov SP, Hannemann RE. Caring for Your Baby and Young Child: Birth to Age 5. Ban-

tam;1998.

Hill BA. Hush Little Baby: Gentle Ways to Stop Your Baby From Crying. New York:

Avery; 1999.

Hogg T, Blau M. Secrets of the Baby Whisperer: How to Calm, Connect, Hogg T, Blau M. Se-

crets of the Baby Whisperer: How to Calm, Connect, and Communicate with Your Baby. New

York: Ballantine Books; 2001.


i. The Holy Bible: Containing the Old and New Testaments, Authorized King James Version. 1996. Luke 2:7.ii. Wise S. Childbirth votives and rituals in ancient Greece [doctorate thesis]. Cincinnati, Ohio: University of Cincin-

nati, 2005.iii. Demause L. Foundations of Psychohistory. Creative Roots Publishing; 1982;52.iv. Linde K. Encyclopedia of children and childhood in history and society. Topic: Swaddling. Available at: http://www.

faqs.org/childhood/So-Th/Swaddling.html. Accessed: January 30, 2010.v. Van Sleuwen BE, Engelberts AC, Boere-Boonekamp MM, Kuis W, Schulpen TWJ, L’Hoir MP. Swaddling: a system-

atic review. Pediatrics. 2007;120(no 4):e1097-e1106.vi. Karp H. The Happiest Baby On the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer. New

York: Bantam Books; 2002;112.vii. Ibid.viii. Brazelton TB, Sparrow JD. Calming Your Fussy Baby the Brazelton Way: Advice from America’s Favorite Pediatri-

cian. Perseus Publishing; 2003;24.ix. Jana LA, Shu J. Heading Home with Your Newborn: From Birth to Reality. American Academy of Pediatrics 2005;109.x. Brazelton TB, 31.xi. Blom MA, van Sleuwen BE, de Vries H, Engelberts AC, l’Hoir MP. Health care interventions for excessive crying in

infants: regularity with and without swaddling. Journal of Child Health Care. 2009;13(2):161-76.xii. Sears W, Sears R, Sears J, Sears M. The Baby Sleep Book: The Complete Guide to a Good Night’s Rest for the Whole

Family. New York. Little, Brown and Company; 2005.;13,77.xiii. Short MA, Brooks-Brunn JA, Reeves DS, Yeager J, Thorpe JA. The effects of swaddling versus standard positioning

on neuromuscular development in very low birth weight infants. Neonatal Network. 1996;15(4).xiv. Van Sleuwen, e1097-e1106.xv. Balaskas J. The Natural Baby: An Instinctive Approach to Nurturing Your Infant. Minnesota: Creative Publishing

International; 2002;87.xvi. Brazelton TB, 25.xvii. Sears W, 81.xviii. Kellicker, PG. Neonatal drug withdrawal (Neonatal Abstinence Syndrome). Beth Israel Deaconess Medi-

cal Center (Teaching Hospital of Harvard Medical School). 2009. Available at: http://www.bidmc.org/YourHealth/ConditionsAZ.aspx?ChunkID=535598. Accessed: January 30, 2010.

xix. Neonatal Abstinence Syndrome. Children’s Hospital Boston (Primary Pediatric Teaching Hospital of Harvard Medi-cal School). Available at: http://www.childrenshospital.org/az/Site1338/mainpageS1338P0.html. Accessed: Janu-ary 30, 2010.

xx. Karp H;112.xxi. Karp H;121.xxii. Pantley E. Gentle Baby Care: No-Cry, No-Fuss, No-Worry—Essential Tips for Raising Your Baby. New York: Mc-

Graw-Hill; 2004;451.xxiii. Karp H;120-123.xxiv. Shelov SP, Hannemann RE. Caring for Your Baby and Young Child: Birth to Age 5. Bantam;1998.


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