Choosing Swaddles and Sleep Sacks | From a Pediatric OT & Sleep Consultant

This blog post was written by Brooke Boruff, a pediatric OT and Abby Sharpe, the sleep consultant through Infant Insights. Learn from these professionals and others inside Bloom by Infant Insights.

There is so much info on the web about what sleep gear to use and it can be a little overwhelming for parents. 

Sleep is a crucial need for all of us, so of course we are going to want to choose the best gear that sets ourselves and our baby up for success.

As a first time parent, I remember being so very overwhelmed with the options around sleep sacks and swaddles. “What even is the point of a swaddle? Should it be weighted? What is a "TOG"?” were all questions that popped into my mind.

Side note: TOG is the rating of insulation in the sleep sack or swaddle. A higher TOG = warmer for your baby. Keep this in mind during different times of the year! Additionally, choose a fabric for the appropriate climate if a TOG isn't provided. Wool is going to be warmer than cotton, and bamboo fabric will be cooler than cotton.

After dealing with "flat head" with my first born, I have learned a thing or two about using & choosing swaddles & sleep sacks so I want to share some thoughts.

First, let's start with swaddles. 

Swaddles have been around for a while, with the first swaddles dating back to 4000 B.C. 

Swaddles are a great tool to help your baby transfer from "womb to world" and there is nothing more adorable than a baby in a swaddle! Swaddles allow your baby to sleep comfortably on their back with less risk of the startle reflex disrupting their sleep in the first few weeks and months of life.

When choosing a swaddle for your baby, as a professional in the baby space, I recommend a few things:

1. Choose a swaddle that can be used with arms in or out. Here is a great option!
2. Choose a swaddle that is non-weighted, least-resistive, and only serves as a wearable blanket. Here is another great option!
3. Practice having your baby sleep without their arms in the swaddle during the day after ~2 weeks of age to integrate their startle reflex and support swaddle transitions in the future.

You may ask yourselves questions like "When should I stop swaddling my baby?" and I suggest a few things around this topic.

We want to unswaddle your baby as soon as the first signs of rolling over in order to encourage your baby’s milestones and prevent "flat head". Swaddling restricts movement, so we want to allow free movement as much and as soon as possible with our babies! 

Hence, the importance of having our babies sleep with the arms out of the swaddle during the day after the age of ~2 weeks, to integrate their reflexes, encourage movement, and support the transition from swaddled to unswaddled. 

Begin the unswaddling process when your baby is showing ANY signs of rolling. This includes: rolling to the sides, turning head to view items above head, arching back in attempt to roll, grasping feet, and bringing arms across body in attempts to roll over back to belly. Unswaddling your baby at the first signs of rolling will ensure safety, "flat head" prevention, and encourage milestones! 

When you are ready to move away from swaddling with arms in, there are a few things you can do. Whatever works for your family is ultimately best, but here are a few suggestions 👇 

1. Always practice daytime sleep with arms out after the age of ~2 weeks. This will aid for a smoother transition because your baby is familiar with this sleeping position and movement has allowed the startle reflex to integrate more.
2. If your baby has been sleeping with arms swaddled during the day, you may alternate one arm out each nap in preparation to unswaddle the arms during naps initially. Once your baby can tolerate one arm out well during sleep, you can begin to unswaddle both arms at naps. Some people, like myself, begin this process sooner than later and others choose to wait a bit longer. Regardless, begin this process at the first sign of rolling back to belly as stated above.
3. Begin removing one arm at night time after daytime unswaddling has been achieved. You can expect some wakes as this is very typical when you intially begin this process. If your baby's sleep seems to be is disrupted a lot initially, you may choose to swaddle both arms after gradual exposure to the arms being out during the swaddle weaning process. Be patient with yourself and your baby as this can take some time to adjust, and every baby is so different. 
4. Choose a swaddle that can be used with the arms out, and has a torso wrap. This is an excellent tip from Abby, the sleep consultant on the Infant Insights team. Using a swaddle with a torso band, like a Halo Sleep Sack or Kyte Baby will add an extra hug to your baby's body which may help settle them and support sleeping with arms unswaddled. 
5. Additionally, begin the unswaddling process when your baby is attempting to break out of the swaddle, especially during day time sleep. Daytime unswaddling is going to set you and your baby up for success down the road.

It’s hard to estimate a time frame with how long this unswaddling process will take because every baby is different, but the main thing is follow your baby’s cues, swaddle both arms if needed after frequent wakes, and be consistent. 

Once you have conquered unswaddling, it's time to choose sleep sacks that are best for your baby! 

As a pediatric OT specializing in baby development & "flat head", I do not recommend putting a weighted sleep sack on your baby registry or using one with your baby. 

Weighted sleep sacks have actually been discontinued at several retailers and are not recommended by the American Academy of Pediatrics due the possibility of unsafe sleeping. Read more about this here. These sleep sacks inhibit free movement and are not only possibly unsafe, but not productive for free movement and supporting milestones. 

When choosing a sleep sack, I recommend a minimal sleep sack, like stated previously. Brands like the Halo or Kyte Baby that can be used with arms in and out are perfect for your baby. When shopping for these products, think less is best! 

Additionally, it’s great to purchase an option that allows arms to be free, as well as swaddled if appropriate, because free movement leads to reflex integration which supports better, and less interrupted, sleep! This is particularly important if you are purchasing a Love to Dream sleep sack. These are great and very popular, but when choosing this brand, I recommend the transition option that can have the arms in or out. This will support the transition away from the swaddle when your baby is ready.

Some parents choose to use the Merlin Suits, and I am not against these unless your baby has a side preference, torticollis, "flat head", or milestone delays. I would steer clear of these suits if that is the case because with these common issues in infancy, less is best and free movement is the goal!

Regardless of the sleep sack or swaddle you use, there will come a time when you may choose to move away, or stop using the product. When that time comes, consistency is key. Stay the course, be patient, and you and baby will reach the goal you have set! Need specific sleep help? Join Bloom by Infant Insights for access to content, experts, and community!