Parents have been warned to strictly follow safe sleeping guidelines when swaddling babies, with new research showing that the practice of wrapping infants may increase the risk of sudden infant death syndrome (SIDS).
Researchers from the University of Bristol found that swaddling increased the risk of SIDS for babies placed on their side or front to sleep.
Older babies who were swaddled, and potentially capable of rolling themselves onto their side or front, were also at greater risk of SIDS than those fo the same age who were not swaddled.
"The focus of our review was not on studies about swaddling - a traditional practice of wrapping infants to promote calming and sleep - but on studies that looked at Sudden Infant Death Syndrome (SIDS). We tried to gather evidence of whether there was an association between swaddling for sleep and SIDS," Dr Anna Pease, lead author of the study, said.
"We only found four studies and they were quite different, and none gave a precise definition for swaddling making it difficult to pool the results. We did find, however, that the risk of SIDS when placing infants on the side or front for sleep increased when infants were swaddled."
The four studies analysed by the researchers spanned two decades and came from England, Australia and the USA.
Current baby safe sleeping guidelines advise parents to always place infants on their back to sleep. The new researchs suggests that advice is even more important if a baby is swaddled.
The new analysis found the SIDS risk associated with being placed in the side position almost doubles among swaddled infants. The risk of SIDS was also higher in infants who were swaddled and found on their fronts.
The risks were higher for older infants who were swaddled during sleep, with the studies suggesting that the majority of the older babies found on their stomachs moved into this position.
"We found some evidence in this review that as babies get older, they may be more likely to move into unsafe positions while swaddled during sleep, suggesting an age is needed after which swaddling for sleep should be discouraged. Most babies start being able to roll over at about 4-6 months," Dr Pease said.
"On a practical level what parents should take away from this is that if they choose to swaddle their babies for sleep, always place them on their back, and think about when to stop swaddling for sleep as their babies get older and more able to move."
According to national safe sleep organisation SIDS and Kids, nine children under the age of four die suddenly and unexpectedly every day in Australia.
A statement on the organisation's website lists six key ways to reduce the risk of SIDS and fatal sleep accidents. They are:
1. Sleep baby on the back from birth, not on the tummy or side
2. Sleep baby with head and face uncovered
3. Keep baby smoke free before birth and after
4. Provide a safe sleeping environment night and day
5. Sleep baby in their own safe sleeping place in the same room as an adult care-giver for the first six to 12 months
6. Breastfeed baby