Swaddling

from Wikipedia, the free encyclopedia

The word swaddling is the name given to swaddling techniques in which babies are tied tightly in a sheet in the first few months of life . These are modern variations on very old baby care methods commonly known as diapers . In contrast to traditional swaddling methods, when swaddling the child is not wrapped with long strips of fabric, but surrounded with towels.

The aim of swaddling today is to set limits for the newborn's movement of arms and legs. This setting of boundaries is seen as helpful in calming down the child. It also promotes sleep. There is no consensus on the manner, strength and duration of use of these techniques. It is therefore not entirely clear which technique is referred to as swaddling: The shapes range from tying them firmly in cloths to using textiles with Velcro fasteners to hold the arms in place to using a sleeping bag. The fixation of arms and legs is also handled differently.

The effect of swaddling on babies is controversial among experts.

A swaddled baby

Cultural history

Today's swaddling is a modification of the historical wrapping methods used in numerous cultures. The central thing was to wrap the child with long ribbons of fabric. Ancient authors such as the doctor Soranos of Ephesus (around 100 AD) assumed that the baby's body was soft and malleable and therefore had to be brought into an immovable stretched position and shaped. The fear that without swaddling the infant's soft limbs would be deformed has been widespread for centuries. In the 18th century, diapering was largely abolished in England, and later in other Western European countries. In the western cultural area the traditional constriction of infants has largely been abandoned, in other cultures it is still partly used.

The German babies were supposedly wrapped longer and more tightly than those in France and England, where this method was abandoned earlier. The position of the Enlightenment is represented, for example, by Johann Georg Krünitz in the Economic Encyclopedia . He is of the opinion that children must first be swaddled after birth to give the body support, but not in the "constricting" way that was common at the time. So it says with him:

“It is the greatest cruelty to pound a child into tight bonds for several hours in order to deprive him of the free movement of his limbs. [...] The pale face, the lean body and the ailing life of the children who have been imprisoned in gangs prove enough how much damage the bowels suffer as a result [...] It is not surprising when the children are in these shackles all day are sad, and besides sleeping they spend their time crying. "

- Krünitz : Economic Encyclopedia, article "Child"

Krünitz recommends that after 14 days, the baby should only be swaddled loosely so that it can move.

Nevertheless, according to some sources, this winding method was still used relatively strictly in Germany in the 19th century. In 1877 an article appeared in an English magazine in which a German baby is described as a "pathetic object" that is wrapped up like a mummy and only released from its bandages for a short time to change the diaper . This method was used until the sixth month. At the beginning of the 20th century, German babies were only taken out for the first eight weeks to change nappies because the body was considered extremely weak and fragile.

Effects of swaddling

Babies' reactions to being swaddled vary: many initially resist being swaddled, but then quickly give up and become passive. Weeping outside of the weighing board occurs as well as refusal of the weighing board after a long time outside. Various studies have shown that swaddled children sleep longer and more quietly, spend more time in non-REM sleep and wake up less easily spontaneously, but more easily to acoustic stimuli. Some authors consider this method to be suitable for increasing the acceptance of the supine position as a prevention against sudden infant death syndrome, as many parents prefer the riskier prone position, despite recommendations to the contrary, because the children would supposedly sleep better on their stomachs.

Positive effects of swaddling in pre-damaged babies and premature babies

There is evidence that this changing method can significantly reduce crying times in brain-damaged babies and has a pain-relieving effect. Therefore, swaddling from different sides is also recommended to support the treatment of baby babies. Swaddling has a supportive effect in cases of neonatal abstinence syndrome and in neonatal brain damage.

Babies born prematurely are not traditionally swaddled. Premature babies have a variety of medical problems due to their physiological immaturity (particularly of the lungs , kidneys and heart ). Their motor deficit can be considerable and they tire quickly. Numerous medical interventions are carried out in the premature babies' wards to maintain and facilitate the lives of these children. The "swaddling" of these premature babies (very low birth weight infants, VLBW infants) is very loose and serves to keep the weak and poorly mobile arms on the child's body. As a result of this help, the precocious baby can make certain movements. The aim of this type of wrap is to facilitate movements. Therefore, this form of "winding" must be distinguished from actual winding. The extremely retarded motor development of these children requires the simulation of the previously “weightless” state of the arms in the aqueous medium of the uterus . Therefore, the children's arms are wrapped in flexion (not in extension as described in Soranus ) and the hands are placed close to the mouth. This position allows for self-soothing, something that is just prevented with ordinary swaddling. Premature babies showed improved neuro-muscular development, less physiological stress, better motor skills, and better self-regulation when swaddled.

Negative effects of swaddling

Empirically proven negative effects of swaddling or swaddling relate to the following problems:

  • Traditional forms of swaddling increase the risk of hip dysplasia if the legs are stretched and placed together.
  • While swaddling initially promotes the lower-risk supine position, the combination of swaddling and prone position increases the risk of sudden infant death syndrome. It should therefore be stopped when the infant begins to turn on its own.
  • The risk of developing respiratory infections - especially if the swaddles are too tight - was four times higher in one study.
  • If used incorrectly, there is a risk of overheating ( hyperthermia ).
  • By lying quietly for a long time, there is a risk of the back of the head flattening .
  • Changing diapers immediately after birth can delay weight gain in normally developed babies. The authors of a study attribute this effect to the reduced direct skin contact between baby and mother. If children are swaddled and physically separated from the mother during the first two hours after birth, or if there is no skin contact, maternal relationship behavior, affective affection and reciprocity are made more difficult, as was found in a study of mother-child dyads in one-year-old babies.
  • Changing diapers is associated with reduced physical contact between child and mother.

literature

  • Alp Akman, Ayşe Korkmaz, M. Cemalettin Aksoy, Muharrem Yazıcı, Murat Yurdakök, Gülsevin Tekinalp: Evaluation of risk factors in developmental dysplasia of the hip: results of infantile hip ultrasonography . In: The Turkish Journal of Pediatrics . tape 49 , no. 3 , 2007, ISSN  0041-4301 , p. 290–294 (English, turkishjournalpediatrics.org [PDF; 172 kB ; accessed on May 18, 2019]).
  • Barry, Herbert; Leonora M. Paxson (1971): Infancy and early childhood: Cross-cultural Codes 2. In: Ethnology, 10 (4), pp. 466-508.
  • Blair, Peter S .; Peter Sidebotham; Carol Evason-Coombe; Margaret Edmonds; Peter Fleming (2009): Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. In: British Medical Journal, 339, b3666. doi: 10.1136 / bmj.b3666
  • Bloch, Aaron (1966): The Kurdistani Cradle Story: A Modern Analysis of This Centuries-Old Infant Swaddling Practice. In: Clinical Pediatrics, 5, pp. 641-645.
  • Bystrova, K .; S. Matthiesen; AT THE. Widstrom; FROM. Ransjö-Arvidson; B. Welles-Nystrom; I. Vorontsov; K. Uvnäs-Moberg (2007 a): The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling. In: Early Human Development, 83, pp. 29-39.
  • Ksenia Bystrova: Skin-to-skin contact and early suckling in the postpartum: effects on temperature, feeding and mother-infant interaction . Karolinska University Press, Stockholm 2008, ISBN 978-91-7357-167-8 (English, ki.se [PDF; 1.5 MB ; accessed on May 18, 2019]).
  • James S. Chisholm: Navajo infancy: an ethological study of child development . Aldine, New York 1983, ISBN 0-202-01169-0 (English).
  • Danzinger, Lotte, Liselotte Frankl (1934): On the problem of functional maturation: first report on development tests on Albanian children. In: Zeitschrift für Kinderforschung 43, pp. 219-254.
  • Dennis, Wayne (1940a): Infant Reaction to Restraint: An Evaluation of Watson's Theory. In: Transactions of the New York Academy of Sciences, 2 (2), pp. 202-219.
  • Dennis, Wayne (1940b): The Hopi Child. New York.
  • Franco, Patricia; Nicole Seret; Jean-Noël van Hees; Sonia Scaillet; José Groswasser; André Kahn (2005): Influence of Swaddling on Sleep and Arousal Characteristics of Healthy Infants. In: Pediatrics, 115, pp. 1307-1311.
  • Ralph Frenken: Bound Children: History and Psychology of Swaddling . Badenweiler: Wissenschaftlicher Verlag Bachmann, 2011, ISBN 978-3-940523-10-5 .
  • Kutlu, Abdurrahman; Recep Memik; Mahmut Mutlu; Ruhusen Kutlu; Ahmet Arslan (1992): Congenital Dislocation of the Hip and Its Relation to Swaddling Used in Turkey. In: Journal of Pediatric Orthopedics, 12, pp. 598-602.
  • Lipton, Earle L .; Alfred Steinschneider; Julius B. Richmond (1965): Swaddling, a Child Care Practice: Historical, Cultural, and Experimental Observations. In: Pediatrics, 35, pp. 521-567.
  • Meyer, LE; T. Erler: Swaddling: a traditional care method rediscovered. In: World J Pediatr., May 7, 2011 (2): pp. 155-60.
  • Short, Mary A .; Jo Ann Brooks-Brunn; Deborah S. Reves; Janet Yeager; Jean Ann Thorpe (1996): The Effects of Swaddling Versus Standard Positioning on Neuromuscular Development in Very Low Birth Weight Infants. In: Neonatal Network, 15 (4). Pp. 25-31.
  • van Sleuwen, Bregje E. and Engelberts, Adèle C. and Boere-Boonekamp, ​​Magda M. and Kuis, Wietse and Schulpen, Tom WJ and L'Hoir, Monique P .: Swaddling: A Systematic Review . In: Pediatrics . tape 120 , no. 4 . American Academy of Pediatrics, October 2007, ISSN  0031-4005 , p. 1097–1106 , doi : 10.1542 / peds.2006-2083 (English, aappublications.org [PDF; accessed September 29, 2019]).
  • Yurdakok, Kadrye; Tuna Yavuz; Carl E. Taylor: Swaddling and Acute Respiratory Infections . In: American Journal of Public Health . tape 80 , no. 7 . American Public Health Association, 1990, ISSN  0090-0036 , pp. 873–875 (English, aphapublications.org [PDF; accessed September 29, 2019]).

Web links

Commons : Swaddling  - album with pictures, videos and audio files

Individual evidence

  1. ^ A b Priscilla Robertson: The home as a nest. Middle-class childhood in Europe in the 19th century.
  2. ↑ Danzinger & Frankl (1934), p. 229; Lipton et al. (1965), p. 534; Chisholm (1983), p. 166, Gerard et al. (2002 b), p. 398; Blom (2005), p. 148.
  3. ↑ Compare the discussion in Dennis (1940 a), p. 213 f. and 216, Dennis (1940 b), p. 96 ff.
  4. ^ P. Franco et al .: Influence of Swaddling on Sleep and Arousal Characteristics of Healthy Infants. In: Pediatrics 2005; 115: pp. 1307-1311 full text online (English).
  5. ↑ LE Meyer; T. Erler (2011).
  6. ↑ a b c d e f g h i van Sleuwen et al. (2007), p. 1097
  7. ↑ CM Gerard et al .: Spontaneous arousals in supine infants while swaddled and unswaddled during rapid eye movement and quiet sleep. In: Pediatrics 2002; 110: pp. 70–77 full text online (English).
  8. ↑ S. Ohgi et al .: Randomized controlled trial of swaddling versus massage in the management of excessive crying in infants with cerebral injuries. In: Arch. Dis. Child. 2004; 89: pp. 212–216 full text online (English).
  9. ↑ Short et al. (1996), p. 25.
  10. ↑ Compare the figure in Short et al. (1996), p. 27.
  11. ↑ Overview in Frenken (2011), pp. 60–66.
  12. ↑ Kutlu et al. (1992), pp. 598 f., Akman et al. (2007), p. 290. Review of literature in Mahan & Kasser (2008).
  13. ↑ Blair et al. (2009).
  14. ↑ Yurdakok et al. (1990), p. 878.
  15. ↑ Bloch (1966). P. 645.
  16. ↑ Bystrova et al. (2007 a), p. 29 ff.
  17. ↑ Bystrova (2008), p. 46.
  18. ↑ Barry & Paxson (1971), p. 487.