OBJECTIVE: The goal of this study was to conduct an individual-level meta-analysis of sudden infant death syndrome risk for infants swaddled for sleep. Swaddling risk varied according to position placed for sleep; the risk was highest for prone sleeping (OR, 12.99 [95% CI, 4.14–40.77]), followed by side sleeping (OR, 3.16 [95% CI, 2.08–4.81]) and supine sleeping (OR, 1.93 [95% CI, 1.27–2.93]). The practice of swaddling — wrapping an infant with a light cloth, with the head exposed — has grown in the United States with reports that it promotes better sleep. TABLE 1 Study Characteristics TABLE 2 Study Quality Assessments Using the Newcastle-Ottowa Scale Pooled Results and Heterogeneity In total, 760 SIDS cases were compared with 1759 control subjects. For both the prone and side positions, the risk doubled when the infant was also swaddled compared with nonswaddled. The significant risk of placing infants on their side or prone to sleep doubled when infants were swaddled, and the SIDS risk associated with swaddling increased with age. Few infants were swaddled and placed prone, although this practice was significantly more common among the infants who died, and the risk of SIDS from being placed prone doubled among the swaddled infants. Still, she said, “We already know that side and prone sleeping are unsafe for young babies, so the advice to place children on their backs for sleep is even more important when parents choose to swaddle them.” 
 
 The risk also increased with the age of the infant. Sudden death was more common among older infants, though, and the researchers think this could be because they're more likely to move from their back to their side or stomach while sleeping. The advice given in the Netherlands, a country with low rates of SIDS, is to encourage swaddling to reduce excessive crying.30 Because of the likelihood of rolling to the prone position, the official advice in the Dutch guideline on excessive crying is never to initiate swaddling after the fourth month, to stop swaddling as soon as the child signals he or she is trying to turn over, and always to stop swaddling before the sixth month (after this age, infants will be able to roll over).
– Parents are often told to swaddle their newborn babies in order to help them sleep, but a new analysis of studies finds that the practice may increase the risk of SIDS, the New York Times reports. Researchers looked at four studies that examined a total of 760 cases of sudden infant death syndrome, and found that swaddling (wrapping a baby tightly in a blanket in order to simulate the feeling of being in the womb, AOL reports) increased the risk for SIDS by about a third overall. Of the babies who died of SIDS, 17% were swaddled. The biggest risk was in babies asleep on their stomachs. It was less risky for those sleeping on their sides, and the least risky for those sleeping on their backs. Swaddling makes it more difficult for a baby to move, so a baby on his stomach may be more at risk if he is swaddled and his face is pushed into the mattress. The current recommendation is for parents to place babies on their backs to sleep, and the researchers say this is even more important if the baby is swaddled. The researchers also found the risk increased as the age of the babies increased, and as the study notes, it was greatest for babies older than six months—"babies start to roll over between four and six months, and that point may be the best time to stop" swaddling, the lead author says. As for babies swaddled and then put to sleep on their backs, researchers did find a "small but significant risk" of SIDS, the Atlantic reports, and that's likely related to babies who were put to sleep on their backs swaddled, but then rolled over.