Infant Swaddling and the Startle Reflex

I used to think that my daughter’s startle reflex in reaction to sudden movements, sounds or touch during her first few months was the result of the anxiety (though I have to say the level of which was not excessively high or anything) I felt during my pregnancy and the high levels of cortisol that were most likely present in my body, which would’ve been passed through to my daughter.  Her startle reflex was particularly strong, so much so that it would cause her to startle awake constantly from her slumber.  It was only during the writing of my book that I read that the startle reflex, also called moro reflex—first discovered and described by, and subsequently named after, the Austrian pediatrician Ernst Moro—actually demonstrates proper motor development in babies up to 5 months.  The moro reflex consists of the startle (or twitch), spreading out of the arms (abduction), and unspreading of the arms (adduction).  The baby may also cry as a consequence of the reflex. 

This brings me to the topic of swaddling.  My husband and I learned the hard way,  of course, since no one had advised us on why it is babies are tightly swaddled, that doing so helps them sleep more deeply and for longer stretches, especially for babies with strong startle reflexes.  I just used to think it was done to help the baby feel warm and secure, not to mention womb-like in terms of giving the baby the impression she was in a confined space with movement limitations.  As I’d written previously, for my daughter it wasn’t just the swaddling that helped her to sleep better, it was being kept in a semi-upright position in her car seat.  That was probably due to the  positioning (in my womb) with which she was accustomed.  She couldn’t sleep lying flat. It took us days to put one and two together about the car seat, followed by the swaddling.  For the first month or so, she slept in her car seat in our bedroom.  My parents and in-laws were worried that letting her sleep for long periods of time in a car seat would cause her back to curve.  Our pediatrician told us not to worry about that, so we didn’t.  At least we tried not to.  Fortunately, she was sleeping flat in her crib and unswaddled when the first month was over.  It’s almost like this was my daughter’s 4^th trimester of development that just happened to be, but she was not ready for, outside mom’s belly rather than the dark and protected in utero environment.

As it turns out, swaddling is an age-old practice of wrapping infants snugly to restrict movement of the limbs. It’s amazing that infant swaddling was a practice even as far back as 4000 BC Central Asia! Babies have been swaddled in different countries throughout history but fell out of favour in the seventeenth century when people started to associate such restriction with neglect or unnecessary restriction of movement.  It became popular again as medical studies in the past couple of decades showed that swaddling infants reduces the tendency for them to awaken through reflex motion, which helps infants stay in REM sleep longer.   So, that’s why my daughter was swaddled all the time while in the hospital!  It’s like the hospital thought we’d figure everything out ourselves.  Well, so much for educating the first-time parents!  There was even this particular way of swaddling to ensure a snug fit and the blanket would not come undone. You didn’t simply wrap the baby with a blanket.  So, not only did I have to learn how to diaper properly, I had to learn how to swaddle properly.  Oh, boy – so many things to learn all at once!

So, what’s all this got to do with postpartum depression (PPD)?  Well, remember, the more you know of what to expect, the less surprises–and subsequently anxiety–the new mom will experience.  Had my husband and I known the purpose behind the swaddling, we would not have had to unnecessarily spend a few days not only worrying about our daughter’s strong (and frequent) startle reflex while sleeping but also how to minimize their occurrence.   Childcare classes should throw in a few sentences about the startle reflex and swaddling, so the expectant parents are knowledgeable about all this and won’t have to struggle with so many unknowns all at once. 

After all, it’s the unknowns that raise the anxiety levels in the first-time parent.