Should I Use a Swaddle or Sleep Sack on My Baby?

Medically reviewed by Teja Dyamenahalli, MD, MPH, FAAPMedically reviewed by Teja Dyamenahalli, MD, MPH, FAAP

Many parents turn to either swaddles or sleep sacks to keep their baby comfortable while sleeping. Swaddling also is used as a way to soothe a fussy newborn and promote sleep—especially as they adjust to life outside the womb.

“Swaddling is a traditional practice of wrapping a baby gently in a light blanket in a way that mimics the womb,” says Jessica Morse, MD, a newborn medicine pediatrician at Children's Health and assistant professor at UT Southwestern Medical Center, adding that there are different types of swaddle blankets, including breathable muslin or cotton blankets.

A sleep sack, on the other hand, is an alternative to traditional swaddling and is a specially-designed baby garment for secure sleeping. But deciding which is best for your baby isn't always simple. For this reason, we spoke with pediatric experts to find out the benefits and risks of swaddles vs. sleep sacks and how to determine which is right for you.

What Is a Swaddle?

Swaddling refers to snugly wrapping your baby’s arms near their chest to recreate the sensation they had in the womb, explains Stephanie Napolitano, MD, a neonatologist at Nationwide Children’s Hospital. “Swaddling your infant can help soothe them by giving them boundaries that they developed inside the birthing parent.”

Traditionally, swaddling is done with a blanket, says Dr. Napolitano. “However, when we swaddle with a blanket and leave infants unobserved during sleep, it can become loose and unwrap as the baby moves, and the loose blanket can create a suffocation risk for an infant.”

For this reason, pre-made swaddles or wearable blankets were developed to provide infants that containment but with blankets that will wrap and secure, generally with wings or straps and Velcro.

“A pre-made swaddle is generally more convenient than using a blanket that needs to be specially wrapped and folded, but both serve the same purpose,” adds Rebekah Diamond, MD, an assistant professor of pediatrics at Columbia University, and the author of Parent Like a Pediatrician.

Pros and Cons of Using a Swaddle

Swaddling an infant provides that tactile feedback needed to soothe or calm them in the safest way during sleep, says Dr. Napolitano. That said, there are some drawbacks to using a swaddle as well. Here’s an overview of the pros and cons of swaddling.

Benefits of Swaddling

• Provides tactile feedback

• Can be soothing and calming

• Creates sensation of being in the womb

• Promotes sleep

Drawbacks of Swaddling

• Can pose challenges in trying to wake your baby from a deeper sleep

• Increases risk of overheating

• May interfere with breastfeeding if baby sleeps too long

• Can be difficult to use correctly

Safety Considerations for Using a Swaddle

Typically, it’s recommended that you stop swaddling your baby when they show signs of being ready to roll over. Generally, this occurs around 3 to 4 months of age or older—though every infant is different.

“Once this is the case, babies should never be swaddled with their arms inside,” says Dr. Diamond. “Swaddles can still be used after this age if both of the baby's arms are free."

When you are using a swaddle, also make sure that the swaddle isn’t near your baby’s face or too tight around their chest or hips, adds Dr. Napolitano. “[Their] hips should have ample space to move and develop.”

There also is some evidence that swaddling may make it more challenging for babies to wake from a deeper sleep. And, while this extended snoozing may be attractive for sleep-deprived parents, this can interfere with breastfeeding and nutrition, as well as increase the risk of sudden infant death syndrome (SIDS). There also is a risk of overheating–especially if you notice damp hair, flushed cheeks, or even a heat rash.

You can reduce the risk of overheating by dressing your baby appropriately, says Dr. Napolitano. “A good rule of thumb is generally what you’re comfortable wearing, plus one layer.”

What Is a Sleep Sack?

A sleep sack is similar to a swaddle, but much less restrictive, explains Robert Quillin, MD, a board-certified pediatrician and medical director at Pediatrix Medical Group. “Sleep sacks have unrestricted arm movement, which can be sleeved or sleeveless [and] the lower portion is looser and allows your baby to move their legs more freely.”

Sleep sacks also don’t have the same ability to wrap tightly around a baby's torso and arms but instead has a pouch-like shape that babies can be zipped into, says Dr. Diamond. "A blanket or any loose cloth is unsafe for infant sleep, so sleep sacks replace blankets for added warmth and comfort."

Pros and Cons of Using a Sleep Sack

Because blankets pose a risk of suffocation for babies younger than 24 months, a sleep sack is a safer option, says Maria Lopez, a sleep expert and director of Sleep Sense en Espanol. “A sleep sack also keeps your child warm all night.”

Here are some of the benefits and drawbacks of using a sleep sack:

Benefits of Using a Sleep Sack

• Can be used even when your baby can roll

• Safe for newborns

• May be easier to use than a swaddle

Drawbacks of Using a Sleep Sack

• Comes in limited sizes

• May not be useful or safe once a baby can stand or becomes mobile
  

Safety Considerations When Using a Sleep Sack

According to Dr. Quillin, the same safety considerations that apply to a swaddle also apply to a sleep sack. “The weight or thickness of the blanket may really be the only potential safety concern when used correctly.”

That said, when you choose a sleep sack, make sure that it's roomy enough for free movement, especially if your child can sit or stand up, says Lopez. “As with swaddles, do not use weighted sleep sacks, and avoid overdressing your child when using one. Make sure the fabric is appropriate for the weather to prevent overheating.”

Safe Sleep Guidelines

Whether you choose a sleep sack or a swaddle, familiarize yourself with safe sleep practices provided by the American Academy of Pediatrics. These guidelines are designed to keep your baby safe while sleeping, as well as reduce the risk of SIDS, which peaks around 1 to 4 months of age.

To reduce the risk of SIDs, the AAP recommends:

• Putting your baby to sleep on their back

• Using a firm breathable mattress in a crib, bassinet, play yard, or portable crib

• Keeping their sleep space free of loose sheets, blankets, books, or toys

• Avoiding bed-sharing

• Sharing a room with your baby for the first 6 months, preferably 1 year

• Keeping the room between 68 degrees Fahrenheit and 72 degrees Fahrenheit
  

How to Decide Between a Swaddle or Sleep Sack

Choosing between a swaddle and a sleep sack when your baby is under 3 to 4 months of age—and they’re not yet rolling over—really comes down to personal preference and your goals.

If you have a fussy baby who needs comfort and security during naps, you may want to swaddle them from time to time. But if your baby enjoys moving their arms and kicking their legs—even if they can’t roll over—they may prefer a sleep sack.

The weather and temperature of the room also should be considered. Swaddling in a warm room or during hot weather may cause your baby to overheat due to the restrictive nature of the swaddle. In these situations, a lightweight sleep sack might be a better option for nighttime sleeping—as long as you don’t overdress them.

Ultimately, though, Lopez recommends using age as the primary decision maker. “I do not recommend swaddling babies over 4 months, regardless of whether or not they have learned to roll over.”

Instead, she suggests using a sleep sack as soon as your little one shows signs of rolling over or is 4 months or older. “Taking into account your little one's preferences, it will be very easy to tell early on whether your baby likes to be swaddled or prefers using a sleep sack.”

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