Gerard Claudia M, Harris Kathleen A, Thach Bradley T
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA.
J Pediatr. 2002 Sep;141(3):398-403. doi: 10.1067/mpd.2002.127508.
The calming effects of swaddling may help infants accept back sleeping and so reduce the risk of sudden infant death syndrome. We hypothesized that swaddling, with minimal leg restraint, would be accepted by postneonatal infants with minimal respiratory effects.
Postneonatal infants (n = 37)were studied for the introduction of swaddling. Four infants were studied by using traditional swaddling techniques. Swaddle tightness was increased in 13 infants, simulating traditional swaddles. Respiratory variables-respiratory rate, tidal volume, oxygen saturation, heart rate, sigh rate, and "grunting"-were measured.
Hips were flexed and abducted in the swaddle. The majority of infants accepted swaddling while supine, including 78% of infants who slept prone at home. Acceptance decreased with increasing age. With increased swaddle pressure, respiratory rate increased during quiet sleep (P <.05). In rapid eye movement sleep, a slight effect on heart rate was observed (P <.05). Other variables did not change.
Older infants including usual prone sleepers generally accept a form of swaddling that has minimal respiratory effects. The reintroduction of swaddling, without restricting hip movement or chest wall excursion, combined with supine sleeping, may promote further sudden infant death syndrome reduction.
襁褓的安抚作用可能有助于婴儿接受仰卧睡眠，从而降低婴儿猝死综合征的风险。我们假设，对腿部限制最小的襁褓包裹方式会被出生后新生儿接受，且对呼吸影响最小。
对37名出生后新生儿进行襁褓包裹引入研究。4名婴儿采用传统襁褓包裹技术进行研究。对13名婴儿增加襁褓包裹的紧度，模拟传统襁褓包裹。测量呼吸变量——呼吸频率、潮气量、血氧饱和度、心率、叹息频率和“呼噜声”。
在襁褓包裹中，婴儿髋关节呈屈曲和外展姿势。大多数婴儿仰卧时接受襁褓包裹，包括78%在家中俯卧睡眠的婴儿。接受程度随年龄增长而降低。随着襁褓包裹压力增加，安静睡眠时呼吸频率增加（P<.05）。在快速眼动睡眠中，观察到对心率有轻微影响（P<.05）。其他变量未改变。
包括通常俯卧睡眠的较大婴儿通常接受对呼吸影响最小的襁褓包裹形式。在不限制髋关节活动或胸壁运动的情况下重新引入襁褓包裹，并结合仰卧睡眠，可能会进一步降低婴儿猝死综合征的发生率。
