"Like a drug": A mixed-methods anthropological interrogation of swaddling.

Swaddling is a global infant-care practice in which a piece of material is wrapped firmly around an infant’s body, thought to pacify the infant. This thesis aimed to understand the practice of swaddling from a holistic perspective with a view to addressing several knowledge deficits. Methods Responding to calls for a more holistic approach to the study of infant sleep (McKenna, Ball et al. 2007), the thesis conducted an integrated anthropological interrogation encompassing evolutionary, historical, ethnographic, and biosocial perspectives. The thesis was composed of five components: 1. four-part synthesis of the swaddling-related literature. 2. systematic review of video-based methodology in infant sleep research. 3. lab-based study investigating the impact of swaddling upon infant physiologic and behavioural states. 4. Development and evaluation of novel method of calibrating swaddle tightness. 5. survey of health professionals’ swaddling-related knowledge and opinions. Results Firstly, the literature review positioned swaddling as a universal practice implemented in culturally specific ways. It revealed that infant needs and parental responses are dynamic and interdependent. Next, the systematic review provided in-depth evidence highlighting video as a significant resource for infant sleep researchers albeit with methodological ‘trade-offs’ in validity. The findings of the lab project indicated that naïve breastfed infants’ respond to swaddling in a way that deviates from that previously seen in formula fed subjects. Namely, the naïve breastfed infants did not demonstrate alterations in sleep length when swaddled but experienced an extension of active sleep. Outcomes of the swaddle tightness project indicated the device had a high degree of reliability under experimental conditions. Finally, respondents to the survey thought newborns most appropriate for swaddling, with significant preference given towards non-routine swaddling and the ‘hands out’ configuration. Conclusion The thesis unveiled a range of ethical, methodological, and ontological tensions, and highlighted gaps in knowledge pertaining to swaddling.