Wrapping and swaddling infants: child health nurses’ knowledge, attitudes and practice

Infant wrapping and/or swaddling is an evidence-based care practice that when applied appropriately can be a strategy for settling an infant and promoting supine sleep positioning as recommended for the reduction of sudden unexpected deaths in infancy (SUDI). This study aimed to describe the knowledge, attitudes and practices of child health nurses (CHN) relating to the advantages and disadvantages of wrapping; principles of safe infant wrapping; and parent education about infant wrapping as a settling strategy. Design: Using a descriptive, cross-sectional survey design the knowledge, attitudes and self-reported practices of CHNs working within nine health service districts throughout south-east Queensland, Australia, were explored. Results: Conducted at a time when no statewide guidelines for infant wrapping existed and achieving an excellent response rate from participants (161, 89%), this study demonstrated a wide variation in knowledge, attitudes and practices in relation to wrapping as a strategy to promote infant sleep and to encourage babies to sleep on their backs, consistent with public health recommendations. Conclusions: Study results identified a need for the development of evidence-based practice guidelines for CHNs to promote consistency in practice, parent advice and education that would help to further reduce the risk of SUDI. There is a need for further investigation into the impact that a targeted educational intervention based on evidence-based guidelines for safe infant wrapping would have on CHN knowledge and practice.