Learning to swaddle an infant well is a skill. It is not something anyone is just born knowing. It isn't something you suddenly know when you first have your own children. In the NICU it is a HUGE necessity.
Why swaddle?
It calms the babies. It makes them feel secure, safe and less stimulated.
Why so tight?
The tighter the better, I think, with some kids. Especially those who are withdrawing from some form of drug. When teaching new nurses to swaddle, I show them first to make a diamond shape from the receiving blanket. Then fold down one corner. Then put the baby's head at that folded corner and tuck one arm in the fold and wrap it over them and tuck it under. Pull up the bottom corner, tuck it over their opposite shoulder. Then, and this is the important part, take the other arm and hold it down while you pull the remaining opening over the baby toward you and chinch it tight. You want the baby to go "Uh!" as you pull. It is a lot like saddling a horse. If you don't pull it tight enough the saddle slips off. If you don't pull the blanket tight enough, the baby escapes and then... oh and then. The wrath of God is less than a drug addicted baby who has just escaped from her swaddle.
Of course you can get a little over zealous. I had a baby once after I first started who was continually desating (dropping the level of oxygen in her blood stream... it makes the monitor alarm and means the baby isn't getting enough oxygen). She was a drug baby. She had no other issues, and she had been relatively healthy up until this point. She was screaming early in the night and I asked a friend who is known for her wonderful tight swaddles to help me wrap her. So after a few times of the alarm going off, I went over to the baby and unswaddled her to check her monitor probes were in the right position. As I untucked the tight swaddle I heard the baby take a huge gasp of air. Ok, maybe that swaddle was a little overboard. But she hadn't cried. Of course, she was having a hard time breathing, but at least she wasn't crying. Anyway, we fixed it and she was fine.
So swaddle... tightly... but not too tight.
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