Swaddling is a critical part of caring for a newborn. Babies lack the shivering reflex and are incredibly sensitive to temperature fluctuations. Hypothermia is a significant concern for a newborn, especially one born in the prehospital environment as it is inherently less controlled than a hospital birthing room. After the infant has been delivered, dry him/her off and swaddle, making sure to cover the head with a beanie as there can be significant loss of heat from the head if left uncovered. It is important to note that, while a swaddle should avoid being too loose, there should never be excess force on the baby as limb dislocation can occur. There are several swaddling techniques, but the diamond swaddle is the most simplistic.
The steps for a diamond swaddle are as follows:
- Place the baby in a supine position onto a square blanket with a corner of the blanket at the child's head and a corner towards the feet. The blanket should be longer on its diagonal than the newborn in order to adequately cover the feet.
- If there is no integrated hood, you may fold the top corner down to provide a "collar" for the baby. This is optional.
- Move one of the side corners to the other side of the baby, covering the child laterally.
- Move the bottom corner up until you have covered the baby's feet. Remember to avoid excessive pressure; the baby's legs naturally tend to sit in a frog-leg configuration and can be dislocated easily.
- Finish the swaddle by wrapping the baby with the final corner, which should "lock" the others into place as it is moved across the child.
- After swaddling, place a beanie on the child to reduce heat loss.