NEUROPHYSIOLOGICAL REASONS FOR NOT SWADDLING NEWBORNS AND INFANTS

Neurophysiological motor actions are important for Athletes. “That goes without saying, but now goes with saying, because of potentailly inhibitory newborn baby and infant practices. “Swaddling is an age-old practice of wrapping infants in blankets or similar cloths so that movement of the limbs is tightly restricted.” 

Scientists conclude that restricting Neonatal and Infant Neuro-Network Reflexes retards and/or damages the normal growth and development of mature Human neurophysiological motor actions and movements. Swaddling is a form of restriction.

“Swaddling bands were often used to further restrict the infant. Swaddling fell out of favor in the 17th century.” [Gerard, Claudia M.; Kathleen A. Harris; Bradley T. Thach (6 December 2002). “Spontaneous Arousals in Supine Infants While Swaddled and Unswaddled During Rapid Eye Movement and Quiet Sleep”. Pediatrics110 (6): e70.  doi:10.1542/peds.110.6.e70PMID 12456937]

“Some modern medical studies indicate that swaddling helps babies fall asleep and to remain asleep and helps to keep the baby in a supine position, which lowers the risk of sudden infant death syndrome (SIDS).[1]  However, one recent study indicated that swaddling increased the risk of SIDS.[2]  Additionally emerging evidence is showing that certain swaddling techniques may increase the risk of developmental dysplasia of the hip.[3] [2. Blair et al. (2009)]] [hipdysplasia.org]

The purpose of Swaddling is to “soothe fussy newborns and to promote better baby-naps and longer-nighttime sleep, promote more daycare order and more sleep for parents.

Swaddling aims to restrict the Moro and Startle Reflex, because neonates and infants often awaken and cry following the Moro and Startle Reflex/Reflexes, if considered seperate as some do, and disturb the day care, nursery, parents or guardians.

Some report that “Swaddling is becoming popular again. However, many medical and psychological opinions disapprove Swaddling.

“At this point, many daycares are banning swaddling and the American Academy of Pediatrics has labeled swaddling an “unsafe” practice in childcare settings. In fact, since December 2012 it is now illegal for child care centers in Minnesota to swaddle.” [Is Swaddling Your Baby Now Dangerous (and Illegal)? by Emily DeJeu in Newborns

2018 Minnesota Statutes, PUBLIC WELFARE AND RELATED ACTIVITIES, Chapter 245A, Section 245A.1435, REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT DEATH IN LICENSED PROGRAMS.

“(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended for an infant of any age and is prohibited for any infant who has begun to roll over independently. However, with the written consent of a parent or guardian according to this paragraph, a license holder may place the infant who has not yet begun to roll over on its own down to sleep in a one-piece sleeper equipped with an attached system that fastens securely only across the upper torso, with no constriction of the hips or legs, to create a swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter, the license holder must obtain informed written consent for the use of swaddling from the parent or guardian of the infant on a form provided by the commissioner and prepared in partnership with the Minnesota Sudden Infant Death Center.” [2018 by the Revisor of Statutes, State of Minnesota]

Another report: The basis for the ban stems from “Caring for our Children: National Health and Safety Performance Standards Guidelines for Early Care and Education Programs,” a guidebook produced by the HHS-funded National Resource Center for Health and Safety in Child Care and Early Education (NRC) in conjunction with the American Academy of Pediatrics and the American Public Health Association. “In child care settings,” the manual states, “swaddling is not necessary or recommended.”

According to Pennsylvania state rules, a baby may not be swaddled in the day care without written authorization from a physician. The regulation states that “Infants shall be placed in the sleeping position recommended by the American Academy of Pediatrics (i.e., on their backs) unless there is a medical reason an infant should not sleep in this position. The medical reason shall be documented in a statement signed by a physician, physician’s assistant or CRNP and placed in the child’s record at the facility.”  [Pennsylvania Nannies Ban Swaddling in Day Care, Pennsylvania has effectively banned swaddling babies in day care because it could possibly be dangerous, Abby Wisse Schachter, November 2, 2013]

The following is the Neurophysiological explanation for not Swaddling newborns.

What reflexes should be present in a newborn?

Reflexes are involuntary movements or actions. Some movements are spontaneous, occurring as part of the baby’s usual activity. Others are responses to certain actions. Reflexes help identify normal brain and nerve activity. Some reflexes occur only in specific periods of development. The following are some of the normal reflexes seen in newborn babies:

  • Root reflex. This reflex begins when the corner of the baby’s mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and “root” in the direction of the stroking. This helps the baby find the breast or bottle to begin feeding.
  • Suck reflex. Rooting helps the baby become ready to suck. When the roof of the baby’s mouth is touched, the baby will begin to suck. This reflex does not begin until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability because of this. Babies also have a hand-to-mouth reflex that goes with rooting and sucking and may suck on fingers or hands.
  • Moro reflex. The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out the arms and legs, cries, then pulls the arms and legs back in. A baby’s own cry can startle him or her and trigger this reflex. This reflex lasts about 5 to 6 months.
  • Tonic neck reflex. When a baby’s head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the “fencing” position. The tonic neck reflex lasts about 6 to 7 months.
  • Grasp reflex. Stroking the palm of a baby’s hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until about 5 to 6 months of age.
  • Babinski reflex. When the sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex up to about 2 years of age.
  • Step reflex. This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface. [Newborn-Reflexes Stanford Medicine, Stanford University, Stanford Health Care, Lucile Packard Foundation, 2019 STANFORD CHILDREN’S HEALTH]

Moro and Startle Reflex Sensory Stimuli Triggers:

  • Auditory: sudden, loud, noises
  • Visual: changes in light intensity
  • Touch: rapid touch of baby or a quick movement of attendant
  • Baby Position change or movement: when baby feel unsupported, placing baby into a bassinet while sleeping

Understanding the scientific principles supporting the learning and execution of fundamental and skilled motor movements is central important during human lifetimes in general and sport and exercise more specifically.

Sporns and Edelman (1993) proposed the ‘Neuronal Network Selection Theory’.

Human Development evolves, beginning with neonates, through periods of instability with trial experiences of many motor options in the Human Brain (Neuro-Networks) to solve mental and motor problems.

Trials strengthen the single or multiple Neuro-Network (Neuronetwork) connections by trial and error and subsequently preferred use.

Beginning with basic ‘Human Brain Movement Inventory of Neuron-Networks’ Humans Homo sapien-sapiens, have and amazing ability to sense the effect and efficiency of the movements turning-on with-in different environments and then satisfying various environmental and internal mental restraints.

Most recently, Hameroff and Penrose ORCH OR Theory, also described the phenomenal Human Brain ability to examine and evaluate itself with microtubule Memristors (dendritic resistors) which filter appropriate Neuron signals and other mechanisms and finds the suitable signals necessary for the resultant neurophysiologic motor action.

Dr. Andrea Utley also described Movement Synergies, synorgenic effects, from natural organism selection, which solved the existing neonatal, infant and childhood environmental and biomechanical problems, which were necessary to be overcome with the selected neurophysiologic motor action.

Hadders and Algra (2000) described the 2 phases of variability:

  1. Primary Phase – early fetal into infancy phase, which explores the Human Brain Subcortical Neuro-Networks for solutions, when the spontaneous motor movements, reflexes, gradually disappear.
  2. Some neonatal primordial reflexes become mature neurophysiologic motor actions and movements.
  3. Secondary Phase – the Primary Phase then surrenders to more goal-directed motor neurophysiologic actions and movements i.e.  secondary or adaptive more specific movement patterns milestones, reaching, crawling, and walking
  4. Swaddling aims to restrict the Moro and Startle Reflex, because neonates and infants often awaken and cry following the Moro and Startle Reflex/Reflexes, if considered seperate and disturb the day care, nursery, parents or guardians.

The Human Brain ability to examine and evaluate itself within the Neuron microtubules and achieve its objective i.e. the selection of most efficient productive motor neurophysiologic action and movement patterns, is again, astonishing.

Task-Specific Conditions call-for the adaption of each movement exactly and efficiently in the absence of tight constraints by developing multiple solution strategies, a catalog for each single motor task.

The mature healthy, full-grown and developed adult then manifests The Neuro-Network Catalog necessary to compete and succeed in the world.

Practice and experience are essential for the development of motor skills in the absence of tight constraints.

Beginning with the neonate and continued through the mature healthy, full-grown and developed adult, the variable diverse repertoire of Human Brain neurophysiologic action and movement patterns additionally adjusts with fluctuating Human body weight. Another phenomenal adaptation process.

The result of the 2 phases of variability and adaptation are the freedom of movement during the mature adult phase, the control of motion, rotations, coordination such as throwing a baseball or a football. (Langendorfer and Roberton (2013). Even throwing control has a beginning maturation period, between 7 to 9 years of age.

From birth, neonate, to 9 years of age, Humans have a massive amount with neurophysiologic motor action adaptation and transformation.

Alterations, adjustments and restrictions to muscle, skeletal, cardiovascular and central nervous systems influence neurophysiologic motor actions and control and can cause chronic pain, loss of mobility and other normal physiological actions for a Human lifetime.

Dr. Andrea Utley’s ‘Motor Control, Learning and Development’ offers an accessible, clear and concise introduction to the core concepts of motor behavior, from learning through to developing expertise. Chapters include:

  • definitions, theories and measurements of motor control;
  • information processing, neurological issues and sensory factors in control;
  • theories and stages of motor learning;
  • memory and feedback;
  • the development of fundamental movement skills;
  • and the application of theory to coaching and rehabilitation practice
  •  [Motor Control, Learning and Development: Instant Notes, 2nd Edition, Andrea Utley, Routledge, Dec 20, 2018 – Sports & Recreation – 336 pages]

The infant arousal response involves subcortical and cortical responses occurring as a sequence of stereotyped behavior regardless of the eliciting stimulus. Scientists found that spontaneous arousal activity occurred frequently, and the majority of responses occurred as a sequence involving an augmented breath followed by a startle and then cortical arousal.

Subcortical arousals as reflected by augmented breaths and startles were more common than cortical arousals.

Each of the responses occurred more frequently during rapid eye movement (REM) sleep than during non-rapid eye movement (NREM) sleep.

We conclude that there is an endogenous rhythm of spontaneous activity in infants involving excitatory processes from the brainstem, which may or may not be closely followed by cortical excitation.

The spontaneous arousal responses occur periodically but with a high level of irregularity and the level of activity is affected by sleep state.

Scientists concluded that spontaneous arousal during NREM and REM sleep in infants involves excitatory processes in both the brainstem and cortex. The similarity to evoked arousal responses suggests that there is a common neural pathway to arousal. The spontaneous arousal responses occur periodically, and the level of activity is markedly affected by sleep state, with possibly increased excitability during REM sleep.

There appears to be an inhibitory interaction between the apnoea associated with early arousal and the spread of arousal to higher brain centres such that one rarely occurs in the presence of the other. The spontaneous arousal pattern in infants suggests that there is a possible endogenous rhythm of spontaneous activity given these several considerations.

[McNamara F, Lijowska AS, Thach BT. Spontaneous arousal activity in infants during NREM and REM  sleep. J Physiol. 2002;538(Pt 1):263-9.]

The Human Brain’s Claustrum is the trigger mechanism for Consciousness. Conscious Awareness awakens when the Claustrum is stimulated and up-regulated.

A striking feature of the claustrum is the few neuronal types it has compared with those of the cerebral cortex (figure 4). Moreover, while the latter is clearly laminated, the former is not.

Research concluded that the claustrum appears to possess a relative uniform cellular architecture. What then is the nature of the computations performed by claustral neurons? If waves of information can travel within the claustrum (as we suggest further below), neurons could be especially sensitive to the timing of the inputs, cementing the role of the claustrum in binding disparate events into a single percept, experienced at one point in time.

Claustral neuron cells project to the cortex on the same side, usually to many parts of it. Some claustral neurons also project to the contralateral cortex. Most regions of the cortex send a projection to the claustrum, usually to many parts of it.

Thus, their mappings are far from being a precise local mapping and tend more to be somewhat global (that is, all to all), though not completely so.

It is not known whether there is any one brain cortex region that does not receive an input from the claustrum.

While most of the claustrum-to-cortex projections are reciprocated, there appear to be a few exceptions. (Sherk 1986), (e.g. Mizuno et al. 1981; Perkel et al. 1986; Lysakowski et al. 1988).

The great discrepancy between the sizes of cortex and the claustrum raises the question of the extent of overlap of these diverse connections in the claustrum. Sherk’s (1986) summary illustrates the complexity of this widespread claustrum-centred net.

There are many projections, and most are bi-directional, which often overlap. No region projects everywhere, yet there are a number of more local maps which overlap somewhat. (V1, V2, V4, MT/V5, FST, MST, TEO and TE; Webster et al. 1993; Baizer et al. 1997).

The picture emerging then from tracer studies is that cortical areas having widespread cortical connections, such as area 46 or the cingulate gyrus, are linked to extensive zones within the claustrum and that these large zones are likely to overlap with other claustrum territories. 3

Insights into the physiological role of the claustrum, just like that of any other brain structure, has been obtained from lesion experiments, single cell recordings and stimulation studies in animals as well as from clinical observations and functional imaging in people.

It has been suggested (Ettlinger & Wilson 1990; Calvert 2001) that the claustrum is involved in cross-model processing. The main exhibit for this hypothesis is the previously mentioned imaging study (Hadjikhani & Roland 1998).

Within the context of the neurobiological theories of consciousness, the highly networked nature of the claustrum raises the question of whether it acts as a sort of ‘Cartesian theatre’. This is a metaphor, introduced and ridiculed by the philosopher Dennett (1991), for the fictitious centre where the mind and brain meet, where ‘it all comes together’ and consciousness occurs.

We think that a more appropriate analogy for the claustrum is that of a conductor coordinating a group of players in the orchestra, the various cortical regions. Without the conductor, the players can still play but they fall increasingly out of synchrony with each other. The result is a cacophony of sounds.

This metaphor would suggest that different attributes of objects, both within (e.g. colour and motion) and across modalities (e.g. visual form and sound location), are rapidly combined and bound in the claustrum. Without this structure—and that of its twin in the other hemisphere—the subject may still be able to respond to simple, isolated or to highly familiar stimuli, but not to complex or unfamiliar ones. Objects or events in the real world have many simultaneous attributes: colour, shape, distance, velocity, smell, sound, feel and so on. In the absence of both claustra, these attributes may not be experienced in an integrated manner and the subject may fail to altogether perceive these objects or events or only be consciously aware of some isolated attribute.

It is clear that the claustrum lies at the confluence of a large number of simple loops with cortex. This widespread and reciprocal connectivity with many, if not most, cortical regions raises the obvious question: why is all this information brought together, since this involves most of the loops being much longer than if the claustrum lay more uniformly under the cortex? Even more unusually, there appears to be no long-range connections within the claustrum.

In biology, if seeking to understand function, it is usually a good idea to study structure. Thus, if the claustrum is critical to binding information within and across sensory and motor modalities, certain anatomical constraints would have to be met. In particular, the information from say, a visual cortical region would need to be combined with information from somatosensory, auditory or motor cortices. This demands some sort of intermixing of the associated signals within the claustrum. Several, non-exclusive, anatomical and biophysical substrates for such widespread intra-claustral interactions are possible.

 “In a study published by Mohamad Koubeissi at the George Washington University in Washington DC, he and his colleagues describe how they managed to switch a woman’s consciousness off and on by stimulating her claustrum. The claustrum appears to be the orchestra conductor. (Philosophical Transactions of The Royal Society B, doi.org/djjw5m) [ Consciousness on-off switch discovered deep in brain by Helen Thomson 2 July 2014 New Scientist]

The Claustrum “A patient had epilepsy. The Koubeissi team used deep brain electrodes to record signals from different brain regions to work out where her seizures originated. One electrode was positioned next to the claustrum, an area that had never been stimulated before. Stimulation of the claustrum switched Consciousness on and off, confirming the Crick and Koch Hypothesis. “We may have found the key……Consciousness is created via many structures and networks but we may have found the ignition key,” the claustrum. [A pilot study of the role of the claustrum in attention and seizures in rats. Bayat, A.,Joshi, S.,Jahan, S.,Connell, P.,Tsuchiya, K.,Chau, D.,Syed, T.,Forcelli, P.,Koubeissi, M. Z.; Epilepsy Res.. 2018 Jan 13] [Electrical stimulation of a small brain area reversibly disrupts consciousness.Koubeissi MZ, Bartolomei F, Beltagy A, Picard F; Epilepsy Behav. 2014-08-01] 126

“Other research explained Anesthesia suppression of consciousness by synthesis of 2 Paradigms depending on the type anesthetic;” both probably contribute to on and off switch of consciousness: “In the “bottom up” paradigm, anesthetics suppress consciousness by modulating sleep-wake nuclei and neural circuits in the brainstem and diencephalon, lower level brain anatomy, that have evolved to control arousal states. “In the “top-down” paradigm: anesthetics suppress consciousness by modulating the cortical and thalamocortical circuits, upper level brain anatomy, involved in the integration of neural information. [Bottom-Up and Top-Down Mechanisms of General Anesthetics Modulate Different Dimensions of Consciousness, Mashour GA, Hudetz AG. Front Neural Circuits. 2017; 11:44. Epub 2017 Jun 20]

Imagine, the potential consequences if neonate or infant Conscious Arousal, Moro and Startle Pattered Reflex Responses were permanently slowed and even irreversibly damaged:

  1. Trigger stimuli elicit a fixed sequence:
  2. Stimuli perceptions trigger the Brain Claustrum to awaken the baby
  3. Spontaneous awakening results followed by sequential augmented breath and a startle
  4. followed by Brain Subcortical, Cortical Consciousness, other responses
  5. If the baby Reflexes were restricted, possibly by swaddling
  6. Inturrpting cybernetic feed-to and -back
  7. neonate and infant awakening aka Brain Cortex Consciousness
  8. might be permanently slowed and even irreversibly damaged.
  9. Considering the widespread innervation or connections within the baby and adult Human Brain by the Claustrum, the widespread Consequences might be disastrous.
  10. The Claustrum reciprocally touches every part of the Human Brain
  11. To date, ‘Supression of the Moro and Startle Reflex, following Excitation Stimuli to Trigger to Claustrum to Conscinousness Sequence’ thought experiments have not be conducted in the laboratory
  12. Dr. Andrea Utley and collegues would be superlative investigators.

Dr. Andrea Utley Profile: “Dr. Utley and collegues address the mechanisms of control and disorders of co-ordination in conditions such as hemiplegic cerebral palsy and Developmental Coordination Disorder.

“Particular research interests are how children and adults with a range of movement difficulties are able to control their movements in a variety of contexts. Detailed analysis of reaching/ grasping and catching in children has revealed how these children attempt to control multiple degrees of freedom.

Utrley et al investigate the assessment of movement and how manipulating the movement context can be used as a rehabilitative strategy. Explanations of motor development have taken a step forward through the application of ideas from proponents of dynamic systems, here movement involves the final product or whole being the active cooperation of many parts, and contains multiple subsystems all contributing in a unique manner (Thelen and Spencer 1998).

“The potential for some of these ideas have been initially explored in the context of reaching and grasping in children with hemiplegic cerebral palsy (Utley and Sugden 1998) and catching in children with DCD (Utley and Astill 2006). Such children have to overcome intrinsic constraints where the neural properties provide a direct link to the type of movement observed.

“External constraints such as task demands and context also influence the nature and extent of interlimb coupling and are especially interested in the nature and extent of interlimb coupling and have provided evidence on the nature of bimanual co-ordination in children with cerebral palsy. This work has indicated that one solution to the degrees of freedom problem during upper limb movements is to couple the limbs therefore reducing the number of degrees of freedom to be controlled.

Collaboration with Leeds University Motor Impairment Group (LUMIG) and external collaborators at the University of Nijmegen (The Netherlands) and University of Minnesota (USA). Techniques employed include kinematic analysis, electromyography, eye-tracking and modelling.

In 2016 Dr Utley was awarded The Cutlers’ Surgical Prize by the Royal College of Surgeons for the design of the Yorkshire Micro Forcep.

Funding: British Council, ESRC, Nuffield Institute

  • Manual skills in children with hemiplegic cerebral palsy.
  • Learning to control multiple degrees of freedom during dynamic balance.

BA (Hons) Human Movement Studies 1984, PGCE Physical Education 1985. PhD University of Leeds 1998. Lecturer, School of Education, University of Leeds, 1993 – 1997. Senior Lecturer. Motor Control and Learning, Leeds Metropolitan University, 1997-1999. Senior Lecturer, Director Centre for Sport and Exercise Sciences, Institute of Systems and Membranes Biology, University of Leeds, 1999 – current

Research interests

Motor and Behavioural Science Research Group

Research projects

Any research projects I’m currently working on will be listed below. Our list of all research projects allows you to view and search the full list of projects in the faculty.

Qualifications

  • BA (Hons), PGCE, Leeds Metropolitan, PhD 1998, Leeds

Modules managed

SPSC2240 – Human Motor Development
SPSC3061 – Research Project in Sport and Exercise Science II
SPSC3329 – Motor and Psychological Aspects of Rehabilitation

Modules taught

SPSC1031 – Motor Control: Foundations of Control and Learning
SPSC2240 – Human Motor Development
SPSC2309/2131 – Skill Acq and Motor Learning
SPSC3061 – Research Project in Sport and Exercise Science II
SPSC3061/5382M – SPSC projects
SPSC3301 – Inter-disciplinary Issues in Sport and Exercise Science
SPSC3329 – Motor and Psychological Aspects of Rehabilitation
SPSC3389 – Research Project
SPSC5314M – Personal Development and Employability for Sport and Exercise Scientists

Academic roles

UG Chair of Special Cases Committee – Sports Science programmes

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