The Effect of Nursing-Implemented Swaddling and Dim Light on Sleep Patterns and Weight Gain in Preterm Infants: A Quasi-Experimental Study

BackgroundPreterm infants admitted to neonatal intensive care units (NICUs) are highly vulnerable to sleep disruption caused by environmental stressors such as excessive light exposure, frequent handling, and routine caregiving procedures. Disturbed sleep may negatively affect neurodevelopment, physiological stability, and growth. Developmentally supportive nursing interventions, including swaddling and environmental light reduction, are intended to minimise sensory stress and support behavioural regulation.

ObjectivesTo evaluate the association of nursing-implemented swaddling combined with dim light exposure with sleep patterns and short-term weight gain among preterm infants.

DesignQuasi-experimental controlled study with repeated measurements.

MethodsThe study was conducted on a purposive sample of 60 preterm infants allocated to an intervention group (n = 30) and a control group (n = 30). Infants in the intervention group received standardised swaddling and dim light exposure during designated rest periods in addition to routine NICU care, whereas the control group received routine care only. Sleep–wake behavioural organisation was assessed daily for five consecutive days using the Anderson Behavioral State Scoring System (ABSS), and body weight was measured daily using a calibrated electronic infant scale. Data were analysed using non-parametric statistical tests, including the Mann–Whitney U, Wilcoxon signed-rank, and Friedman tests.

ResultsBaseline characteristics were comparable between groups for gestational age, birth weight, baseline weight, and APGAR scores; however, postnatal age was significantly higher in the intervention group (p = .004). Infants receiving swaddling and dim light demonstrated significantly greater improvements in sleep–wake behavioural organisation across the five-day study period than infants receiving routine care (all p < .001). The intervention group also showed significantly higher mean body weight at Day 5 (p = .009) and a higher mean discharge weight.

ConclusionNursing-implemented swaddling combined with dim light exposure was associated with improved sleep–wake behavioural organisation and higher mean body weight at Day 5 and discharge among preterm infants, supporting the incorporation of developmentally supportive nursing practices into routine NICU care.