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The supine position is recommended for healthy sleeping infants to reduce the risk of sudden infant death syn-drome (SIDS).1 However, some infants arouse more read-ily and sleep for shorter periods of time when sleeping in the supine position,2-10 and some parents may therefore place their infants in the side or prone (ie, nonsupine) position for sleep.11-15 In the United States, approximately 25 % of parents report routinely placing their infants in a nonsupine position for sleep.16 Swaddling is a technique of wrapping the infant in a blanket, usually with the arms enclosed within the blan-ket. Physiologic studies demonstrate that swaddling can increase sleep efficiency and decrease spontaneous awak-enings.17,18 It has been used for centuries to comfort and soothe young infants,19 and more recently, it has been advocated as a strategy to encourage infants to sleep in the supine position.20,21 No published reports in the United States have described parental perspectives about swaddling. We therefore conducted a descriptive study to better understand parental knowledge, attitudes, and practices with regard to swaddling. Furthermore, we chose to recruit participants in an urban, majority African American, community where self-reported non-supine positioning is common,16 to assure adequate num-bers of parents who do not routinely use the supine position for their infant. Our objectives were to determine how common swaddling is practiced and to character-ize the differences between those who routinely swad-dle their infants and those who do not routinely use swaddling. We predicted that routine swaddlers would find swaddling more effective in helping infants sleep and would be more likely to place their infants supine when swaddled. Methods We recruited a consecutive sample of parents and guard-ians of infants 0 to 3 months of age to complete a staff-administered, 5- to 10-minute survey. Participants were recruited at well child visits to a hospital-based pedi-atric primary care site and a WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) site in Washington, DC. Participants were initially shown