Calm Colicky Infants Using 5 Simple Techniques
Can a simple multistep baby-calming technique meant to mimic the intrauterine environment really be the quickest way to calm a colicky baby?
Dr. Harvey Karp, who developed the technique after 2 decades of research on baby-calming techniques in numerous cultures, thinks so.
He said it’s no surprise that the easy-to-learn method can quiet almost any cranky baby within minutes because the combination of tight swaddling, constant rhythmic sound, and motion activate the same internal regulators that help keep babies quiet in the womb.
The sound of blood rushing through the placenta, the sensation of snug warmth, and the near-constant movement of the mother’s daily activity stimulate a variety of reflexes in the fetus that help it stay calm and quiet during gestation, Dr. Karp said in an interview.
“Over time, the fetuses that evolved this ability to stay quiet, to not kink the cord, and keep still in a head-down position, were the ones who survived.”
Humans are prematurely evicted from their snug nest so that their large-brained heads can pass safely through the birth canal, but they’re not really ready for the outside world at birth, said Dr. Karp, a pediatrician in Santa Monica, Calif. “We should really be thinking about the first 3 months of life outside the womb as the last 3 months of fetal life, and giving babies a similar environment when they demand it.”
Dr. Karp’s baby-calming technique consists of five interventions meant to be performed in the following order:
- Swaddle the infant. The infant is tightly wrapped in a light blanket, with arms down and at the sides. This “gets the screaming baby’s attention” and simulates the snug hold of the uterus around the fetus. “This should be about as tight as the elastic waistband on a woman’s pants at the end of pregnancy,” Dr Karp said.
- Hold the infant on his side or on his stomach during calming. “Try keeping them on the side, rolled a little bit toward the stomach,” he said. Putting a crying baby down on his back often stimulates the Moro’s reflex, which results in more crying, Dr. Karp said. However, it’s important to remind parents not to allow the infant to sleep on his stomach, which increases the risk of sudden infant death syndrome.
- Have the parent make a very loud, rhythmic “shooshing” noise. In order for the baby to hear this, it has to be at least as loud as his crying, Dr. Karp said. “This might seem counterintuitive, because it sounds loud and rude,” but it’s similar to what fetuses hear inside the uterus: the constant loud whooshing of blood through the placenta, in addition to their mothers’ internal rumblings, breath sounds, and heartbeat.
- Move the infant in a swinging motion. This is more like rapid jiggling, Dr. Karp said, with small, fast movements that slightly move the baby’s head. “If you stabilize the head too much, you’re not going to activate the vestibular reflex,” he said. Again, the movement must match the intensity of the baby’s crying: The harder the baby is crying, the faster and smaller the movement should be. One good way to do this is to hold the infant in the football or reverse breast-feeding hold, on his side slightly turned toward his stomach. Allow the head to rest on both open palms and lightly and quickly move the baby so that the head slightly wiggles in the parent’s palms. As the baby calms, the movement can become broader and slower, more like conventional swinging or rocking.
It’s important that parents understand that swinging or jiggling does not mean shaking, which can cause brain injury. “Tell parents never to try this technique when they’re angry,” Dr. Karp stressed. “This should be about the amount of movement you could imagine the baby feels when the pregnant mom is in exercise class.”
- Give the infant something to suck. Give something for nonnutritive sucking: A pacifier or fingertip is good.
Most of Dr Karp’s method sounds familiar to experienced parents and pediatricians. But while everyone has tried one—or maybe all—of the interventions, the key to this technique is layering. Some babies’ calming reflexes will switch on with just two or three of the interventions; some won’t be calmed unless all five are performed in just the right way.
“It’s like getting a knee reflex,” Dr. Karp said. “Everyone has one, but you can’t elicit it unless you correctly perform a very specific action. It’s got to be done just right.”
The ability to calm a colicky baby can turn infant crying into a positive interaction between parent and child, rather than a negative interaction with possibly disastrous consequences. Dr. Karp’s residency in the emergency department of a Los Angeles hospital taught him that incessant crying and the frustration it causes can trigger child abuse, especially baby shaking. “Being able to reliably calm a baby is a very empowering thing for parents, especially for fathers. Instead of an aversive event, they can begin to look at crying as a chance to be a great parent.”
Since its release last May, Dr. Karp’s book on this technique, “The Happiest Baby on the Block,” (New York: Bantam Doubleday Dell Publishing, 2002) has drawn national attention and is making headlines in Europe and Japan as well. Well-respected academicians and pediatric medicine leaders have endorsed the technique, including Dr. Steven Shelov, coeditor of the American Academy of Pediatrics’ book “Caring for Your Baby and Young Child: Birth to Age 5,” and former U.S. Surgeon General Dr. Julius Richmond.
Written by Michele G. Sullivan, posted on April 2003, at Pediatric News