Calming Techniques Ease Moms’ Minds

Nurses help new parents overcome their fears about bringing home Baby by teaching about breastfeeding and basic infant care techniques. But if a fussy infant cannot be soothed, both mother and baby are at risk.

A compelling connection exists between colicky babies and postpartum depression (PPD), according to a study published in the January/February 2005 Infant Mental Health Journal. The study included 93 mothers seen at an outpatient colic clinic. Of them, 45% reported moderate to severe depressive symptoms.

Harvey Karp, MD, assistant professor of pediatrics at the University of California-Los Angeles School of Medicine, was motivated to find a cure for calming fussy infants after treating many severely injured babies who were victims of frustrated parents unable to soothe their cries. Karp studied the complexities of infants’ brains in the first few months of life. His research resulted in his book, The Happiest Baby on the Block, which describes infant-calming techniques that elicit a profound neurological response called The Calming Reflex.

The idea is to simulate the baby’s experience in the womb using techniques referred to as “the five S’s” (see sidebar). In the womb, babies are packed tightly in the fetal position, rocked and jiggled, and surrounded by a constant sound that is a little louder than a vacuum cleaner. Karp also created a self-study certification program for childbirth educators, who can then teach the calming techniques to parents and caregivers.

In March 2006, Virtua Health, a multihospital healthcare provider based in Marlton, N.J., incorporated The Happiest Baby on the Block information into its PPD program Virtua Health TLC (Talking, Listening, Caring) for Moms. A certified instructor teaches the two-hour class in a group setting. Participants (most from the TLC program) receive an instructional DVD, a white noise CD, swaddling instructions, and a swaddling blanket. In addition to The Happiest Baby on the Block techniques, parents learn signs of infant sickness, when to call the pediatrician, feeding schedules, and the dangers of co-sleeping.

A three-month follow-up evaluation of the program revealed that including the Happiest Baby techniques has yielded several positive outcomes for women suffering from symptoms of PPD. The participants reported an increase in the hours of sleep they get each night, increased confidence in parenting skills, decreased anxiety, decreased marital stress, and fewer urges related to harming their babies.

Liz Powell, RN, BSN, a certified instructor of Happiest Baby on the Block techniques, says she frequently hears success stories from parents who have taken the class. And soon after receiving certification, she was able to apply her new skills in her personal life.

“My daughter gave birth to twins”, says Powell. “From my own experience, I can say that the methods work like a charm.”

Another Virtua employee, Vincent Berretta of the information services department, took the class with his wife and was amazed with the results. “We thought the concept sounded good but had no idea how indispensable the program would be until we actually had the baby”, says Berretta. Vincent Jr. can be very fussy, and at times, inconsolable. “If it wasn’t for Dr. Karp’s methods, I don’t think we’d be able to calm him. They have been invaluable to my wife and I as first-time parents.”

As Virtua Health continues to expand its PPD screening program to the pediatric setting, it extends the reach of The Happiest Baby on the Block techniques. Virtua is encouraging pediatric staff nurses, lactation consultants, childbirth educators, case managers, and social workers to complete Karp’s certification program.

Five S’s of happy babies

Harvey Karp, MD, who was a pediatrician for 25 years in Santa Monica, Calif., studied the complexities of infants’ brains to learn about how to soothe fussy babies. Parents have found success using his set of techniques

• Swaddling: Snug wrapping of infants with arms down (for babies post-term), avoiding loose blankets and overheating
• Sucking: On a breast, finger, or pacifier (nursing mothers are advised to avoid rubber nipples, such as bottles or pacifiers, until breastfeeding is well established)
• Shushing: Strong white noise
• Side/Stomach: Laying a baby on her side or stomach (for calming only, not to sleep)
• Swinging: Rhythmic, jiggling motion (like a little shiver)

Written by Barbara Johannes, RN, CCE and Lynne Menei, RN, MSN, CRNP, posted on March 28, 2007, The Nursing Spectrum