He Shushes New Parents’ Cry for Help
Pediatrician’s study of other cultures yields tips he says can conquer even the worst colic
Your beautiful new baby is healthy and home. Everything feels perfect. Until the crying starts. You hold him. You caress him. You check for a wet diaper; is it time for dinner? Everything seems on track, but the crying does not cease.
All babies cry, you tell yourself as you cradle your little one in your arms. Maybe you take a walk. You try rocking him. But the baby’s cries continue. Is it gas? Is it something more serious? Am I a terrible mother? A clueless father?
The longer you pace the floor with your newborn, the louder the wails become. Desperate minutes turn into hours. Soon that sweet baby you’ve eagerly awaited all these months begins to pluck your very last nerve. You put her down, thinking you won’t be manipulated. You will not succumb. And the baby screams bloody murder.
There are experts, books and Web sites galore to learn everything there is to know about pregnancy, natural childbirth and breast-feeding, but does anyone really know what to do with a colicky baby? Does anyone even understand that sustained, inconsolable crying known as colic?
For years, doctors have debated the causes of colic, with the prevailing theory being that it is gastrointestinal in nature. Pediatricians often recommend that the breast-feeding mother cut back on “gassy” vegetables and spicy foods in response. Others in the medical field attribute colic to overstimulation of the baby’s immature nervous system, recommending “white noise” to calm the baby.
“It’s such an instinct to want to calm your baby, but it’s not instinctive to know how,” says Harvey Karp, a Santa Monica pediatrician and author of “The Happiest Baby on the Block,” released today by Bantam Books, which details five techniques for calming colicky babies that Karp has taught his patients for many years.
“Babies don’t have a broad vocabulary. They cry the same way if they need to burp, have a wet diaper or are hungry. But when you hear the crying, it makes your skin jump. You feel there is something really terrible going on with the baby.”
If anyone knows crying babies, it’s Karp, a pediatrician for 25 years and a professor of pediatrics at UCLA School of Medicine whose patients include the children of Michelle Pfeiffer and Madonna. In 1981, Karp received an Ehrmann Fellowship to study crying and colic. The more time he spent studying other cultures, the more he wondered why mothers in other countries did not complain about overly fussy babies. What did they know? What were they doing differently?
“One of the things that was very common around the world was the swaddling, the wrapping of the baby,” Karp says. “Babies don’t need freedom. They need protection and security. Inside the uterus, they can’t move their arms, so it makes sense to wrap them. The Russians even put a belt around the blanket to make sure it stays in place. People from other cultures are not all that impressed with my findings.”
The way Karp sees it, there is too much crying going on in the United States, and he believes his book and companion video are the kernels of a parenting movement that can stop it. Every year, 4 million babies are born in the United States; 1 million of them spend at least two or three hours a day crying, Karp says.
“That’s a lot of crying going on in this country, and that’s not even counting the mothers,” he says. “Parents get exhausted, couples get into problems, women get depressed and babies get abused, and are even killed, because people don’t know these techniques, which are really just a return to ancient wisdom we discarded accidentally in our rush to scientific advances.”Karp’s explanation for colic is simple, if a little startling: Babies are born three months too soon.
When Karp announces this at a recent seminar for the staff of St. Anne’s, a residential facility in downtown Los Angeles for adolescent pregnant girls and mothers, the women gasp and roll their eyes. Is the good doctor suggesting women stay pregnant three months longer, as if they really had a choice in the matter?
“Of course not,” Karp laughs. “Nobody would dream of that, but it gets you thinking from the baby’s perspective. Babies are not ready for the world when they are born. For the first three months, they’re really like fetuses. They’re more like they were inside of the womb, but they’re born because they have big brains and they need to come out.”
The transition to the outside world can be very abrupt, and for some babies the adjustment is tougher than for others. For nine months, babies snuggled in a warm, tight, wet womb where there was constant movement and noise. According to Karp’s research, the sound of a mother’s blood flowing through her body is louder than two or three times the noise a vacuum cleaner makes.
“So what’s it like when the baby is born?” Karp asks. “It’s too quiet, too still and too boring. Parents worry about overstimulation, but a bigger problem is understimulation. Babies want hypnotic, repetitive and rhythmic noise and movement that is jiggly. Calming a baby is like dancing with your baby, but your baby is leading.
“Don’t worry about spoiling them,” he says. “You kick them out of the uterus because their heads are too big, and now you want to put them in the crib and have them just lay there and be quiet? That’s not fair. This is a real cutback in attention and stimulation from the baby’s point of view.”
Babies, like adults, have reflexes. Most important, Karp says, they have a calming reflex–“nature’s shut-off switch”–that parents can learn to trigger in “the fourth trimester,” as Karp calls the baby’s first three months of life. Karp’s prescription for a quiet baby rests in what he calls “the 5 S’s”–swaddling, side/stomach position, shhhing, swinging and sucking–techniques and traditions he learned from his studies of ancient and modern cultures.
“We don’t know the cause of why babies are colicky. But these are methods he’s tried with his patients and have worked, and he puts it all together in the book in a simple and systematic matter,” says Dr. Morris Green, who heads the behavioral and developmental pediatrics division at Indiana University’s School of Medicine and has read the book.
To calm a fussy baby, Karp says, wrap him tightly in a square blanket, pinning the baby’s arms against his sides so he can’t break loose. This simply sets the stage for the calming efforts to come, so don’t be alarmed if your baby initially cries harder at being swaddled. Next, position him in your arms on his side or stomach; make a shhhh sound loudly in his ear to imitate the sounds he heard in the uterus; swing the baby; and, finally, give him something to suck on.
Although some infants will respond quickly to two or three of the steps, the most colicky newborns will require all five, Karp says. For those infants, each stage is a layer that builds on previous ones. “If you do these things, and you do them correctly, it will be like a miracle,” Karp says.
But don’t take it from him–or the footage in his video of red-faced screaming infants who quiet down in less than a minute with the doctor’s touch. Take it from those in the trenches.
Baby Emerson Thein, born on April 10, cried at least eight or nine hours a day for the first five weeks of her life. She slept only 10 hours a day, and her parents were beside themselves. How bad did it get? Dhari and Daniel Thein took a decibel reading of their baby’s wails: it was a whopping 95, louder than a chainsaw. Dhari Thein called everyone she knew, but no one, including her pediatrician, could help. Books offered no solutions. Then a lactation nurse suggested Karp.
“My husband would come home from work, and I’d be crying more than she was,” says Dhari Thein, 34. “You love this little being so much, and she looks to be in so much anguish and pain, and you can’t do anything to soothe her. It’s so frustrating. When Dr. Karp came here, she’d been screaming for two hours. I was going to feed her, but he asked me to give him a chance. Truthfully, I thought this man had met his match. I didn’t think his techniques were going to work on my incredibly cranky baby. In about a minute, she was quiet and peaceful. I was amazed and surprised and I wanted to learn it. I thought he slipped something to my baby.”
A week later, Emerson was sleeping 14 hours a day, and she responds to the “5 S’s” as if she came up with them herself, says her more rested mother. “She’s much happier and more playful and so are we. Before, my husband and I had this hot potato thing going on, ‘No, you take her!'”
Joy Chudacoff, of Marina del Rey, knows Dhari Thein’s pain well. Her 18-month-old son, Jack, cried 12 hours a day during his first three months. Karp taught the first-time mother his “cuddle cure,” and baby Jack developed a charming personality.
“He developed colic in the hospital, and nobody there knew what to do,” says Chudacoff, who is five months pregnant. “There was no help for us. When Dr. Karp showed us his technique, my baby started resting comfortably. Now, with my second child, I have no concerns. Those five steps really do work, and I think they’re most effective when they’re done together like he suggests.”
Debi Halpert-Storosh of Mar Vista is such a fan of what some parents call the “Harvey shuffle” that she teaches it to any pregnant woman who will listen. Her children, Victoria, 13, and Matthew, 10, were colicky babies who calmed down when she learned the “5 S’s.”
“I’ve told everyone I know, because it works,” she says. “I even stop people in baby stores to tell them. The first three months of being a parent are harder than heck.”
Karp, who has no children of his own, claims he hasn’t yet met a howling infant he could not console.
“If I said that about knee reflexes, nobody would think anything, and it wouldn’t sound like bragging,” he says. “But if you think about these techniques, it’s kind of what you want to do for the baby naturally. It’s just learning to do them right and in the right order. It takes practice. It’s a skill. And when you get it right, you’re unstoppable.”
Written by Maria Elena Fernandez, originally posted on May 28, 2002, at LA Times