This is the first of three blogs on infant/toddler sleep. Over the next few weeks: how exhaustion can trigger postpartum depression and tips to boost add hours to the slumber of older infants and toddlers without making them cry it out.
Being pregnant is one of life's most magical experiences. But, the last couple of months of bedtime heartburn and twice nightly peeing may leave you pretty tired. And, since babies often wake every two to three hours for comfort and feeding, having the baby may be just the start of your exhaustion.
But, what if there was a simple way to quickly boost any baby's sleep? And, what if the same method could soothe most fussing ...even colic?
When something sounds too good to be true, it usually is. But every once in a while, new ideas emerge that truly solve long-standing riddles.
A New Approach to Ancient Problems
In 2002, The Happiest Baby on the Block DVD (and book) were released detailing three new ideas in baby care:
1) The missing fourth trimester - Our babies have to be born early because their brains are so big. For the first months, these immature infants need tons of rocking, shushing and holding. (Holding 12 hours/day may seem like a lot, but it is an instant 50 percent cut back from what our babies get in the womb.)
2) The calming reflex - All infants are born with an automatic response that is a virtual off-switch for crying and on-switch for sleep.
3) The five S's - Five steps that imitate a baby's womb experience and trigger the calming reflex. (Like a knee reflex, which is activated only when the knee is hit exactly right, the five S's work only when done correctly.)
This approach solved the 3,000-year medical mystery, "What is colic ... and how can it be stopped?" And, like a cherry atop a sundae, it also showed how to boost a baby's sleep by one to three hours.
Soon, this work was translated into 20 languages and supported by America's top doctors. Dr. Julius Richmond, former Surgeon General saluted it by saying, "Fascinating. It will guide new parents for many years to come."
In a nutshell, this work is based on the recognition that newborns tend to fuss because our world is just too quiet and still! They need the cuddling and hypnotic rhythms of the womb to stay calm and sleep well.
In 2007, nurses working for the Boulder Colorado department of health taught the five S's to 42 high-risk families (teen parents, addicts, parents of premies, etc.) with irritable babies. After a one-hour home visit they gifted each family with a swaddling blanket and a Happiest Baby DVD and CD of womb sounds. They found that this approach quickly calmed 41/ 42 of the babies (98 percent). And, they further reported that many of the babies slept an extra one to three hours sleep/night.
But what about gas pains, overfeeding and overstimulation? Amazingly, contrary to long held beliefs, babies rarely fuss from tummy aches and they don't need us to tip toe around while they're sleeping. Sure, banging pots can cause infants to cry, but a much bigger problem for them is that our bedrooms are as weirdly still and empty as sitting in a dark closet feel to us. Grownups may sleep better in silence, but babies don't.
In the womb, babies are frequently jolted by tiny jiggles and constantly surrounded by the loud whoosh of blood rumbling thorough the placenta (it's noisier than a vacuum cleaner!). This sound (shushing is the 4th of the 5 S's) switches on the calming reflex and helps infants (and many big kids and adults) drift into slumber. No wonder babies fall asleep when they hear a hair drier, take a car ride or go to a noisy party.
And don't be fooled, exhaustion from infant crying and sleeplessness is no mere nuisance. It commonly triggers illness...and even death! Such health hazards include: post partum depression (more about this in my next blog), Shaken Baby Syndrome (the number one cause of child abuse death), SIDS, breastfeeding failure, marital stress, wild over-prescription of infant medication, maternal smoking, and perhaps even maternal weight gain, car accidents and infant obesity (from overfeeding).
Problems provoked by colic and crummy sleep probably raise health care costs by over $1 billion/year and shred the confidence and happiness of millions of new parents across our nation and around the world.
Happiest Baby Classes Launch
In 2004, in response to these serious consequences - and because doing the five S's correctly takes a bit of guidance - a program was launched to train health care professionals to teach the five S's in classes. (Think of these as childbirth ed classes for what to do after the baby is born.)
In 2008, the University of Arizona surveyed 225 parents before and after a Happiest Baby class. Pre-class 40 percent were moderately to very worried about calming their newborn's crying. Post-class that dropped to a mere 0.5 percent. Describing the benefits of these classes at her hospital, Debra Smith, director of the University of Michigan prenatal education program said, "It is absolutely one of the best resources. It empowers parents."
Today, this program has swept across the country. There are over 2000 Happiest Baby educators (another 1800 in training) teaching in hospitals, clinics and military bases across America. Minnesota's department of health has trained 250 educators; Wyoming trained 200 home visiting nurses; and Pennsylvania has almost 300 certified educators teaching in every WIC clinic in the state.
From Boise to Boston to Birmingham, an increasingly common use of these classes is to try to reduce the 300 infant deaths and 1,500 hospitalizations occurring every year from Shaken Baby Syndrome. Commenting on the potential of this approach, James Hmurovich, president and CEO of Prevent Child Abuse America noted that the five S's are "a key to reducing the anger and frustration that can lead to shaking."
Quickly Boost Your Baby's Sleep
So what should you do to help your baby? The top S's for sleep are swaddling (snug wrapping) and shushing (white noise). I recommend using both techniques with all babies -- from the first days of life, all night long.
Why swaddling? Simple, our world is too big for little babies. Swaddling keeps their arms from flailing around and accidentally whacking and waking them. Contrary to popular myth, new babies don't need freedom, they need holding and security.
But, it's imperative to swaddle correctly (that's why it's demonstrated three times on the DVD). Poor swaddling can cause dangerous overheating, blankets over the face and stress on the hips. On the other hand, correct swaddling can save lives. In this regard, wrapping is very similar to infant car seats. Car seats can kill babies if used incorrectly, but used correctly they are a blessing and save lives.
It is well know that back sleeping lowers a baby's risk of SIDS. But, a large Australian study found back sleeping plus swaddling dropped SIDS risk an extra 30 percent. Wrapped babies are have a harder time flipping into the dangerous tummy down position. Swaddling soothes fussing so well it reduces the chance of exhausted parents accidentally falling asleep with their babies on a bed or sofa (potentially hazardous locations for little babies). Finally, swaddling reduces the chance of a parent being tempted to put her flailing baby to sleep tummy down.
Many parents are confused bout swaddling because their babies struggle when first wrapped, but don't give up or assume your baby "doesn't like it." Remember, fetuses are quite happy in the womb, despite having little room to stretch out. You may hate the idea sleeping wrapped, but your baby's likes/dislikes are very different from yours. (For example, would you like to eat only milk for six months? Babies love it!) For little ones who struggle against the wrap, adding another S (like shushing) usually does the trick. Once settled, continuing the swaddling and sound will add over an hour to your baby sleep.
Even if your baby sleeps fine with just swaddling, I strongly recommend you also play a womb sound CDall night long as loud as a shower. Whooshy womb sound imitates the noise fetuses hear 24/7 from blood rumbling through the placenta and is a powerful way to turn on the calming reflex.
Womb sounds help all babies sleep better. They also make it easier to wean babies off the swaddling and to help nosey little four months old sleep through ringing phones, passing trucks and Papa's snoring.
As I'll discuss in part three of this blog, white noise also helps babies stay calm on car rides and sleep well when you're on vacation or staying at Grandma's. And, it can prevent sleep struggles that often pop up later in the year (e.g. from teething pain).
The Happiest Baby helps babies about 95 percent of the time. If the S's are not working for you, review the DVD to check you are doing them right. If your technique is good, but it's still not working - don't get frustrated - take a break and call your baby's doctor to make sure the crying isn't signaling a hidden medical problem. (10 percent of colic may be from food allergy or illnesses like urine infection, ear infection or - rarely - acid refux.)
And remember, the only safe sleeping position for a baby is on the back.
Dr. Harvey Karp is a world renowned child development expert and America's most read pediatrician. Creator of the bestselling DVDs and books, The Happiest Baby on the Block and The Happiest Toddler on the Block, his work has literally revolutionized our understanding of the needs of young children.
The Happiest Baby teaches how parents can calm even the fussiest babies in minutes...or less...and help any baby sleep an extra one to three hours per night. The Happiest Toddler teaches a new way to communicate with children eight months to five years of age that can quickly prevent 50-90 percent of tantrums and boost a toddler's patience and cooperation in just days!
Dr. Karp’s work is taught in hundreds of hospitals, clinics and military bases across the US and has been featured times on shows like Dr. Phil, Larry King Live, The View and Good Morning ... no wonder the NY Times celebrated his work by proclaiming "Roll over Dr. Spock!"