It usually starts about a month after new parents bring their baby home from the hospital. Their bundle of joy begins to cry inconsolably for no discernible reason. The baby has been fed, burped and changed but nevertheless howls with displeasure for long stretches of the afternoon and evening.
Not all babies go through these bouts of ceaseless crying, popularly known as colic. But the condition, which affects about one in five babies, can bring otherwise competent adults to a state of helplessness.
Dr. Harvey Karp, 69, a pediatrician and author, is one of the world’s most famous gurus for parents of colicky babies. His 2002 book, “The Happiest Baby on the Block,” has sold over a million copies, while its accompanying DVD is the most-watched parenting video of all time, according to The New York Times.
Last week, Karp visited Israel to promote a new Hebrew-language translation of “The Happiest Baby on the Block,” and sat down with The Times of Israel to share his insights on child-rearing for parents who are sleep-deprived and in need of help.
“My work is very specific,” said the soft-spoken Karp. “Do this special technique and the baby will cry less.”
Karp’s baby calming technique consists of five S’s: swaddling, side lying, shushing, swinging and sucking, which if done correctly and in tandem, will switch on a baby’s calming reflex, he said.
In fact, the internet is full of home videos of parents performing the five S’s on wailing babies. As the parents progress through the five steps, crying gives way to blissful repose.
Some scientific studies have suggested that the five S’s are in fact an effective technique.
When Karp’s book came out in 2002, he said, what made it different from other parenting advice books was that it rejected the notion that colic is caused by stomach pain. Instead, he posited that it is caused by over-stimulation of an immature nervous system.
“Of course, some babies have gas, but that’s not enough to make them cry for two hours straight. Also, why is it that they calm down when you go for a car ride? If you had stomach pain, going for car ride wouldn’t help your stomach. Babies don’t get colic until they’re one month to six weeks old. But they have gas when they’re first born. So that theory doesn’t make sense.”
According to Karp, the reason for colic is that babies are born three months too soon, a situation necessitated by the large size of the human head relative to the mother’s pelvis.
“They’re not ready. They’re still a fetus. Colic is too much stimulation combined with not enough stimulation and a lack of rhythmic stimulation. Among the African Bushmen, they hold and rock their babies, they’re walking for miles and miles. All of that is putting money in the bank and that balances the overstimulation. The big problem is that we think that silence and stillness is what babies need.”
The five S’s — swaddling, side lying, shushing, swinging and sucking — work, he said, because they simulate conditions inside the womb.
“Once you understand what it’s like inside the uterus — it’s louder than a vacuum cleaner, even when you’re asleep. You’re constantly rocking your baby because your diaphragm is moving up and down. They’re packaged into little balls, not flat on their backs. Once you understand that, you go, yeah, they had it for nine months and then they’re born and it took everything away.”
Colic usually goes away on its own after a few months, but those months can be miserable and consequential.
“It can lead to postpartum depression, marital stress, breastfeeding failure, car accidents and even obesity. About 15-20 percent of women get postpartum depression. It creates a lifetime predisposition to depression. You become very judgmental of yourself, like you’re failing. You look on Instagram, everyone’s smiling with their baby and you think you’re the only one who’s having a difficult time.”
Karp gave a lecture on March 6 sponsored by the Hebrew publisher of his book, Matar, and the women’s news site Onlife.co.il. He also visited Sheba Hospital where he met doctors and tried to interest them in conducting studies of a bassinet he invented called the Snoo, which performs three of the five S’s on babies automatically.
He hopes Israeli doctors will want to study whether the Snoo helps babies born with addictions to opiates, reduces infant sleep death and relieves postpartum depression by encouraging babies to sleep longer. Ultimately, he hopes the outcomes of such studies will be so positive that Israel’s National Health Insurance will pay for new parents to buy a Snoo, which currently retails for $971.
The last time Karp, who is Jewish, visited Israel was in 1969. He said he believes Israel has better prenatal care than the United States because it has universal health insurance.
“In Israel 50 babies a year die in their sleep. In the United States the number is 3,600.”
Karp said he would like to teach his techniques to Israeli doctors as well as have nurses train parents in Tipat Halav baby care centers.
Parenting without a village
Throughout the interview, Karp insisted that despite modern conveniences, today’s parents have it harder than past generations.
“Up until a hundred years ago and for the entire history of humanity, you had helpers. Today, if you have a nanny, you feel like you’re self-indulgent or privileged. But a hundred years ago, you had five nannies, your grandmother, your aunt, your older sister and so on.
“The next door neighbor’s older daughter would come and say, ‘Can I hold the baby all day?’ Today we think the normal family is just a husband and a wife or two parents. And no wonder people get depressed and stressed because you’re doing work that no one really ever did before.”
Karp said that 50 percent of women go through some type of psychological stress with a new baby, if not full-blown depression.
“The thing about postpartum depression that’s surprising is that for most women it’s not depression, it’s anxiety. It’s like you worry and you can’t turn your mind off. You’re checking the baby. Anxiety can turn into obsessive compulsive disorder, paranoia or even a desire to run away because it’s so overwhelming.”
One positive trend he has noticed, though, in his years as a pediatrician, is that millennial fathers tend to be more participatory.
“Actually studies show that men spend more time with their babies today than they have in the last 50 years.”
Karp pitched the smart bassinet he developed, the Snoo, as a tool that can help parents get more sleep. The responsive bed plays white noise and rocks babies while swaddling them in a secure position on their backs.
“Our joke is that this is not even a bed. This bed is your older sister. It’s not all on you. Your head is on the pillow. The baby starts to cry. The bed responds immediately and puts the baby to sleep. And that’s one time you didn’t have to get up. You can sleep a little more.”
How to talk to a toddler — or an adult
In 2008 Karp published a book about older children, “The Happiest Toddler on the Block: How to Eliminate Tantrums and Raise a Patient, Respectful and Cooperative One- to Four-Year-Old.”
It hasn’t been translated into Hebrew yet.
Like the “Happiest Baby” book, it contains practical techniques for calming children that are counterintuitive but that work, he said.
“There’s a technique I call ‘toddler-ese.’ It’s about how you speak their language. There are three steps. The first is short phrases, the second is repeating yourself eight to ten times and the third is using about a third of their emotion.’
If a child is upset, Karp advises against saying, “Honey, I know that’s upsetting, but…”
Instead, he said, repeat yourself eight to ten times.
Karp demonstrated the technique.
“Say, ‘Oh, no. Of course you’re mad. You don’t like it. You don’t like it. You don’t want to leave now. You’re having a good time. You don’t want to leave. And you’re mad at me because I said, let’s go. And you’re looking at me like you don’t want to go. Yeah. And I wish we didn’t have to go. Because I know how much fun you’re having.’”
Once a parent has mirrored their child’s feelings, with about a third of their emotional intensity, and repeated themselves eight to ten times, they can get to the “but” stage, said Karp.
“Then you can say, ‘But we have to go. We can’t keep so-and-so waiting. You know, there’s a cab outside.’”
Karp said that a child will be more amenable to doing what their parent asks if they feel understood.
“We all know in life there are a lot of times we’re not going to get what we want, and even a child can accept that. What they can’t accept and what we can’t accept is not to be understood by the most important people in our lives. How do you know you’re understood? Because someone says, ‘I get it.’ And you don’t rush past that.”
Karp lamented that most parents don’t read a single parenting book after the initial infant stage.
“If you had a bad experience in childhood, you can get therapy and you can have good friends and kind of recover from that. But if you have a really great experience in those first five years of life, it sets you up for a happier life. There are books that allow parents to understand how a child thinks.”
Aside from his own books, Karp warmly recommends “How to Talk So Kids Will Listen & Listen So Kids Will Talk” and “The Whole-Brain Child.”
The techniques in his book on toddlers bring quick results, he said.
“Literally within days you can see better patience, better cooperation, more response. The baby stuff is very important for so many reasons. But I always tell people the toddler stuff is the most important part of this work because it ultimately has the longest-ranging effect on a child’s life.”