From the Publisher
"A must read! Dr. Karp offers insights into parenting by combining ancient and modern wisdom. Our baby boy responded to the 5 S’s immediately!" Keely and Pierce Brosnan, TV journalist/environmentalist and actor
"Harvey writes about areas that most parenting books don’t address. What every mother needs are simple tools that really work . . . and Harvey’s do." —Michelle Pfeiffer, actress/producer
"A witty and masterful book bursting with wisdom from start to finish. It contains some of the best, most original ideas about new babies I have ever seen. Dr. Karp entertains as he teaches, providing wonderful and innovative suggestions in a family-friendly way." —James McKenna, Ph.D., chairman, Department of Anthropology, University of Notre Dame, and director, Mother-Baby Behavioral Sleep Laboratory
"What a marvelous book! Parents for years to come will be grateful to Dr. Karp for this lucid and entertaining explanation of why babies cry and how to help them." —Martin Stein, M.D., Professor of pediatrics, University of California, San Diego Medical School, author of Encounters with Children: Pediatric Behavior and Development
"Harvey Karp is the type of pediatrician that every parent would want. His experience is beyond compare and his ability to relate to parents is impressive. The Happiest Baby on the Block has the perfect solutions for helping parents grow and thrive . . . along with their babies." —Sandra Apgar Steffes, R.N., M.S., member, Board of Directors, Lamaze International
"There is nothing quite like watching Dr. Harvey work wonders on a screaming baby. He’s not a pediatrician, he’s a magician. Every time I bring my kids in to see him, I walk out wishing he was their father." —Larry David, star of Larry David: Curb Your Enthusiasm and co-creator of Seinfeld
"The Happiest Baby on the Block is fun, fascinating and convincing. I highly recommend it to all new parents to help them accomplish one of their most important jobs…soothing their crying baby." -Elisabeth Bing, author and co-founder of Lamaze International
"Simply put, this is the best book I've ever read about keeping babies calm and happy. It is a must for everyone who cares about infants." -William Lord Coleman, MD, Center for Development and Learning, University of North Carolina, author of Family-Focused Behavioral Pediatrics
"Dr. Karp’s practical approach is a superb way to help babies when they are crying or upset. All who care for children will gain greatly from this new addition to our parenting library." Steven P. Shelov, M.D., Chairman, Department of Pediatrics, Infants and Children’s Hospital of Brooklyn, Maimonides, editor-in-chief, American Academy of Pediatrics Caring for Your New Baby and Young Child: Birth to Five
"This beautifully written volume meets a tremendous need for a scientifically sound and effective parent guide to the care of persistently crying babies. Dr. Karp has written the best book that I've read on this challenging topic." -Morris Green, M.D., Perry W. Lesh Professor of Pediatrics, Indiana University School of Medicine
"Dr. Karp's 'Cuddle Cure' is quite simply the best way I know to calm crying babies." -Stanley Inkelis, M.D., Professor of Pediatrics, UCLA School of Medicine Director, Pediatric Emergency Medicine, Harbor-UCLA Hospital
"Dr. Karp's book is extraordinary. The advice contained in this book, will make any parent, or grandparent, feel like a baby expert." —Neal Kaufman, M.D., M.P.H., Professor Of Pediatrics, UCLA School Of Medicine, Director Primary Care Pediatrics, Cedars-Sinai Medical Center
"The 'Karp Wrap’ can stop a baby’s cries instantly!" —Lynn Sullivan, RN, Director, Newborn Nursing Services, SM-UCLA Hospital
"Dr. Karp was exactly the doctor to see us through parenthood. He has the magic touch – not just with babies, but with new parents too." —Robin Swicord and Nicholas Kazan, screenwriters of Matilda, Reversal of Fortune and Practical Magic
"I wish I had known Dr. Karp for my first two children. With the soothing, loving tips in this book, caring for my two most recent babies has been a dream." —Hunter Tylo, actress/founder of Hunter’s Chosen Child
"Dr. Karp is simply the best. Any time a problem pops up in our children, he guides us with warmth, wisdom and humor. And that helps us sleep better at night." —Jerry Zucker, director of Airplane, Ghost, and Rat Race
"Harvey Karp’s enlightened and creative approach has been a benefit not only to our children, but to my wife and me as parents." —Kristen and Lindsey Buckingham, photographer and singer-songwriter, Fleetwood Mac
"Harvey Karp would make my Big Mama proud! He is leading us back to ages old basics, back to motherwit." —Alfre Woodard, actress
Karp, a pediatrician in Santa Monica, Calif., and assistant professor at the School of Medicine, UCLA, offers a new method to calm and soothe crying infants. While nursing or being held satisfies some babies, others seemingly cry for hours for no reason. These babies suffer from what Karp calls the Fourth Trimester. When you bring your soft, dimpled newborn home from the hospital, you may think your nursery is a peaceful sanctuary.... To him, it's a disorienting world part Las Vegas casino, part dark closet! Karp recommends a series of five steps designed to imitate the uterus. These steps include swaddling, side/stomach position, shhh sounds, swinging and sucking. The book includes detailed advice on the proper way to swaddle a child, the difference between a gentle rocking versus shaking and more. According to the author, virtually all babies will respond to these strategies although some trial and error may be needed to find the most effective calming method. A number of the steps letting kids nurse more frequently or encouraging babies to use pacifiers, for instance contradict other childcare experts. However, parents who are at their wits' ends because of a baby's incessant crying will find this book invaluable. In fact, expectant parents may want to read it before they bring their newborns home from the hospital. (June) Forecast: Promotion along with celebrity endorsements from actors including Pierce Brosnan and Michelle Pfeiffer should boost sales of this title. Copyright 2002 Cahners Business Information.
Read an Excerpt
At Last There's Hope:
An Easy Way to Calm Crying Babies
All babies cry, but most new parents have little experience soothing them
The Basic Problem: In many ways, babies are born three months too soon
The Calming Reflex: Nature's Off switch for a baby's crying
The 5 "S's": How to turn on your baby's calming reflex
The Cuddle Cure: Combining the 5 "S's" to help any fussy baby
Suzanne was worried and exhausted. Her two-month-old baby, Sean, was a nonstop screamer. He could cry for hours. One afternoon her sister came to watch the baby, and Suzanne bolted to the bathroom for a hot shower and a quick "escape." Forty-five minutes later she awoke, curled up in a ball on the blue tile floor, being sprayed with ice-cold water!
Meanwhile, half a world away in the rugged Kalahari plains of northern Botswana, Nisa gave birth to a tiny girl named Chuko. Chuko was thin and delicate but despite her dainty size, she, too, was a challenging baby who cried frequently.
Nisa carried Chuko in a leather sling everywhere she went. Unlike Suzanne, she never worried when Chuko cried, because like all mothers of the !Kung San tribe, she knew exactly how to calm her baby's crying-in seconds.
Why did Suzanne have such trouble soothing Sean's screams?
What ancient secrets did Nisa know that helped her calm her baby so easily?
As you are about to learn, the answers to these two questions will change the way you think about babies forever! They will show you the world through your baby's eyes and, most important, they will teach you how to calm your baby's cries in minutes and help prolong her sleep.
Your Baby Is Born
When perfectly dry, his flesh sweet and pure, he is the most kissable object in nature.
Marion Harland, Common Sense in the Nursery, 1886
Congratulations! You've done a great job already! You've nurtured your baby from the moment of conception to your baby's "birth"-day. Having a baby is a wonderful-and wonder-full-experience that makes you laugh, cry, and stare in amazement . . . all at the same time.
Your top job as a new parent is to love your baby like crazy. After showering her with affection, your next two important jobs are to feed her and to calm her when she cries.
I can tell you from my twenty-five years as a pediatrician, parents who succeed at these two tasks feel proud, confident, on top of the world! They have the happiest babies and they feel like the best parents on the block. However, mothers and fathers who struggle with these tasks often end up feeling distraught.
Fortunately, feeding a baby is usually pretty straightforward. Most newborns take to sucking like they have a Ph.D. in chowing-down! Soothing a crying baby, on the other hand, can be unexpectedly challenging.
No couple expects their sweet newborn to be "difficult." Who really listens to horror stories friends and family share? We assume our child will be an "easy" baby. That's why so many new parents are shocked to discover how tough calming their baby's cries can be.
Please don't misunderstand me. I'm not saying crying is bad. In fact, it's brilliant! Leave it to nature to find such an effective way for helpless babies to get our attention. And once your baby has your attention, you probably zip down a checklist of questions and solutions:
Is she hungry? Feed her.
Is she wet? Change her diaper.
Is she lonely? Pick her up.
Is she gassy? Burp her.
Is she cold? Bundle her up.
The trouble comes when nothing works.
Estimates are that one out of every five babies has repeated bouts of terrible fussiness-for no apparent reason. That adds up to almost one million sweet new babies born in the U.S. each year who suffer from hours of red-faced, eyes-clenched screaming.
This is why parents of unhappy babies are such heroes! A baby's scream is an incredibly heart-wrenching sound. Bone-tired and bewildered moms and dads lovingly cuddle their frantic babies for hours, trying to calm them, yet the continued crying can corrode their confidence: "Is my baby in pain?" "Am I spoiling him?" "Does she feel abandoned?" "Am I a terrible mother?"
Confronted by this barrage, sometimes the most loving parent may find herself pushed into frustration and depression. A baby's unrelenting shrieks can even drive desperate caregivers over the edge-into the tragedy of child abuse.
Exhausted parents are often told they must wait for their babies to "grow out of it." Yet most of us feel that can't be right. There must be some way to help our babies.
I'm going to show you how.
Help Wanted: Who Do New Parents Turn to When Their Baby Cries a Lot?
Although a network of clinics and specialists exists to help mothers solve their infant's feeding problems, there is little support for the parents of screaming babies. That's unfortunate because while the urge to quiet a baby is instinctual, the ability to do it is a skill that must be learned.
Today's parents have less experience caring for babies than any previous generation. (Amazingly, our culture requires more training to get a driver's license than to have a baby.)
That's not to say that inexperienced moms and dads are abandoned. On the contrary, they're bombarded with suggestions. In my experience, America's favorite pastime is not baseball but giving unasked-for advice to new parents. "It's boredom." "It's the heat." "Put a hat on him." Or "It's gas."
It can be so confusing! Who should you believe?
In frustration and concern, parents often turn to their doctor for help. Studies show that one in six couples visit a doctor because of their baby's persistent crying. When these babies are examined and found to be healthy, most doctors have little to offer but sympathy. "I know it's hard, but be patient; it won't last forever." Advice like this often sends worried parents to look for help in baby books.
Parents of colicky babies spend hours scanning books for "the answer" to their infant's distress. Yet, often the advice can be equally confusing: "Hold your baby-but be careful not to spoil him." "Love your baby-but let her cry herself to sleep."
Even these experts confess that for really fussy babies, they have nothing to offer:
Very often, you may not even be able to quiet the screaming.
What to Expect the First Year, Eisenberg, Murkoff, and Hathaway
The whole episode goes on at least an hour and perhaps for three or four hours.
Your Baby and Child, Penelope Leach
It's completely all right to set the baby in the bassinet while trying to drown out the noise with the running water of a hot shower.
The Girlfriend's Guide to Surviving the First Year of Motherhood, Vicki Iovine
But a hot shower is cold comfort for the parents of a screaming baby.
Many exhausted parents I meet have been persuaded, against their better judgment, that they can only stand by and endure their baby's screaming. But I tell them otherwise. Unhappy babies can be calmed-in minutes!
The Four Principles of Soothing Babies
In many ways, the peoples living in primitive cultures are backward compared to Western societies. However, in some areas their wisdom is great . . . and we are the "primitive" ones. This is particularly true when it comes to soothing crying newborns.
I teased out shreds of information from the past and wove them with cutting-edge modern research and some unique observations made during my years of caring for more than five thousand infants. From this, I distilled four principles that are crucial for anyone who wants to understand babies better and be skillful at comforting them and improving their sleep:
The Missing Fourth Trimester
The Calming Reflex
The 5 "S's"
The Cuddle Cure
The Missing Fourth Trimester-Many Babies Cry Because They're Born Three Months Too Soon!
Did you ever see a baby horse or a baby cow? These newborn animals can walk, even run, on their very first day of life. In fact, they must be able to run-their survival depends upon it.
By comparison, our newborns are quite immature. They can't run, walk, or even roll over. One British mum told me her new daughter seemed so unready for the world she and her husband affectionately nicknamed her "The Little Creature." They're not alone in seeing babies that way; the Spanish use the word criatura, meaning creature, to describe babies.
In many ways your new baby is more a fetus than an infant, spending most of her time sleeping and being fed. Had you delayed your delivery just three more months, your baby would have been born with the ability to smile, coo, and flirt. (Who wouldn't want that on their baby's first day of life!) However, I've never been able to talk a woman into keeping her infant inside for a fourth trimester . . . and for good reason. It's already a tight squeeze getting a baby's head out after nine months of pregnancy; by twelve months it would be impossible.
Why are our babies so immature at birth? The reason is simple. Unlike baby horses whose survival depends on their big strong bodies, a human baby's survival depends on big smart brains. In fact, our babies' brains are so huge we have to "evict" fetuses from the womb well before they're fully ready for the world to keep their heads from getting stuck in the birth canal.
Newborns have some abilities that demonstrate their readiness to be in the world, but these notwithstanding, for the first three months, our babies are so immature they would really benefit if they could hop back inside whenever they get overwhelmed. However, since we're not kangaroos, the least we can do as loving, compassionate parents is to make our little criaturas feel at home by surrounding them with the comforting sensations they enjoyed twenty-four hours a day in the womb. However, in order to give babies a fourth trimester, parents need to answer one important question: What exactly was it like in there?
In your womb, your baby was packed tight into the fetal position enveloped by the warm wall of the uterus and rocked and jiggled for much of the day. She was also surrounded by a constant shushing sound a little louder than a vacuum cleaner.
For thousands of years, parents have known that mimicking conditions in the uterus comforts newborns. That's why almost every traditional baby-calming technique around the world imitates the sensations of the womb. From swaddling to swings to shushing, these methods return babies to a cuddly, rhythmic, womblike world until they are ready to coo, smile, and join the family. As helpful as this fourth-trimester experience is for calm babies, it is essential for fussy ones.
Most parents assume that this imitation soothes their baby simply by making her feel "back home." Actually, these experiences trigger a profound neurological response never before recognized or reported-until today. This ancient and very powerful baby reflex is the calming reflex.
The Calming Reflex: Nature's Brilliant Off-Switch for Your Baby's Crying
This automatic reset switch stills a baby's crying and is truly a baby's (and parent's) best friend. Why did nature choose imitating the uterus as the trigger for this blessed reflex? The reason is clear but unexpected: As important as it was for our ancestors to be able to quiet their babies, it was triply important for them to be able to quiet their fetuses!
Just imagine what it would feel like if your fetus threw a temper tantrum inside you. Not only could pounding fists and kicking feet make you sore, they could damage the fragile placenta or rip the umbilical cord, causing a fatal hemorrhage. Perhaps even more deadly than the risk of accidental injury was the chance that a squirming baby might get stuck in a bad position in the uterus and be unable to slide out, thus killing herself and her mother.
I'm convinced that the survival of our fetuses, and perhaps even the survival of our species, depended on this ancient calming reflex. Over millions of years, fetuses who became entranced by the sensations inside the uterus didn't thrash about and thus were most likely to stay alive. Our babies today are direct descendants of those "Zen" fetuses who were so easily pacified by the womb.
The 5 "S's": Five Steps to Turn On Your Baby's Calming Reflex
How is a vacuum cleaner like a lullaby? How is a Volvo like a flannel blanket? They all help switch on your baby's calming reflex by imitating some quality of your womb.
Although our ancient ancestors intuitively understood how to turn off their baby's crying and turn on their baby's calming, recognition of the calming reflex itself remained completely overlooked until I identified it during the mid-1990s while studying the characteristics of hundreds of crying babies in my practice.
I was struck by the fact that many traditional baby-calming methods failed to work unless they were done exactly right. I realized that, similar to a doctor setting off a knee reflex with a precise whack of a little hammer, the calming reflex could only be triggered by certain very specific actions. When presented correctly, however, the sounds and feelings of the womb had such a powerful effect that they could carry an infant from tears to tranquillity, sometimes even in mid-cry.
Parents and grandparents traditionally have used five different characteristics of the womb to soothe their babies. I refer to these time-honored "ingredients" of calm as the 5 "S's":
Side/Stomach-lying a baby on her side or stomach
Shushing-loud white noise
Swinging-rhythmic, jiggly motion
Sucking-sucking on anything from your nipple or finger to a pacifier
These five methods are extremely effective but only when performed exactly right. When done without the right technique and vigor, they do nothing. (Detailed descriptions of how to perform each "S" are in chapters 8 through 12.)
The Cuddle Cure: Combining the 5 "S's" into a Perfect Recipe for Your Baby's Bliss
You don't have to be a rocket scientist to be a terrific parent, but there are some little tricks that can help you do your job better. Most infant-care books list these calming tips, but that's as unhelpful as listing the ingredients of a recipe without giving the instructions for how to combine and cook them.
Each individual "S" may be effective for soothing a mildly fussy baby. Your "easy" baby may only need to suck or to be danced around the room in order to be calmed. However, doing all five together can switch on the calming reflex so strongly that, for many babies, they become an irresistibly soothing force for even the most frantic newborn. This layering of one "S" on top of another is so successful at making unhappy babies feel cozy and calm that one of my patients dubbed it "the Cuddle Cure."