In many ways, newborns are not quite ready for the world at birth and need a “fourth trimester” of gentle holding, stroking, shushing and wrapping, says Harvey Karp, M.D., assistant professor of pediatrics at UCLA School of Medicine. And babies who have colic are especially in need of such soothing, he says.
A baby’s needs during the first three months of life — and not gas, immaturity or temperament — are colic’s main causes, Karp says. Colic is defined as:
- Crying that lasts more than three hours a day and occurs more than three days a week or
- Crying that lasts more than three hours a day and continues for more than three weeks, regardless of how many times a week it occurs.
“Although today’s mothers and fathers are well-educated, they are the least-experienced parents in history,” he says. “No wonder the most loving parents sometimes feel pushed to the breaking point by their infant’s screaming.”
COLIC IS NOT UNCOMMON
Researchers have found that 15 to 20 percent of infants younger than 3 months old cry or fuss for more than 3 hours a day, and 50 percent cry or fuss for 2 hours a day.
In a recent presentation at the American Academy of Pediatrics’ national conference, Karp noted that a fourth trimester of rhythmic stimulation calms babies by activating their calming reflex. “This reflex is a virtual ‘off switch’ for crying infants younger than three months,” he says, and any parent can learn how to activate it through five S’s: swaddling, side/stomach positioning, shushing, swinging and sucking.
These activities mimic babies’ experiences during their months inside the uterus and also help most babies sleep an extra one to two hours a night, Karp says. The techniques also may help prevent other troubles associated with colic, such as impaired bonding, breastfeeding challenges, marital stress, depression and abuse, he adds.
CALMING TECHNIQUES
Here’s how the five S’s work:
- Swaddling — Wrapping the baby snugly in a receiving blanket provides the continuous contact and support experienced in the womb.
- Side/stomach position — Place your baby, while holding her, either on her left side to assist in digestion or on her stomach to provide reassuring support. Once she is happily asleep, you can safely put her in her crib, on her back.
- Shushing Sounds — These sounds imitate the continual whooshing sound made by the blood flowing through arteries near the womb. This white noise can be in the form of a vacuum cleaner, a hair dryer, a fan, etc. Fortunately, you can save the motors on your household appliances by buying a white-noise CD.
- Swinging — Newborns are used to the swinging motions experienced in the womb. After baby is born, this calming motion, so comforting and familiar, is abruptly taken away. "It's disorienting and unnatural," says Karp. Rocking, car rides and other swinging movements all can help.
- Sucking — "Sucking has its effects deep within the nervous system and triggers the calming reflex and releases natural chemicals within the brain," says Karp. This can be accomplished with breast, bottle, pacifier or even a finger.
Karp urges patience as you try different calming techniques. Anxious parents, he says, “may make their baby’s crying worse by impatiently jumping from one calming intervention to another” without waiting to see how their baby responds.
A FAULTY ALARM
“Crying in early infancy is an excellent signal of need, but a poor signal of what is needed,” Karp writes in an article for Contemporary Pediatrics magazine. It is a graduated system of alerts, with mild cries giving the impression of mild need and intense cries giving the impression of urgent need, he explains.
“The trouble is that some babies skip right past a mild cry into an intense cry, even when their need isn’t urgent. Like a smoke alarm, which blasts out the same sound regardless of whether the toast is burning or the house is in flames, a colicky baby emits the same powerful shriek regardless of whether he is startled, needs to burp or is in true pain. This can be terribly burdensome to new parents.”
Recreating the sensory environment of the womb “calms newborns, not because they’re nostalgic for the ‘good life’ they had in the womb,” says Karp, “but because it triggers a profound soothing response — what I call the calming reflex — it halts crying and promotes relaxation.”
My husband and I can testify first-hand about the effectiveness of these techniques. When our son was born 13 years ago, Dr. Karp (who was yet to become the best-selling author he is today) was our pediatrician. As nervous first-time parents, Randy and I watched amazed as the doctor showed us how to snugly swaddle 1-day-old Matthew in a receiving blanket, with his arms at his sides, so that he looked like an adorable little burrito. Then the doctor taught us to make the shushing sounds that worked better than any tonic. I can still picture Randy walking around our hospital room, making shushing sounds, with our little burrito man on his shoulder — fast asleep.