Oct. 11, 2005 (Washington) -- A California pediatrician says he may have found the "off switch" for crying infants.
"This may be the solution to a 3,000-year-old medical mystery of what causes colic," said Harvey Karp, MD, associate professor of pediatrics, University of California at Los Angeles Medical School, and author of The Happiest Baby on the Block. "There is a lot of advice on baby feeding, but almost nothing on how to help crying babies."
The term "infant" means without a voice in Latin, he says. "So how is it that a 7-pound baby's cries can get a 130-pound mother off the toilet running with her pants down? Sometimes there is an emergency; but most of the time the baby merely wants attention."
Babies Miss the Womb
Karp contends that babies are evicted before their "fourth trimester," before they are fully developed and still needing the gentle stroking, holding, and shushing of the womb. An infant's crying, which can last from minutes to hours, may actually be the result of missing the constant noise and stimulation of the womb, he told pediatricians attending the American Academy of Pediatrics National Conference and Exhibition.
Past studies have shown that the average infant at 6 weeks of age cries about 3.5 hours a day, he says. "This results in nursing problems, marital stress, postpartum depression, unnecessary emergency room visits and even shaken baby syndrome."
The Answer to Colic?It has been thought for years that the main cause of colic in infants was due to gastrointestinal problems, but this may not always be true, Karp says, adding that colic appears to stop after 3 months of age and in preemies it only begins two weeks after the original due date. Pediatricians have also associated colic to temperament, environment, and an immature nervous system.
The 5 S's
But now a new system that involves the 5 S's -- swaddling, side/stomach holding, shushing, swinging, and sucking -- can calm squalling infants, he says. This, says Karp, activates the baby's calming reflex during the first three to four months of life by mimicking the experiences in the uterus.
- Swaddling. Wrap your baby tightly in a receiving blanket to duplicate the feelings of warmth and protection, and the "tight fit," in the womb. Swaddling also stops your baby's uncontrolled arm and leg flailing that can contribute to hysterical wailing. Karp says your baby will be calmer if she's swaddled 12-20 hours a day in the beginning. "Twelve hours may seem like a lot from our point of view, but to the newborn, it's already a 50% cutback on the 24-hour-a-day 'snuggling' in the uterus," he explains.
- Side/stomach soothing. Lay your baby on her side or stomach, which Karp believes shuts down the baby's "Moro reflex," or a sensation of falling, and thus helps keep her calm. (He adds, however, that a baby should never be put to sleep on her stomach, since this may increase the risk of SIDS, or sudden infant death syndrome).
- "Shhhing" sounds. There is a whooshing noise within the womb, caused by blood flowing through the mother's arteries. You can recreate this sound with a "white noise" machine, a tape or CD with these "white noise" sounds, a dishwasher, a car ride, or a hair dryer.
- Swinging. Rhythmic movements in an infant swing, hammock, moving automobile, or baby carrier can keep your baby content.
- Sucking. Occupy your baby with a pacifier, infant bottle, or a mother's nipple (which Karp describes as "the all-time, No. 1 sucking toy in the world.")
Karp says that tightly swaddling a crying infant with its arms down by its side initially may make the crying worse, but holding the baby on its side after swaddling and gently jiggling it while supporting the head and neck has an immediate calming effect, he notes. "Overstimulation is not nearly as big of a problem as understimulation. Babies miss the rhythmic, hypnotic sounds and movement."
"If the five S's are done exactly right with just enough vigor, the calming reflex will be turned on and the baby will stop crying," Karp explains. "If a parent can get the baby to stop crying they feel like a million bucks, but if they can't they feel miserable. Parents need to be taught how to quiet their babies."
Teaching this to parents may be useful," says Karen Miller, MD, associate professor of pediatrics at Tufts University in Boston. "But more research needs to be done to show the techniques are safe and effective."
Many of the individual techniques have been found to be valid, she says. "It's the whole package that needs further research before it is endorsed."