Rock-a-Bye Baby: Get Your Newborn to Fall Asleep

[MUSIC PLAYING] Welcome, everyone. I'm Dr. John Whyte. I'm the Chief Medical Officer at WebMD. What's the first question you ask when someone has a newborn? You say, "How's the baby sleeping?" Then you usually follow with, "How are you sleeping?"

But what really is so important about sleep for infants? Does it really matter? And more importantly, how do you know when to intervene? And what do you do? My guest today has the answers. Dr. Harvey Karp is a pediatrician and is a best-selling author on books around how to raise the healthiest baby. Dr. Karp, thanks for joining me today.

Thanks, John. It's good to be with you.

I want to start off with, can you talk to our audience about just how important is sleep at this time of life in a baby's really early days?

You know, we all need sleep, right? And we're a sleep-deprived nation as it is. But babies are great at sleeping actually. They sleep when they need to. It's usually the parents who are struggling because they're not getting the sleep they need because think of it this way: In the womb, you're caring for your baby, feeding them every second, holding them every second.

Once they're born, your baby goes, "Well, I gave you 2 hours off. What are you complaining about?" And that interruption of sleep can be so, so challenging for the parents. Sleep deprivation is probably the number one struggle that new parents have. Of course, babies do need sleep. And studies show that sleep helps improve brain development, et cetera. It's very valuable for babies to get extra sleep as well.

And how much sleep should they be having early on, say in that first year?

On average, they're getting about 14 hours a night. Twelve hours would be rock bottom. And 18 or 19 hours might be the top level.

And what's the impact on parents? I mean, a lot of people may think, well, that's just a rite of passage. And it'll get better in a few months. What were you seeing in your practice that you said, hmm, now might be the time to intervene?

Well, what I was seeing in my practice was I, as all pediatricians, all doctors are taught that some babies cry a lot. We call it colic. Don't know what causes it. But it goes away. And babies don't sleep a lot in the beginning. They have to wake up and eat a lot.

But by the time they get to be 4 or 5 or 6 months, if they're not sleeping better, they can go through sleep training. And we basically told parents, suck it up and get ready to deal with it because it's not going to be easy.

And understand the fact that today, having a nanny is pretty kush, not many people can afford that. But up until 100 years ago, everyone had five nannies. You had your grandmother, your aunt, your older sister, all living with you or right near you.

And so what parents are doing today, they could kind of-- they should be patting themselves on the back for doing a great job. Having jobs, taking care of other kids, and taking care of a baby, it's hard work.

So it turns out that, what do babies need to sleep? Everybody knows. It's rocking and shushing. And in fact, even though we, pediatricians, tell parents, well, babies don't sleep a lot in the beginning, if a family or when a family came to me and said, "I'm struggling here. I'm exhausted. I'm getting depressed. I can't handle this anymore. It's just too hard." We would often say, OK, there's a secret thing you can do that immediately increases sleep and reduces crying. Drive them all night in the car. Of course, the parent's not going to.

I've done that. I've done that.

Have you? Really?

Yes.

But what if you could drive them all night in the car with you keeping your head on the pillow? And that's really what the goal is. How can we give tools to parents to improve infant sleep imitating the car?

And basically, the car is imitating the experience in the womb because, believe it or not, before the baby is born, the sound is louder than a vacuum cleaner 24/7, rah, rah, rah, rah kind of a sound. The baby is constantly rocked. Every time you breathe, you're rocking your baby with your diaphragm pressing against the uterus. And they're constantly held in a tight little ball.

So the idea that as soon as they're born, we take everything away from them and put them in a dark still room on their back for 14 hours, it's a crazy thing if you think about it that way. So giving these womb-like sensations and rhythms become incredibly important for improving infant sleep and reducing crying.

And you created a technology to do this. Tell us about this tool.

So there's a baby bed called SNOO, which we launched about 7 years ago, which rocks and shushes babies all night long, which helps them sleep.

How does it shush the baby?

It has a speaker that makes white noise. And some people go, "Oh yeah, I use white noise, or "I use a rocker," things like that. But it turns out, once you understand babies, you understand that it isn't motion and sound. It is a specific type of motion and sound that changes depending on the baby's level of upset.

So for example, so you have your little baby in your arms who's asleep. And you're going shhhhhhhh. I mean, just that sound makes you feel a little bit more comfort and relaxed. But if your baby is in your arms screaming at the top of their lungs, would you go shhhhhhh? Or would you go shhshhshhshhshhshhshh? Which one do you think you would do?

The second one.

Absolute. I'm father of two. And we almost intuitively know to do that. Why do we do this? What are we doing? It turns out we're triggering a reflex. And that really is the observation that I added to the discussion.

So 20 years ago, I wrote a book called The Happiest Baby on the Block that describes the baby's need for these rhythmic sensations. And what's interesting about that from just a general medical point of view is that most people fall asleep in trains and planes and cars, especially if they're tired. They like to rock in the hammock. They like the sound of the wind and the ocean.

But there's not a single medical study that explains why that occurs. And the answer is it occurs because of babies. In the womb, the rhythms of the womb put babies to sleep. And the reason that that's important is because if a baby's swimming around too much inside there, they can get stuck in a bad position and then get stuck coming out. And they can die and even kill their mothers.

So we are all the descendants of these Zen little babies who are put into a trance by these rhythms. And then when the baby is born, you can do these things to soothe the baby and improve sleep. And then by 6 months of age, they're past that. And they've outgrown it. But in those first 6 months, the rhythms are incredibly important in improving sleep and reducing crying.

And so we built SNOO, which constantly rocks and shushes babies all night, imitating the womb, responds when they're upset with four different levels of motion and sound. Fifty percent of the time, we calm the crying, usually within a minute. And half the time, it won't calm the crying because the baby is hungry or needs a diaper change or has some other need. And then the bed also secures babies on the back.

About 3,500 babies die -- healthy babies -- die every year in the United States, most of them when they accidentally roll over and get their face in a in a mattress or a pillow or something like that, sometimes because parents bring them into bed, and they roll into a dangerous position there. But SNOO is the first FDA de novo-authorized bed that keeps babies securely on the back so they can't roll to an unsafe position to keep them safer.

We also know about the position in terms of sudden infant death syndrome. And that's a concern that a lot of parents have, especially new parents with early times in infancy. Can you talk a little bit about that?

Yeah, that's exactly right. So 30 years ago, pediatricians recognized that what we were doing with baby sleep was completely wrong. We were recommending that babies slept on their stomach because we thought that if they were on the back, they could vomit and choke on their vomit. And maybe that could injure a child.

But what we discovered 30 years ago is that we were 180 degrees off. They need to be on their back to be safer. And we recommended all babies sleep on the back. And we saw almost a 50% drop in the number of babies who were dying in their sleep -- from 5,500 a year down to 3,500 a year.

Then since the year 2000, no-- I mean, we're still telling people to put their babies on the back. But babies are still dying 3,500 a year. Why is that? It's because more parents are now bringing babies in bed with them or because the babies are rolling over during their sleep to an unsafe position.

So what's end up happening is for the last 20 years, we've made no progress. And in certain populations, it's even gone up 15 or 20%. What we're hoping to do with SNOO is by keeping babies on the back, which we know is the number one way of reducing infant death-- by keeping them on the back, we'll be able to keep babies safer and keep parents having more peace of mind that when they put the baby down safely, they know the baby's going to stay in that right position.

I want to ask you, How do parents bring this up, this issue of sleep, either the baby's sleep, their sleep, to the pediatrician? Because let's be honest: Sometimes pediatricians can be dismissive of it. They're focused on other aspects. And some parents think, as you referenced, well, that's just how it is. That's the rite of passage. How do they bring it up? And how do they know when there needs to be an intervention?

Well, that's the sad part. It's a great question. But the sad part is that parents today assume that they're the Alpha Omega. They're everything that the baby needs. And if they're not sleeping, that's just the way it is.

And so often they don't even complain to the doctor that they're exhausted until they get to the point where they're depressed or really seriously decompensating, or they got in a car accident, or they're missing work because they're so tired.

And what we're trying to do, my team and I, is to help educate doctors as well as parents that we can do so much better. I think, when we look back on this podcast 5 years from now, there are two things that are going to be different that all parents and doctors know.

First, why wouldn't you secure a baby when you put them in bed at night? You secure them when you put them in a car. You belt them in when you put them in a highchair or a swing or a stroller.

But the number one place babies die is in their own bed. And we put them there for 14 hours a day completely unsecured. So I think that we're going to look back five years from now and go, what were we thinking? Why didn't we just secure them? And now with SNOO, we can.

And the second thing is, why would we put a baby in total darkness and silence by themselves for 14 hours a night when we know that the richest, the most nurturing environment for a baby is to be held and rocked and shushed?

We know that if you feed a baby milk but you never pick them up and hold them, their brains will not develop normally. So it's great to hold your baby and rock your baby all day long. But why not give them the richness of that sensory environment for hours more at night as well? And I think that that's going to become a complete change in the practice of parenting and medicine going forward.

Does one need a prescription for this tool?

No, this is over-the-counter. And actually, I have to say, I just turned 72. I'm not a start-up techie, robotics person. I'm a pediatrician. But my wife and I started this company because we were so upset with so many babies dying in their sleep.

And not just that -- a million new mothers develop postpartum depression every year. And key triggers of postpartum depression are crying babies, exhaustion, and feeling like there's no one there to help you.

You wrote a book a few years back called the happiest baby on the block. What have you learned now that you didn't know when you wrote that book?

One of the things I've learned is that giving information is not enough. Parents are so overwhelmed. We need tools. I was teaching these techniques for 10, 15 years. And then I realized, I had to create a bed,

and I worked with MIT engineers to create this type of a soothing bed because even parents who know what to do with their babies need help all day long and all night long. And so, that's one thing I learned.

The second thing is that sleep-- to your first question, sleep is important for brain development. And one of the things we're studying now is, can we optimize the development of a child's brain not just by giving them nutritious food but by giving them a nutritious environment of rhythmic sensations?

And so we're studying child development of children who have SNOO versus don't have SNOO. We're looking at that for babies ... babies who are withdrawing from drugs, premature babies, and regular full-term babies because now SNOO is used in over 160 hospitals to improve the care of the infant.

And actually, we just published two studies last year showing that each bed reduces nurse labor 4 to 5 hours per day, which is very important now because there's a shortage of nurses. And we're trying to help reduce nurse burnout.

Well, Dr. Harvey Karp, I want to thank you for helping us to raise happy babies and also to be happy parents. So thank you for all that you're doing.

Thank you, John. I really appreciate the opportunity of talking with you.

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