This week we attended AWHONN’s (Association of Women’s Health, Obstetric and Neonatal Nurses) Annual Convention in Long Beach, CA.  This is an event that we look forward to every year. The speakers, the people, the vibe and the learnings are so great and we are always energized and inspired for weeks after!  While we could fill pages and pages with all the valuable information we took away from this year’s convention, we thought a recap of key insights from Dr. Harvey Karp’s presentation would be one of the most valuable things we could share with all of you parents who are expecting a baby or have newborns.

Dr. Harvey Karp, nationally renowned pediatrician and author of The Happiest Baby on the Block series, spoke about the connection between infant crying and postpartum depression (PPD). It’s so obvious, it almost doesn’t need to be said – infant crying and parental exhaustion are key challenges to new parents, and especially so for those with premature babies. However, it’s very important to acknowledge and recognize that these stressors are proven triggers for multiple serious postnatal problems, including marital stress, shaken baby syndrome, unsafe sleeping practices, and postpartum depression.


Key facts to know:

– Postpartum depression (PPD) affects 10-40% of women

– 50% of American babies cry for 2 hours or more a day

– Babies who have a colicky cry longer than 20 minutes at a spell increase the PPD risk in Mom by 4 times

– Moms often think baby isn’t getting enough milk – not because baby isn’t gaining weight – but because baby is crying and hard to console

– When it comes to PPD, exhaustion in Mom is as predictive as a prior history of depression

– Poor subjective sleep – how you feel versus a quantitative # of hours you got – most influences PPD risk. Some of us need more or less sleep, so listen to your body. Some parents will truly feel “drunk tired”.


Ok, so what can you do?

  • Increase amount of sleep for parents and you the decrease risk of depression. Well that’s obvious, right? But how to get more sleep for you? Although there are many suggestions, Dr. Karp’s methods focus on soothing baby, which as a result, will allow more rest and decrease stress for you. Karp focuses on making the whole family unit healthier and more equipped with tools to soothe baby and this includes Dad or partner. He notes that parents who feel able to soothe their babies are empowered and confident.


The foundation of Dr. Karp’s process for soothing baby in the 4th trimester focuses on what he calls the “5-S’s”:

  • 1st S: Swaddle:
    • As Dr. Karp says, “this is the cornerstone of calm.” While it may often increase crying at first, once baby feels snug, secure and with arms tucked in, it will decrease baby’s crying.   Key safety factors when swaddling: be careful not to overheat baby, be sure you allow room for the hips to flex and legs to move freely, and baby should always be swaddled and placed on his/her back, never on her stomach.


  • 2nd S: Side/Stomach:
    • For baby, being on their back can trigger what’s called the “Moro reflex”. This is when baby feels like they are free falling and you’ll see arms flailing and baby looks startled. Being held on their side or stomach can take away that free-falling feeling and make baby feel more secure. Take note that side-lying or stomach-lying is not a position for safe sleep, but is ideal for when baby is awake and you are holding them or right next to baby.


  • 3rd S: Shushing:
    • We often tiptoe around when baby is born, thinking they need a lot of quiet. But it’s actually quite the opposite. When baby was in the womb, it was very, very loud in there! In Mom’s belly, sounds are actually louder than a vacuum cleaner. Remember this when you “shhhhh” baby and experiment to find the volume level your baby prefers and responds to. More often than not, baby actually needs louder sounds to calm and soothe. Babies hear low frequency in utero. That means that white noise apps are often too high frequency, which is actually annoying to baby. Pay particular attention to play or create sounds lower in frequency.   One idea to try is a hairdryer.


  • 4th S: Swinging:
    • When baby was in the womb, there was constant movement as Mom was getting up and down throughout the day to do different things. That movement is very familiar and soothing to baby, and why many babies really like the motion of swinging, whether in your arms, a chair, or even the car. Also, may sound funny, but light jiggling is another soothing method as it mimics in-utero jiggling from when Mom ran to catch the bus, chase a toddler or go about her day to day life. Please note, there is obviously a big difference between light jiggling or swinging and shaking a baby.


  • 5th S: Sucking:
    • “Sucking has its effects deep within the nervous system,” notes Karp, “and triggers the calming reflex and releases natural chemicals within the brain.” Nurse baby as often as possible possible, as it’s one of the most effective ways to calm and sooth baby. Parents often have questions about pacifiers. If you’re breastfeeding, it’s okay to introduce a pacifier once everything is well established with with nursing. Dr. Karp has found that pacifiers do not shorten duration or exclusivity of breastfeeding and they reduce SIDS risk, so go for it!


For more in-depth information on how to soothe baby and the 5 S’s, Dr. Karp’s book, The Happiest Baby on the Block, is a terrific resource.  This video is also a great resource for visually seeing how to actually “do” his 5 S’s! In addition, you can locate a professionally trained Happiest Baby on the Block educator in your area.


For support in helping to identify whether you, or someone you care about, is dealing with postpartum depression, or for support in dealing with PPD, we recommend Postpartum Support International. Please seek out help and know that there are many factors that trigger PPD, and also many different methods and angles for helping to treat PPD.   Soothing baby, via Dr. Karp’s methods, is just one of many suggestions to help in preventing and treating PPD and while it may work for some babies and parents, it may not work for others. There is no one “solves all” in terms of PPD, but information, resources and help are there for you. Don’t shoulder your feelings and thoughts alone.


Thank you, Dr. Karp, for a great presentation at AWHONN!