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How to Cure the Crankies

My firstborn had awful colic. His nightmarish, hours-long wails had my husband and me pacing the floors, running the vacuum cleaner, burping him like mad and endlessly singing every lullaby and love song we could remember. Nothing worked. Half the time, I'd wind up crying too. Why wasn't he a happy baby like those TV-commercial cherubs? What was I doing wrong?

Nobody told me my squalling lumpling was like an unfinished cupcake that just needed more time in the oven. Or that by imitating the atmosphere of the womb (his "oven"), I could turn off the crying.

At least that's what parents over the past 20 years have been learning from Harvey Karp, M.D., assistant professor of pediatrics at the UCLA David Geffen School of Medicine. In his best-selling book and companion DVD, The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Newborn Baby Sleep Longer, Karp teaches an approach to baby calming that parents from Texas to Maryland are calling "magic" and "a lifesaver" in their five-star write-ups on Amazon.com. Even celebrities Madonna and Gwyneth Paltrow have consulted the doctor about their fussy tots. Across the country, it seems, a hush falls over noisy nurseries as parents try out Karp's lineup of soothing strategies -- swaddling, sucking, side positioning, shushing and swinging -- that are the core of his baby-calming philosophy.These "Five S's" are not exactly revolutionary. In fact, they're probably as old as humanity: Various cultures have been using the same techniques on their children for centuries. What is fresh is his idea that when these tactics are used in just the right way, they can trigger a neurological reflex that instantly quiets most fussy infants and adds one to three hours to their sleep. That's right -- Karp believes that most parents can activate their child's "calming reflex" and soothe even the worst case of the crankies on the spot.But is there really a magic formula for fuss-free babies? Or is this just another gimmick akin to weight loss without exercise or making money without working? Well, some experts in the field remain skeptical, and a few of our road-testers were not completely sold. But legions of parents have become devotees of Karp's step-by-step method. If you're at your wit's end with a colicky or crying newborn, read on to learn more about the soothing secrets of the "baby calmer."

The Fourth Trimester

That a "calming reflex" even exists hasn't been scientifically proven. Neither has a cure been confirmed for colic, which can often be at the root of chronic crying. But Karp's theory goes like this: Because humans have such big brains, our babies' heads would get stuck in the womb if they waited to become fully developed. So instead, Karp explains, our newborns emerge relatively small and immature, and in need of a "fourth trimester" to finish getting ready for the world. By re-creating the sensations, rhythms and sounds of the uterus during the first three months of your newborn's life, you can keep a baby reassured and content, he says. Most babies outgrow their craving for each of these soothing elements by 3 or 4 months. But aside from swaddling, many parents find the techniques have a calming effect for months afterward.

The idea that babies may need a fourth trimester of womblike nurturing "totally reframes this period for parents," says psychologist Debbie Glasser, Ph.D., founder of newsforparents.org and past chair of the National Parenting Education Network. She discovered Karp's work during her child's colicky stage. "I was able to say, 'You know what? My son's had a big journey too.' It helped me connect with him in a loving way at a time when I was feeling exhausted and overwhelmed."

The "Five S's"

To make the transition to life outside of the womb easier during this fourth trimester, Karp believes in mimicking many of the elements of your baby's in-utero environment. Perform the five simple techniques below whenever your baby seems inconsolable:

1. Swaddling consists of snugly wrapping your baby in a blanket, arms tucked in at the sides. "It gives a nurturing touch and stops limbs from flailing," Karp explains. Swaddled babies sleep longer, according to a study in Pediatrics. The researchers also found that being swaddled in the crib or bassinet may help babies stay longer in the supine (on the back) sleep position, which has been proven to lower the risk of Sudden Infant Death Syndrome (SIDS).

Be sure that you swaddle correctly so the blanket stays tight; talk to your nurse or pediatrician about proper technique. Or try a special swaddling blanket to ensure you're folding and tucking the right way. Loose or unraveled blankets in the crib while your baby sleeps are actually a suffocation hazard. Larger babies may be more difficult to wrap and are more likely to free themselves from the swaddle, so some parents may need to skip this step. Karp warns that some babies cry more right after swaddling, but as soon as you add some of the other "Five S's," your baby will relax and may even fall asleep.

2. Sucking is perhaps the element most familiar to parents. Babies suckle your nipple or a pacifier to soothe themselves. Sit down with your fussy baby for breastfeeding or pop a paci in his mouth, Karp says, and watch as he sucks himself into nirvana.

Many new parents worry that their newborns rely too heavily on pacifiers, but "it's impossible for young babies to suck too much," says Karp, who recommends weaning infants off pacifiers by 4 to 5 months of age.

3. Side positioning imitates the fetal position. "Before birth, your baby was never flat on his back," Karp notes. Keeping your baby on his side also avoids the Moro (falling) reflex -- the baby flings his arms out suddenly as if bracing for a fall -- which often happens when babies are lying on their backs, and frightens them. "Side positioning is great for your baby's waking hours, but on his back is the preferred position in which to put him to sleep," Karp says. Indeed, the American Academy of Pediatrics (AAP) has recommended placing infants to bed on their backs to reduce the risk of SIDS since 1992.

To avoid laying your baby on his side in the crib, try holding him with his back against your chest, supporting his side with one arm and hand, and resting his head in the crook of your other arm. Most babies love being carried in this position, especially when it's combined with any of the other S's, Karp says. Newborns often like a feeling of pressure on their tummies. (But again, babies should always sleep on their backs.) You can hoist your baby over your shoulder as you would if you were burping him. Little ones find this sensation on their stomachs extremely comforting.

4. Shushing is basically loud white noise, simulating the sound of blood rushing through your arteries that your fetus heard. "One of the greatest myths in our country is that babies need quiet and stillness," Karp attests. "In the womb, [your baby] was surrounded by a constant shushing sound that was louder than a vacuum cleaner." You can make noise yourself ("Shhhhhhhhhh") or play radio static or a white-noise machine. The trick is for the sound to be loud -- Karp recommends putting your mouth right up to your baby's ear. "Practice making the 'shh' at different pitches and see what works best for your baby," he suggests.

5. Swinging or gentle jiggling or swaying causes relaxation in a fussy baby the same way adults are calmed in a hammock or on a train, Karp says. This movement also echoes the constant motion your baby felt as a fetus. That's why babies love car rides, infant swings and being in your arms while you dance. Ask your pediatrician about how to safely swing your baby, and always follow the manufacturer's instructions on mechanical swings.

So Does it Work?

Many enthusiasts cry (no pun intended) a resounding "Yes!" Glasser of newsforparents.org says she saw an immediate reduction in her son's crying. "Did it work every time? No. Nothing does. But after we had him evaluated by our pediatrician, it gave us concrete things to do that were incredibly helpful and beat just 'waiting it out' as I did with my older two children, who were also fussy babies," she says. She now shares Karp's ideas with the parents she works with as a parenting educator.

Others cherry-pick their favorite elements. "I'm not big on jiggling or loud noise," says Michael Speer, M.D., a professor of pediatrics at Baylor College of Medicine in Houston and a past member of the AAP's Committee on Fetus and Newborn, although he agrees that newborns do find snuggling, holding and sucking soothing. One element he finds missing from Karp's plan: the attitude of the mom or dad. "The best thing for calm babies is calm parents. If parents are upset and trying one thing after another, babies feed off this and become equally upset." So even if you're following the "Five S's" to the letter, if you're frazzled, there's a good chance your baby will be too, he says.

If you've already tried any or all of the "Five S's" with little or no success, the problem is usually "a little mistake in the fine points," according to Karp. "It's just like hitting the knee with a hammer to trigger the reflex where your leg kicks out. You have to do it exactly right to trigger the reflex," he explains, although "right" varies from child to child. Try each of the steps a few times with your child. Babies need time to adjust to anything new.

But above all, follow your instincts. If you feel that loud noise, jiggling and the tight swaddling are more of an annoyance to your little one than anything else, do what feels right to you -- most likely, it will feel right to your precious bundle as well.

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