According to The New Yorker, Harvey Karp knows how to make babies happy. The truth is that, after an hour chatting via Zoom, it is clear that this 71-year-old American pediatrician adores these creatures, a reason for happiness but also for concern.
This latter feeling is fueled by both existential questions (“Will I be a good parent?”) and practical ones (“Are you hungry?” “Are you cold?” “Why are you crying so much?”). And it is that babies, although adorable, give a lot of work. Especially in those first few weeks that Karp calls "the fourth quarter." A period where crying abounds which, if prolonged, becomes the so-called "infant colic", the study of which has marked Karp's career. And it is that from his interest in colic his interest in childhood sleep awoke and his books also arose (such as The Happiest Baby: the best method to understand your baby), sold by millions in the United States and translated into Spanish by Palabra editorial.
Karp's fans include celebrities like Michelle Pfeiffer, Pierce Brosnan and Beyoncé, though the Los Angeles-based pediatrician doesn't talk about celebrities. He does talk—at length—about his research and his latest venture, Snoo: a cradle that responds to the baby's reactions and creates an environment of sensory richness similar to what exists in the womb.
He has been described as "the man who soothes babies." His cradle, Snoo, incorporates artificial intelligence to help them fall asleep and calm crying, moving automatically... How did this invention come about?
Snoo is linked to a basic concept: colic. A discomfort that, from the first weeks, almost all babies have at some point of the day, for no clear reason. It is a very prolonged cry, which can be unbearable. However, colic is treated as a mystery. The only answer given to parents is: "They will go away with time..." But, meanwhile, lives get complicated: there is fatigue, depression, arguments and, even, some hurt their baby out of desperation. I remember that when I started working as a pediatrician and I came across this reality I thought: “We can send a man to the Moon, but… Can't you know why babies cry?! Has no sense". So I started to investigate.
And what did he discover?
My theory is that babies, after two or three weeks of life, begin to respond to stimuli and feel their bodies. But there are things they perceive (like their intestines moving, which is normal), that startle them. Depending on the personality of each one, this reaction is more or less intense; there are some who can't take it and cry. But if you do the right thing and apply what I call The 5 S's, you can calm colic fast.
What are the 5 S's?
The first is by swaddle, an ancient technique, which consists of wrapping the baby in a swaddle or cloth. This recreates the enveloping effect, typical of the uterus, reducing agitation. Then there is the “s” for side or stomach position, which involves placing the crying baby on your arm or shoulder, either on the side or on the belly. The third “s” is a classic: the hiss (shush). I think this onomatopoeia was one of the first words spoken... Babies calm down when they hear it! The fourth is the swing (rocking): cradling the baby gently keeps him calm but, if he cries, it is better to do it with quick and short movements, although never shake him.
And the last “s”?
The pacifier (suck). Many babies go into a state of deep relaxation when they start to suck. Some calm down more easily with a pacifier. I say it's the icing on the cake, but if you can't calm him down with the 5 S's, then the baby needs a medical evaluation.
You are also known for the concept of the “fourth trimester”. What does it consist of?
It's a concept he's worked on for years. The name is not mine, there was already a book on the fourth quarter, but I have popularized it. The idea is this: while foals can run on the first day of their lives, human babies are very immature. In the first four months of life they are still fetuses, and our job is to hold them, rock them, hug them, calm them...
An absolute dedication, for many hours...
Yes, but from the point of view of babies, those many hours are not enough. Twelve hours in their arms are not enough for them! They are used to the womb, where they have been rocked by the mother's movements and have constantly heard sounds. And what we do is put them in a crib, in an environment of sensory deprivation... A big mistake is to believe that the sleep of babies is like that of adults: that they need silence and darkness. I assure you, if you could ask babies where they prefer to sleep (In the arms, rocked? or In a crib, still?), they would choose the first option. And we are seeing that they not only want it, but that they need it. They need their arms to develop normally.
But having the baby in their arms all day is not possible for parents...
There are incorrect expectations of what it means to be a mother: many are convinced that they have to do everything and always be available. Before, the way of raising was that you had the whole family helping you: but today you don't have aunt or grandmother. Parents are overwhelmed, don't know what to do, and seek "expert" opinion. And if some expert tells you, "You have to be with the baby every second," you do it. But what you're doing is endangering the baby. That's why I always say that my crib, Snoo, is like having an extra pair of hands: a big sister who comes to help you.
This "not leaving it for a second" is one of the pillars of the so-called "attachment parenting", today in vogue. What do you think of this trend?
We must differentiate the psychological theory of attachment with the so-called "attachment parenting". The problem is that today these concepts have been mixed up and there is a lot of confusion and very rigid positions on how to breed. I like many things about this movement —breastfeeding, carrying…—, but babies are not rigid. When she worked as a pediatrician, she used to tell parents: "Be flexible, because you can have preconceived ideas but things, in reality, are different." The problem with "attachment parenting" is that you have to strike a balance: it's not good to be ideological when you're raising a baby. And if you can breastfeed, great, but if it doesn't work or you have to stop, don't beat yourself up. The baby will be fine if you are fine.
What does the inventor of the intelligent co-sleeping cradle think, sharing a bed with children as a rule?
The safest way for a baby to sleep is at the parent's bedside, in a safe crib. This way you will avoid crushing it. The problem is that, about thirty years ago, doctors said: "Put them to sleep on their stomachs." Until we saw that we were completely wrong and we literally turned the indication around. Today we know that sleeping on the back is the only suitable position for babies.
But, by making their sleep safer, we have spoiled it, because babies don't like to sleep like that... And they show it. As a result, parents despair. And if there are people who tell you that sleeping with them is the right thing to do (because it's done in Japan etc.), well then, you put them in bed. It's very nice, too. But it's not safe.
Another controversy of contemporary parenting is the methods to teach children to sleep: What is your position in this debate?
Well, it's not my position, it's what science says. Science says that sleep training methods do not cause them any kind of emotional damage. I think they cause more emotional damage to parents.
And what is the role of Snoo, his cradle, in a key aspect such as childhood sleep?
In the United States, 3,500 babies die each year in their sleep. Most, when they roll over, either in their crib or in their parents' bed. There have been no changes in the last twenty years regarding the rates of SIDS (sudden infant death syndrome). They were very significant from 1990 —when the indications of the sleeping position were changed— until the beginning of the century. But this improvement has stalled. The reason is that parents are so desperate for sleep that they do things that are not safe: they put the baby on their stomachs, they put them in bed... So we started this company, ten years ago - even though I was retired and happy - , because we understood that we had to do something to save the lives of babies and support parents.
We designed this crib, with MIT engineers and A-list designers, and we're keeping babies safe: a sleeping bag is built in that keeps babies on their backs. And we are also making life easier for parents: I have studies that show that, thanks to Snoo, at two months, babies sleep an hour more on average and that, with use, they learn to sleep on their own natural.
Snoo is constantly swaying and making what is called "white noise". With so much stimulation: how can the baby sleep?
Babies are born dependent on sound and movement: they've had them non-stop in the womb. Do you know why many people fall asleep on trains? Because it is an experience similar to that of the womb. In babies, in the first months of life, this is an automatic reflex: it was not for nothing that it was recommended to take them in a car, so that they would sleep... When babies wake up in a normal crib, they ask themselves: “Where are you? Come back!" But with Snoo, when the baby wakes up, he's being rocked and he hears white noise, so she goes back to sleep. He feels safe.
Does Snoo ever stop moving?
At six months the brain of babies is much more sophisticated. They have more abilities to interact, to control their sleep, to focus their attention. Then you can take it out of Snoo or stop the cradle: we have a setting where it no longer moves throughout the night (although the sounds do continue). But, if the baby cries, the movement starts.
Snoo is still a robot. Can a machine be applied to breeding?
We don't like the word “robot” because it doesn't sound like something suitable for a baby. Snoo is not a substitute: it is a parenting aid, a support. If the baby does not calm down, the caregiver has to intervene.
It costs more than a thousand euros, the famous have it: Is it their cradle for the elites?
We did not want a luxury object, but to design a crib that helps families. But such a design was expensive. In any case, they can be rented: in the US two-thirds of users rent them, for five dollars a day. That means having an extra pair of hands, being able to rest for another hour and your child learning to sleep... I think it's worth it. But we want it to be free, to be financed by insurers (it is approved by the FDA, the body that regulates medicines in the US) and by the public health systems in European countries. In the US, many future parents already receive it as a gift from their companies.
Our arguments are that, in the long run, this crib saves money, because it is an ally for a good upbringing, for the health of parents and children. There is a very clear link between lack of sleep and postnatal depression. We know that crying, lack of sleep, the fear that your baby will turn around and the feeling of being incompetent... All of this leads to states of anxiety or depression. It is a public health problem, without a doubt. But also, of the companies.
Especially in your country: Would having longer maternity leave be a solution?
Here the lows are very short and, although they are getting longer, I think that this alone is not enough. In Canada, for example, there are up to 50 weeks of maternity leave, but the incidence of postpartum depression is higher than in the US. One reason is probably the weather. But another is the isolation of parenting: when a mother is alone at home, with the baby with colic, she is eager to go back to work... Extending maternity leave is not enough: tools must be provided for parenting to be satisfactory
