<I have not personally read or seen Dr. Karp's book and video but plan
to
search them out.  ...my fears on the swaddling is based part on what I
observe and how people tend to take only part of your message to an
extreme

....that it will used too much and not just to calm.  A baby
should not be put to sleep this way for hours at a time.  They need
their
hands near their face to wake themselves for feeding cues....


... what period of time are they told to keep the baby this way?  Is it
just until the baby settles and then they should gently move their arms
out of the swaddle? As a last note, you said that the 5 S's replicate
the baby in the uterus.  It is a tight fit in the last months but the
uterus does not restrict the hands down to the sides of the baby. >



Dear Ann,

I agree...extremism is a very unhelpful personality trait in parents and
in those who counsel parents.

That is especially true in our culture. While "1st world" parents are
arguably the most educated people in history, we are also the least
experienced when it comes to babies. I know it's a gross generalization,
but while it is instinctual to want to nurse and calm your baby, there
are many parts of the process that are learned skills (ask any mom how
much easier it was to care for her 2nd baby versus her 1st).

This lack of experience makes them extra vulnerable to the unbalanced
and inflexible opinions of writers and consultants.

I hope you will watch my video...and even more importantly read my book.
Then you will understand that I am advocating the use of swaddling as A
TOOL...to be used by parents for new babies who need it.  Parents who
have fussy babies needing help in staying in a calm state and those who
want their babies to sleep longer.

How long should a baby sleep?  How many times should she be nursed
between 10P and 6A?  What is your recommendation?  In some cultures,
babies may be put to the breast a dozen times a night...or more!  There
is much evidence (the biochemical analysis of our milk) to argue that in
the "natural state" babies are meant to nurse almost continually (100
times a day and more).

Of course, there are few mothers today, in our culture, who nurse so
frequently (and I am not arguing for or against such frequent suckling).
I am merely saying that most parents aren't trained in the use of all
the tools that exist to help soothe their babies (the 5 S's, plus
massage, warm baths, walks outside, etc).  Training is required because
many of these techniques require some special finesse if they are to
work well (that holds for breastfeeding as well as swaddling and
jiggling).  In fact, that is exactly why I wrote this book and made this
video.  In my experience, many infant care specialists (doctors, nurses,
child birth educators and lactation consultants) either don't know all
the tools or don't know an easy way to teach them to parents.

When it comes to having hands close to the face...you are right a baby's
hands are usually in that position in the uterus.  However, that
notwithstanding, during the last 1-2 months of pregnancy the fetuses arm
movements ARE highly restricted.  Their arms can only be held in flexion
(as just described) or in extension with the arms AT THE BABY'S SIDE.
(They are prevented from extending in any other direction by the
muscular walls of the uterus.)  SO the arms extended position is a
physiologically normal, albeit not the usual, position for a term baby's
arms.  (Again, I am only advocating that swaddling be used for certain
specific times of the day...most of the day the baby will be able to
have the arms out and in flexion or extension,...baby's choice.)

Finally, I would like to reassure you that your worry that babies in an
arms-down swaddle will be forced to cry to request a feeding is
incorrect.  They have the ability to make all sorts of gradually
increasing intensity of sounds to inform parents of their growing
hunger.  Swaddling will, however, prevent a baby from accidentally
whacking herself in the face and causing an arousal before she would
otherwise "need" to get up to eat.

The duration of a baby's sleep is in large part based upon the maturity
of their state control.  Some babies are better able to return to deep
sleep from light sleep while others wake up everytime they enter light
sleep (they are aroused by even a little bit of stimulation - eg they
move or hear a noise). These later babies may wake to nurse every 1-1.5
hours during the night.  Again, I am not saying moms shouldn't nurse
that often (much biological and anthropological data argues that the
should!), however, human beings are an adaptable species.  We can live
in Alaska and in the Amazon jungle...likewise babies can survive very
well being fed every 1 hour all day long...or 2 or 3...infact as we all
know many newborns are even able to sleep for 4 hours in a row within
the first weeks of being born.

Four hours is pretty much the limit that I personally feel comfortable
during the first month of life.  That is why I recommend mothers wake
their newborns to nurse them if they are sleeping longer than 4
hours...during the night.  (During the day I recommend that babies be
fed at least every 2 hours...sooner if the baby is fussy or rooting).


I apologize for the long-winded question, but I know there have been
lots of questions about my recommendation and I wanted to take advantage
of your inquiry to present my approach more fully.  I don't claim to
have "the  answer", but I do believe I have developed an extremely
helpful method.  Teaching parents about the "4th trimester", the
"calming reflex", the "5 S's" and the "cuddle cure" (doing 4-5 of the 5
S's simultaneously) has the potential for making moms more successful at
breastfeeding.  It can also help them get more rest, have happier
marriages, lessen depression and, hopefully, even prevent some of the
more than 1500 hospitalizations from shaken baby syndrome in the US each
year caused by parents who are driven to extreme measures by their
baby's persistent crying.

Warmest wishes,

Harvey

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