> Winnie, I have been following the Dr. Karp's book thread. I do not see any  
> post that shows an inability to disagree respectfully.  Disagreement is  
> possible.  Those of us who disagree with Dr. Karp have not been rude or  
> disrespectful.  Just the fact that we do not agree with him does not show a  lack of 
> respect for him. We may even agree with part of his theories (even  though they 
> are not really his) we just a disagree with part of the  direction he took the 
> concept.  I do not consider what he creates to  be a reflex.   He can promote 
> it as such and he can have many experts  agree with him.  I still have the 
> right to disagree and say so.  To do  so on Lactnet requires I do not personally 
> attack him or show disrespect for him  as a person.  It does not require I tip 
> toe around my disagreement.   


I completely agree that disagreement is possible and that it is acceptable to "agree to disagree." What I continue to have a problem with is the persistent labeling of something when the author or person putting forth an idea or intervention does not, e.g. persistent labeling of these techniques, tools, recommendations as a "method" when that is not how the author/person presents it. (I went through Dr. Karp's posts, follow-up posts and an online publication 
(http://www.contemporarypediatrics.com/contpeds/article/articleDetail.jsp?id=108006 ) about his techniques using my "find" mode. The word "method" came up only once in Dr. Karp's online article but it was in reference to observing mothers for coping ideas -- not his recs/tools; he did not refer to his techniques as a "method." The word "method" in reference to his techniques seems only to be used by others who have posted on it.

Per the dictionary "method" tends to refer to a more rigid or orderly way/system, but "techniques," "tools," "skills," etc. may refer to a set but implementation tends to connote less rigidity or orderliness. Personally, I have no clue whether the 5S techniques "must" be applied in a particular order -- usually try my 1st S of skin-on-skin contact or BF first, but if baby is working himself/herself into a tizzy still, a bit of shushing with a sway often does the settling trick. If not quite enough, now I try arms-down swaddling; often that's enough but I go back to shush/sway post-swaddle p.r.n. Sometimes the swaddle seems the thing to do first -- can't explain why but believe it's related to incoming subtle assessment data from baby. After an apparent effective BF and mom needs some rest, the hands-down swaddle often helps too. I also believe I've been at this long enough as a health professional (including NCAST certification a number of years ago), mother, grandmother, etc. and have studied infant behavior enough to distinguish a baby that is demonstrating relaxation cues vs. distress cues vs. zoned-out cues. When colleagues imply that those of us who've implemented and found these techniques helpful may not be reading baby well or may be jeopardizing baby's physical/mental health, it feels insulting vs. disagreement to me.

After Nikki posted several swaddle refs the other day, I went and checked all of them out. There's some interesting stuff there -- mainly research support that swaddling can be a helpful technique and/or it does not appear harmful if done correctly and baby is on back to sleep. Interestingly, one study that contrasted before/after stats re: a back-to-sleep educational intervention for SIDS indicated that the cultural group with the lowest SIDS in pre-intervention period also appeared to have both a lot of BF and a lot of swaddling as part of cultural norm. 

Perhaps I would also argue at this point whether the "calming reflex" is a true reflex; I know other HPs have too. (A concise description of reflex at: http://en.wikipedia.org/wiki/Reflex.) I'm a doubter until I see the research support for it. But there's lots of notions about physiology and discoveries of new aspects that have changed in the last couple of decades, e.g. oligosaccharides number and role in human milk, the discovery of prostaglandins, fibronectin, etc. Just because it wasn't previously known, doesn't mean it isn't. 

Mainly, I don't care if the 5 Ss work to trigger a true reflex; I care that parents have safe, effective tools that allow them to get to know their babies, and help empower them as parents -- and those don't all have to be the ones I would use or think best. And I've not met one parent who implements them to avoid contact with baby -- usually it's the opposite, lots of contact has not helped and they're at their wit's end (and BF is often cited as being in jeopardy). These parents also indicate that snug swaddling for a few consecutive hours is mainly done after effective BF and before typical sleep time. (Not saying there aren't parents who wouldn't use it to avoid contact or swaddling for 10+ hours in a row, simply that those aren't the ones I see or who I've been in contact with.) 

It doesn't distress me that the work or theories are "old" info and made to seem a new discovery. I don't care that it isn't written as I may have written it. And I say "more power to you" if the marketing approach works. It appeals to the current generation having children; it "knows" that group and addresses their issues while intro'ing them to those old theories in a way that works today.

For me there isn't anything black (it's bad)/white (it's good) about this issue. These are techniques I find helpful for some particular babies using an individualized care approach. I would feel badly about the care I provide if I knew such techniques but never offered them as one more option for parents coping with a baby for whom the techniques may help -- and I'd feel even worse I thought I'd contributed to a baby being weaned from breast because I had withheld possible calming coping skills from parents who had reached their limit and BF was the only thing they could see to change. 

Finally, this discussion makes me I wonder how personality style, e.g. Myers-Briggs type affects our responses/approaches to various discussions here. Hmm...

Karen 
(who'd told herself she wasn't going to "say" one more word on this topic and also means no disrespect to anyone commenting on it)

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