Monday, February 25, 2008

Quieting colicky infants and soothing temper tantrums...

Dr. Harvey Karp is receiving a lot of attention for his advice about dealing with infants and toddlers these days. Since I have not read his books, I cannot personally critique them. Nor, do I know enough about Dr. Karp's theories to do a true analysis. Perhaps, some of you are more familiar with his work and can share your thoughts with us. In the meantime, this post is based on reading an interview with Dr. Karp and some articles which review his works and quote him.

If I do understand his underlying theories, I'm not sure that I'm wild about them. However, some of his practical suggestions sound helpful. In my opinion, this is probably because he has brought together in one book some time-tested suggestions that parents have used for centuries.

Dr. Karp apparently believe that human infants are born about three months too soon. He cites as evidence the fact that many animals are born with more survival skills than human babies are. It seems that he believes that in order to keep infants happy, we must recreate what they are missing by not maturing further in the womb.

If he does, in fact, believe this, I don't look at a human baby's need for comfort in the same way that he does. I don't believe that God made a mistake when he determined that a human mother's gestation period is about nine months.

I do believe that human infants need a lot of comforting and physical touch from their parents during the first three or four months. However, I don't see this as a substitute for the womb, but the beginning of human communication and relationship. Human infants are endowed with a spirit and are born with the capacity to know God and to form deep, complex, and lifelong relationships with others. It makes sense to me that intense parental nurturing in the first few months of life starts a child on the road to relationships.

Emerging from the womb at nine months gives a baby the chance to be held in his mother's arms and to suckle at her breast, precious experiences that lingering in the womb cannot offer. Plus, the first three or four months of a child's life are something of an apprenticeship for the mother as well, because she learns to love and care for her dependent baby in a profound way.

So, let's glance at Dr. Karp's parenting suggestions -- as least, as I understand them to be. Dr. Karp studied societies where infants seldom cried, and he made note of their parenting practices. Here are some in a nutshell:

Dr. Karp advises that you swaddle your baby by wrapping him tightly in a soft blanket with the arms at the sides to stop the child from flailing his arms and legs. In centuries past, this was a common practice among many cultures, and you read of swaddling in the Bible.

As my children came along, the theory was that children should not be swaddled, as it was thought the moving the arms and legs about was a natural part of a child's development. It was thought that the child needed freedom of movement in order to learn how to control his appendages. However, when my first child was having trouble settling down, an older mother showed me how to swaddle her in a blanket and my baby immediately became contented and peaceful. I quickly yielded modern theory to the wisdom of the ages! My approach -- as an ordinary mom and as a non-exert -- would be to swaddle the child when the child needs soothing or calming, but to allow the baby some other times to move arms and legs freely.

Dr. Karp advised holding your baby in the side or stomach position. Today, the theory is that the back is the safest position for sleeping. Dr. Karp advises that you don't let the baby sleep on his stomach or side, but that you do hold the baby on his side or on his stomach when trying to calm him. I think most parents have that one figured out. How many times have we seen a mother gently lay her baby across her knees and softly pat his back.

Dr. Karp says shush your baby. Again, I think we all do this one instinctively. Shushing or white noise helps a baby feel comfortable. Saying shush into a child's ear simulates the sound he heard in the womb, according to Dr. Karp, and I do think that does make some sense. On the other hand, I know many adults who use white noise in order to sleep well, too. At any rate, we all try to soothe children by saying in whatever version our native language is something like, "Hush now. It's okay. Shh, now. Shush."

Additionally, there are other ways to make white noise. Being near a running dryer worked for my children.

Dr. Karp says swing your baby. He says to move baby in a rhythmic jiggling motion that moves to a swinging motion as the baby calms down. He cautions that you should never shake a baby. Again, parents usually do this instinctively, but I would reiterate to be gentle, gentle, gentle! No shaking! Also, when my children were little, I got a lot of use out of a baby swing.

A friend of mine, who is studying occupational therapy, relates that certain chemicals that promote a sense of well-being are released with the movement of swinging. Babies, older children, and even adults can benefit from a few minutes of swinging every day. Soothing touch also release chemicals that promote a sense of well-being. I don't know if Dr.Karp covers that or not, but I do think it's interesting.

Dr. Karp says to let your baby suckle. Provide breast, pacifier or a clean finger. Again, there's nothing new here, but it does reinforce the idea of nurturing your child.

While these may not seem like earth-shattering innovations, being reminded of them can help a first time mother. You'll probably find that if you combine these five things in whatever amounts work for you, you'll be able to soothe your fussy baby. The best way to learn how to do these things, I've found, is to watch experienced mothers or grandmothers handle babies. If you do regularly practice these things, and the baby does not respond, it's time to talk to your doctor.

Regarding toddlers, Dr. Karp has a suggestion for dealing with tantrums . If the toddler is going on and on, saying, "I want cookie. I want cookie. I want cookie now, " kneel down until you are at the child's level. Indicate that you understand, using simple language. Say something like, "I know. You want cookie. You want cookie now." Once your child has calmed down, you can say something like, "It is not time for a cookie. You may have a cookie after lunch."

Dr. Karp's reasoning for mirroring a toddler's own language this way, I think, is that toddlers still use simple language and, thus, understand simple language. Sometimes, a toddler will become frustrated that he cannot make his needs known or fearful that his parent has not understood his need.

All people respond better when they feel they have been heard. Even with adults, if someone makes an emotional statement and you feel just a wee bit defensive, it's helpful not to overreact. Instead, you can mirror their sentence back to them to make sure you understand how they feel and to let them know that you are listening. Then, you can calmly state your point of view.

Since toddlers use simple, repetitive phrases, much as an over-excited adult might, use that language when mirroring a child's thoughts back to him. Also, when giving directions to a toddler, stick to simple phrases.

Perhaps, Dr. Karp does have a valid point that parents too often try to reason with a child on an adult level. This can frustrate a toddler, who is just beginning to develop mastery in communication skills.

To a toddler, whose experience of life is limited, a small disappointment might loom in his mind as a real crisis, the kind of crisis that brings out emotional language, tears, and anger. A child does need his parent to listen to his childish troubles with a spirit of compassion; remembering that we, too, take our daily needs to our loving Heavenly Father. Mirroring his speech, as Dr. Karp suggests, could be one way to put that into practice.

My own thoughts would be that in addition to this, do not reward the child by giving into his wants when he is in the middle of throwing a fit. I suspect toddlers are more sophisticated than we give them credit for, despite their immature language skills. Toddlers can manipulate parents by throwing tantrums. Their first tantrums are probably caused by emotional frustration. However, somewhere along the way, toddlers can make the connection that if they throw enough fits, they'll get their way --at least some of the time. At that point, tantrums become a habit.

There will be times when you just have to say, "No," and mean it, whether or not your child understands your reasoning and whether or not he feels as if you understand him. Additionally, you may need to apply some appropriate discipline. In the process, the child may benefit from working out some negative emotions. This is an important part of development. Learning how to manage one's personal reactions to life is important for a child.

Proverbs 16:32 says, "He that is slow to anger is better than the mighty; and he that ruleth his spirit than he that taketh a city."

Having said all of that, I do think it sounds as if the the five soothing techniques Dr. Karp recommends, plus the re-stating of a toddler's request in simple language, can be effective parenting tools. Try them and see if they work for you.

Has anyone read Dr. Karp's books? If so, what did you think of them?



Anonymous said...

I've read both the Happiest Baby on the Block and the Happiest Toddler on the Block.

I thought "Baby" was particularly geared for -- and most useful to -- parents with colicky babies under four months old (the ones who have the least amount of time to read the book). As you said, most of his suggestions for comforting babies were things we had done anyway, without reading the book: swinging, shushing, and sucking.

As for "Toddler," I did find it a helpful reminder to have discussions in what he called "caveman speak" to better get your point across. I mostly talk naturally to my toddler, but it does seem to be more effective, for example, to repeat: "No! Hot!" about the stove rather than to use a bunch of subordinate clauses: "No, don't touch the stove, because it's hot and Mommy doesn't want you to get hurt."

Elizabeth said...

That is a good point about giving toddlers simple directions. That does work better. Were there any other hints in Happiest Toddler on the Block that you liked?

Elizabeth said...

That is a good point about giving toddlers simple directions. That does work better. Were there any other hints in Happiest Toddler on the Block that you liked?

Anonymous said...

I don't remember a lot of specifics about the book other than talking to toddlers on their level and the "mirroring" their emotions to deal with a tantrum. I took the whole caveman thing metaphorically, and it was helpful to have an additional perspective on how much is accomplished in the first three years: from walking upright, to using tools (like a spoon and fork), to socializing in groups.

I am enjoying and appreciating your series on child-rearing topics.

Elizabeth said...

I'm glad you mentioned that you took the caveman idea metaphorically. After I first posted this, it occurred to me that he might have meant this as an illustration; sort of like Men are from Mars; Women are from Venus; Children are Cavemen.

Anonymous said...

I am so sad that we have come to the point of NEEDING doctors to tell us how to raise our children (yes, I know it started even before Dr. Spock) but surely all the things you mention here are SO VERY BASIC!! Mothers seem to lose confidence in their own abilities before they have even left the hospital (Which I am not an advocate for either, surprise surprise!) Gill.

Elizabeth said...

Hi Gill,

Thanks for your thoughtful comment about the need for mothers to trust God and to have confidence in their God-given parenting abilities.

You're right; the suggestions that Dr. Karp gives are basic, and, if I understand correctly, I suspect he goes a little off-base when he tries to offer his own explanations for why these techniques work.

The ideas mentioned are things you might pick up on your own simply by being in tune with your baby. And, they are things that many moms absorb simply from watching their mothers, grandmothers, and other experienced mothers.

However, I do think that books can be a source of useful information for parents, particularly when it comes to discerning medical issues. The key, I think, is to keep the advice in parenting books in proper perspective. I think the problem comes when parents slavishly try to follow whatever man made theory is popular at the moment, without comparing it to scripture or adapting it to fit a particular child's needs.

Of course, the Bible is the only infallible guide. And, according to the scriptures, it is the older women who are to teach the younger ones how to love their children. Books are merely a supplement to that.

Dr. Bruce Narramore, a noted expert in child development, once joked, "I used to have four theories about child-rearing and no children. Now, I have four children and no theories." Any parent with more than one child knows exactly what he means!

It's important to really know and be in tune with each of your own children.