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April 20, 2018 1:54 PM   Subscribe

 
He had some decent ideas, but as a new parent, I've really been questioning the consensus wisdom around swaddling that Karp helped to popularize.

Rethinking Swaddling
Responses to 'Rethinking Swaddling'

"I remember a professor telling me she used a certain DVD to teach what ‘shut down’ looked like in a newborn."

That's exactly what I thought watching 'The Happiest Baby On The Block' video. I was shocked at how different his philosophy was from my own: that you should treat a baby with respect and give them agency and autonomy to express themselves, the way you as an adult would like to be treated. Is putting a straitjacket on your baby to restrict them until their functions shut down really the solution? But also, what is the problem that needs a solution?

I'm a fan of the RIE philosophy, and its proponents fall more in line with my thinking. Janet Lansbury: "It is never easy to hear a baby cry, and we mistakenly believe it is our job to quiet a baby’s tears immediately, and by whatever means necessary. But babies communicate by crying, and sometimes they are expressing a particular need, like hunger. Other times they are expressing feelings... Babies need their feelings heard, respected and calmly supported, just like we all do." Magda Gerber: "Don’t do what comes naturally. Do what pleases me, your parent. I am in control of how you should feel and how you should show your feelings."

Swaddling is a solution to a problem not with respect to the baby, but rather a problem with respect to the parents. "How do I effectively power down my baby so that I can get some sleep?" That might be necessary for parents on their last tethers, and at the end of the day, everyone should do what works best for them. But that's a separate question from what is best practices for the baby. And I was very much put off by how the newborn training we received at our hospital unquestionably involved swaddling technique as one of the main cornerstones of what you 'have' to do.
posted by naju at 2:21 PM on April 20, 2018 [7 favorites]


I'm 51 and swaddling sure as hell calms me down. Though usually I go all in the soft bed under three quilts. Sometimes I ask my partner to lie down on me. I seem to recall wossname.. the cattle whisperer person, with autism... ah hell... Temple Grandin! She liked to be hugged to calm down too. Hugging is kind of like swaddling?

Anyway, my daughter had colic but this was pre-Karp and man, I wish I'd have thought of just hugging her.
posted by seanmpuckett at 2:28 PM on April 20, 2018 [8 favorites]


Well, yes, hugging is nice! Hugging, skin-to-skin contact, laying on your chest... I think these are all magnitudes better than tight swaddling.
posted by naju at 2:30 PM on April 20, 2018


I don't know who told Dr. Karp that because people bought into his zero-cost techniques to soothe infants (Which in personal experience work fantastically) are at all likely to buy into a $1000 robot cradle that by its very nature is only useful for a couple years at best. That person was wrong. I admit people are willing to shell out ungodly loads of money at anything that looks like it will placate a baby, but I guarantee there's nothing this $1000 wonder can do that can't be done by a $100 swing from Walmart, or you know, a caregiver with an interest in caring for their child.

As for whether swaddling is a good idea or not, well, it's a practice that's likely been around since the invention of cloth. It's not a substitute for breastfeeding or skin to skin contact, it's meant to simulate the only environment a newborn baby has ever known, the tight confines of the womb. It's not a straightjacket or some kind of manipulative trick, it's an effort to put your baby at ease. I assure you if your baby doesn't feel safe or is uncomfortable they will not hesitate to let you know. Swaddling eases the newborn into a new environment, and parents should closely monitor their child's development and stop swaddling when it stops being beneficial. On top of that, every child is different. Our oldest was swaddled religiously for nearly six months and would invariably smack himself in the face and wake himself up as soon as he wiggled an arm free. Our next child slept at the drop of a hat and needed nothing more than his dad's chest to go out like a light. Our third swaddled for less time but breastfed for far longer than the other two, nearly to the age of 3.

All that aside, I agree that hospital policies re: babies needs a societal shakeup. If It were up to me there would be no nursery and your baby would never be more than 6 feet away from you from before birth to the moment you leave the hospital. Frankly I'd rather not have hospitals involved in routine birth at all, but that's even less likely.
posted by Mr.Encyclopedia at 2:49 PM on April 20, 2018 [17 favorites]


. If It were up to me there would be no nursery and your baby would never be more than 6 feet away from you from before birth to the moment you leave the hospital

Are there still nurseries like you see in the movies with a giant window and the dads all lined up?
I've never actually seen one in real life.

All the hospitals around here have changed to "birthing suites" where your labor and delivery and recovery all happen in one room.
They have convertible couches for the other parent to sleep on, a sitting area.
They're pretty nice actually.

The new hospital has a set-up with a sort of "butler pantry" type deal, so if your baby needs observation and assistance but isn't in need of NICU, they slide the cot into the little observation chamber, so the nurses can do what they need to do without entering into the room itself.
posted by madajb at 3:17 PM on April 20, 2018 [4 favorites]


I was a new parent in 2003, not that long after the publication of Karp's "The Happiest Baby on the Block," and what I remember most is how compassionate his advice was in contrast to that of my son's pediatrician's office. When I told the nurse that I was doing the Karp protocol, and co-sleeping, and breast-feeding, and sling-wearing, I got back a fleeting look of disgust, followed by a lecture about the need for cry-it-out and about the tyranny of infants. I left that office in tears and never went back. After that--after the nurse's contemptuous and pitying advice--Dr. Karp's far more gentle approach sounded so much kinder and saner, and I swaddled my little guy for three months (not least because asleep, he'd have sudden muscle spasms and the suddenly-sprung arm would wake him, screaming). I owe Karp a debt of thanks for making a way for me not to lose my damn mind in those days. Baby 2 was just much more together, and so definite about not being swaddled that I gave it up after a few tries. She was a "toss the book, look at the baby" kind of kid who bypassed baby food entirely, but who clearly benefited from skin-to-skin, sling-wearing, breast-feeding, etc. Karp was not for her, although his recommendation for closeness sure was. (There weren't many sling-wearers in my area at the time, and I can remember the furtive looks of connection, like "YESSSS! Someone else who values baby-wearing, even though her mom and all of the older ladies around here give her stink-eye for spoiling the baby!")

I can't get too upset about this article and about Karp's evolving empire at this point in my parenting; it's still a hell of a long way from the older advice about not touching the baby (Deborah Blum's excellent Love at Goon Park: Harry Harlow and the Science of Affection (NYT review) is, in part, about old-school parenting in the first half of the 20th century, and it is horrifying reading), and Karp helped to shift the (ever-changing) way we think about infant development and babies' needs and to popularize a more gentle approach, so that's a win.
posted by MonkeyToes at 4:07 PM on April 20, 2018 [9 favorites]


a crutch for parents

This phrase makes me ragey. And let's be real, when people say "parents" they usually mean "moms."
posted by soren_lorensen at 4:15 PM on April 20, 2018 [33 favorites]


My experience was similar to MonkeyToes -- in that Kid BlahLaLa was born in 2003 and swaddling him was the thing that got him to sleep at a time when that was literally all I wanted in the entire world. Swaddling is free and easy and it worked. And I liked the shushing and the swinging. As for the rest of it, I've never had any problem with the "take what you want and leave the rest" philosophy. So I did some baby-carrying. I did some sling time. I did some co-sleeping. I did what felt right to me, and I don't have any problem rejecting any of Karp's ideas that didn't match up with mine.
posted by BlahLaLa at 4:32 PM on April 20, 2018 [10 favorites]


If It were up to me there would be no nursery and your baby would never be more than 6 feet away from you from before birth to the moment you leave the hospital.

You would love most modern "baby-friendly" hospitals, then! ("Mother-friendly" is not really a big priority.)
posted by Ralston McTodd at 4:37 PM on April 20, 2018 [11 favorites]


Swaddling (and to a lesser degree the side, shush, shake tips) certainly worked for us with our two kids (4 and 1.5 years). They have better sleep habits and history of the same than any kids we've met. That's the end of our sample size but I highly recommend it to anyone that asks how we did so well by our two.
posted by RolandOfEld at 4:40 PM on April 20, 2018 [2 favorites]


"If It were up to me there would be no nursery and your baby would never be more than 6 feet away from you from before birth to the moment you leave the hospital. "

Sounds awesome for women recovering from C-sections with no partner available who can't get out of bed to tend the baby, and not at all like going way too far the other way.
posted by Eyebrows McGee at 4:49 PM on April 20, 2018 [37 favorites]


You would love most modern "baby-friendly" hospitals, then!

Yeah, I gave birth at a massive mainstream women's hospital and indeed the baby never left my room (except for a brief NICU stay for observation). Which, like, I'd just had major abdominal surgery and did not have another responsible adult in with me at all times so that maybe was not such an awesome idea?
posted by soren_lorensen at 4:50 PM on April 20, 2018 [13 favorites]


Sounds awesome for women recovering from C-sections with no partner available who can't get out of bed to tend the baby, and not at all like going way too far the other way.

Was coming to say the same thing. I've had three csections and hospitals here still have nurseries (probably because there are so many csections but that's another topic). With my last baby I asked to have him in my room the whole time, but by the second night I knew I had to get some sleep if I wanted to speed up my recovery, and the nursery nurses took him from 12-to5am and it was wonderful.
posted by CrazyLemonade at 5:26 PM on April 20, 2018 [12 favorites]


Hugging, skin-to-skin contact, laying on your chest... I think these are all magnitudes better than tight swaddling.

Hugging is wonderful, but I definitely find wrapping myself up tight in covers to be much more relaxing and conducive to sleep.

Is it possible there isn't a single best right way to take care of babies that's better than all the other ways?

But, no of course there must be One Right Way. After investing so much time and effort and emotion in taking care of your baby, who could bear the thought that they didn't do it The Best Right Way? Who could bear to watch other parents doing it The Wrong Way?
posted by straight at 5:31 PM on April 20, 2018 [8 favorites]


We swaddled our two kids and as a person who had little baby experience to start with, the Dr. Karp's DVD was a great introduction to soothing and the bedtime process. I really liked having something to do and had a plan to do it.
posted by nickggully at 5:32 PM on April 20, 2018 [2 favorites]


Shitty judgemental nurses make my blood boil.

As for the baby being with you - ideally hospitals should be set up to be family friendly meaning able to accommodate everyone’s needs because everyone is different. Some women who have c-sections for example get really upset and feel disempowered if staff whip their baby away so they can rest. Some women love it. It’s rather like...women are individuals and their birthcare should respect that? No. That can’t be right. It’s the women who are wrong.

As for the HBotB - I also am finding it useful to try stuff out and leave what doesn’t work. Our bub loves being in a sling but always looked puzzled and mildly annoyed at being swaddled so we didn’t bother. Overall I personally like that Karp encourages you to just actually be responsive to your baby. Like hey look at them and react to what they’re actually doing. It gives me the confidence to trust my own judgement when the little voice in the back of my head says “but the book said...but the other mums say...but I read on the internet...” It’s not like first-time parents are typically overflowing with self-confidence right?

As a new parent if I had a wish for parenting it would be that we took the energy we collectively put into being prescriptive and overly concerned with how other people are raising their children, and instead channeled it into working towards policies that actually support parents and children. Like free pre and post natal care. Paid parental leave for both parents. Subsidized childcare so that mums can return to work if they want. Etc.
posted by supercrayon at 5:43 PM on April 20, 2018 [10 favorites]


But, no of course there must be One Right Way. After investing so much time and effort and emotion in taking care of your baby, who could bear the thought that they didn't do it The Best Right Way? Who could bear to watch other parents doing it The Wrong Way?

I'm not saying I have the one true right way and everyone else is bad and wrong. I'm personally questioning one popular approach this guy championed that has become widely accepted. I think that's allowed.
posted by naju at 5:46 PM on April 20, 2018 [1 favorite]


Hugging, skin-to-skin contact, laying on your chest

The common denominator with all of these is that the parent cannot be sleeping in any of these positions. Hug the baby all you want, but it's not considered a safe sleep position if the caregiver is also asleep.
posted by soren_lorensen at 5:59 PM on April 20, 2018 [11 favorites]


I'm personally questioning one popular approach this guy championed that has become widely accepted. I think that's allowed.

Yeah, sure. But also, doctors don't sell millions of copies because they themselves are popular, books like these become popular when parents like them, use them and talk about them to other parents. I bet there's lots of moms like me who just do.not.want a baby sleeping on my chest all night. Or sleep nursing. Or being half naked so much time. Whatever. I happily swaddled my baby until he just could not fit in the velcro swaddle thingy anymore. We both slept happily in the same bed but each in our own space. My neighbor slept with her baby on her chest for 3 months straight. *shrugs*
posted by CrazyLemonade at 6:13 PM on April 20, 2018 [5 favorites]


The article mentions Tracy Hogg meeting Dr. Karp back when she was still a celebrity baby nanny. I loved Secrets of the Baby Whisperer. It gave me a lot of confidence in myself as a mom and taught me to really see my baby as a person right from the beginning. With my first I felt like going through the motions of the regular baby routine (diaper changing, feeding, not-sleeping etc) and really doubting myself and generally not enjoying the whole newborn thing.
posted by CrazyLemonade at 6:19 PM on April 20, 2018


Swaddling is fine. Not swaddling is fine. Throwing not-so-subtle shade on parents who aren't doing things the "right" way is just not acceptable.

We got our first dose of this twelve hours after our son was born, when we asked the nurse if he could be looked after in the nursery for a few hours so we could rest. "Are you sure?" she asked. "Most parents want to stay close to their newborns." After two days of labor, two hours of pushing, an emergency c-section and no sleep for three days? Yes, history's greatest monsters are sure.

There's a performative parenting culture out there that's especially visible online, and it's really toxic. Caring for a child is hard enough without having external forces throw you into a spiral of guilt and self-sacrifice. If you gently cradled your child on your chest all night, you are a good parent. If you let them cry for ninety minutes until they tired themselves out and fell asleep, you are a good parent. If you bought your child a thousand-dollar bassinet, you are a good parent. If you cursed at your newborn while you changed them when they woke up for the fifth time that night, you are a good parent. If you let your child marinate in their own poop for an extra hour just to get a little more sleep, you are a good parent.

Just don't give other parents shit, ok?

apologies for the rant but i have feels on this
oh and please ask me how I feel about the phrase 'natural childbirth'

posted by phooky at 7:23 PM on April 20, 2018 [22 favorites]


I brought it up because my wife and I have been sorting through what we'd like to do for our week old baby, and sometimes we find accepted wisdom worth assessing and interrogating instead of blanket accepting whatever we're told is best. I thought I'd air some of that publicly instead of silently and privately working through it. Not because I'm interested in throwing shade at anyone or telling people they're bad parents. Sheesh! I'll show myself out.
posted by naju at 11:04 PM on April 20, 2018 [1 favorite]


Sounds awesome for women recovering from C-sections with no partner available who can't get out of bed to tend the baby, and not at all like going way too far the other way.

Worked fine for me in pretty much exactly that position. UK hospitals never have newborn nurseries and usually have limited partner visiting hours, so I spent the first 12 hours on the postnatal ward after a c-section with various drips and wires and things and strict instructions Not To Move even to lift the baby, ring a buzzer and someone would pass her to me. (This does of course rely on having decent staffing, which postnatal care often doesn’t, but then we wouldn’t have the staffing for nurseries either so eh.)

But it is also one of those cultural things that becomes seen as the only obvious way to do things after about a generation. My mother can’t believe we didn’t have hospital nurseries (and 2-week postpartum stays, and midwives running a babysitting service so you could go out to dinner with your husband in the evening, apparently this was a thing for a while) but now, even though there’s a lot of pressure to reform hospital postnatal care in a lot of ways to make it less awful for mothers, this specific thing never seems to get suggested. After a while it just becomes: well obviously that’s the way it is, how would it ever work any differently?

Like so much else baby stuff, of course. I’ve read baby-raising guides from the 18th century where the authors were furious about rocking cradles because they were a new craze at the time and therefore obviously a sign of deep maternal/nurse laziness that would inevitably lead to damaged, ignored babies. Rocking cradles! But I suppose not a million miles away from some of the grumbling about expensive electric swings now.
posted by Catseye at 12:03 AM on April 21, 2018 [3 favorites]


what I remember most is how compassionate his advice was

Absolutely. We had a heck of a time q with our first, and soanu baby books - and people on general - are so judgemental, and act like if you just do this one thing, follow this one baby recipe, they will sleep through the night and everything will be great, and deviating one little bit makes you a failure and you feel awful etc.

Karp was like " just try this and basically chill out and don't be so hard on yourself" and honestly, merits aside, it was exactly the attitude and the words we desperately needed to hear.
posted by smoke at 12:12 AM on April 21, 2018 [5 favorites]


baby-raising guides from the 18th century where the authors were furious about rocking cradles

I would love to see a timeline of advice and justifications, just to get some perspective on how expert advice changes, how fast, and why, and how quickly or slowly it's adopted in popular culture.
posted by MonkeyToes at 6:14 AM on April 21, 2018 [1 favorite]


We became parents in 2005, and while my wife was pregnant we watched the Happiest Baby on the Block DVD. I've recommended it to several people. The swaddling/shushing/sucking/side/swinging thing absolutely worked for kid #1. Of course you can't just do this to shut them up. You do this when nothing else works. You have to first take care of their needs. Are they wet? Are they hungry? Is a shirt too tight? Is a button rubbing their tummy?

With kid #1 her favorite thing was for me to hold her on her side while I bounced furiously on a big yoga ball. That would sorta put her into this blissful state and she could calm down.

We just had kid #2 at the end of January, and she doesn't really like sucking (she's all about the boob but doesn't want a pacifier). She's definitely ok with being swaddled. We no longer have a yoga ball, but the one thing that sorta "resets" her when she's fussy is the ONE BIG BOUNCE while I'm holding her in my arms. A almost "jump and then land and bend your knees until you're in a deep squat". Almost like the kid is in free fall for a second. We got lucky with both kids (especially #2) and they are great sleepers and not overly fussy (for now at least, I hope I'm not jinxing it).

I hate the way some parents will shame others for "not doing it the one true way". It's real, and it sucks. I remember my grandmother chastising both me and my wife when we visited for holding our newborn in our arms. She was maybe 3 or 4 weeks old, and we were parents for the first time, and she was happy to sleep while we held her. It really bothered my grandmother that we held her so much, and she said more than a couple times "Look, I'm just really worried that you're going to spoil that baby by holding her so much." We had to gently say "Thanks for your concern, but we're going to figure this out on our own, and if she's spoiled, she's spoiled."

Karp's Happiest Baby book and DVD can be extremely helpful, in my opinion, to new parents who don't have a fucking clue what to do when their baby can't be consoled. I would go through a mental checklist "ok, diaper is dry, belly is full, she seems otherwise comfortable, let's try swaddling, ok let's try shaking/bouncing, ok that worked". I haven't seen the SNOO that he's developing. I know we'd definitely not spend +$1000 on anything that's not life saving. It helps that on our second time with a baby we have an idea of what works for us and what doesn't, so we don't end up with a ton of gadgets and crap that's not useful for us and just takes up space.

The one space-age thing we got that's honestly pretty awesome is the mamaRoo. It's a "swing" that moves around in different patterns. We have 2 (one for my wife's office and one for our home) that we found used for a total of $105 on Craigslist. We had a second-hand swing that was working fine but the footprint is pretty big and the motor died a couple weeks ago, hence the mamaRoo.
posted by spikeleemajortomdickandharryconnickjrmints at 8:36 AM on April 21, 2018 [1 favorite]


I’ve always thought that you should be a parent of at least four children before you can tell others what The One True Way is. Especially because a parent of four will tell you that every baby is different and there is no One True Way. (Parent of one, and I’ve blocked most of the sleep deprived baby time so don’t come to me for advice.)
posted by 41swans at 9:02 AM on April 21, 2018 [3 favorites]


I am fascinated to learn that babies started sleeping worse in 1992 when the SIDS recommendation came out to put babies on their backs to sleep. No wonder there have been so many sleep books since then.

And I was surprised to see the article say that every baby does well with swaddling, as mine did not. (She also hated slings and cosleeping.) She used powerful kicks and punches to get out of swaddles (which actually strongly reminded me of when she was in my womb) and she calmed down when she was in loosened blankets.
posted by Margalo Epps at 2:17 PM on April 21, 2018 [2 favorites]


> who told Dr. Karp that because people bought into his zero-cost techniques to soothe infants (Which in personal experience work fantastically) are at all likely to buy into a $1000 robot cradle

Well, apropos of nothing, there is this guy in our neck of the woods who spent a lifetime selling things like $1000 baby cribs etc, and look how he turned out--a one-man argument for repealing the 2nd amendment . . .

So, let that be a word of warning--or something?
posted by flug at 2:22 PM on April 21, 2018


Huh. Baby nursery in the hospital? When I was dealing with preeclampsia and a difficult birth, We still had to care for my 4 week early twins. Their poor dad was exhausted... and had never held a baby before. I would have loved a nursery!

My kids were swaddled. It kept them happy and well rested. And you know what? I breastfed and pumped for 1.5 hours every 3 hours for months (so 12 hours a day). I needed them to sleep sometimes.
posted by Valancy Rachel at 7:32 PM on April 21, 2018


Hug the baby all you want, but it's not considered a safe sleep position if the caregiver is also asleep.

So I was told. Loudly and at length. And when a Monster was shrieking and inconsolable even after nursing and pacing and swinging and rocking and back patting...well, I laid down on my back, positioned said Monster on my chest, and we both proceeded to pass the fuck out.

As far as all the child care book writers are concerned, everything is dangerous. So I threw out all the books and did what worked for us. That meant co-sleeping, baby wearing, nursing on demand...and me being a Monster Bed.
posted by MissySedai at 9:01 AM on April 24, 2018


Parent of six - so as usual, late or last to arrive

First child 1991 - last 2004. and in that time there were major changes on the whole process of what happened in the hospital and what happened afterwards. Although after number four was born (natural breech birth) I was not going to put up with anything that did not suit me.

If it works for you and the baby, then you have a contented mother and a contented baby.

You are making the acquaintance of a new young person who will give you limitless "one in ten thousand" ref:xkcd moments - there is no sweeter feeling than cuddling a child. And afternoon naps allow you to carve out a cave of respite from the world. I was learning how to be a parent and my beautiful babies were learning how to trust the new world that they had entered. We made our own rules and lots of hugs and cuddles were a key part.

Swaddling - ugh. Carrypacks - who wants their face squashed into someone's chest, unable to see. Backpacks - yes, baby gets to see and hold/pull your hair. Strollers - only for brisk journeys, no child should fall asleep in one. Prams belong EVERYWHERE - the office, the dinner table, the living room, the kitchen.

Best trick for hot sweaty restless babies - pleasant temperature deep bath, laundry basket in bath, baby in laundry basket - you don't need to hold the baby tightly so they can wriggle and splash and it is easy to get the baby in and out of the bath quickly if they get a mouthful of water.
posted by Barbara Spitzer at 8:10 PM on May 10, 2018


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