I Tried Dr. Karp’s 5 'S's for Baby Sleep… and They Worked

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1 When to Start Sleep Training

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According to Dr. Karp, parents can start introducing sleep cues on baby’s first night. “Everyone tells you you can sleep train at 3 or 4 months of age — they can’t learn how to sleep before that,” he says. “But how come they can learn bad sleep clues? Why can’t they learn the good sleep clues? It’s so transparently wrong, yet everyone keeps doing the same thing over and over again!”

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Swaddling Is Key

Though some doctors are now recommending against it, Dr. Karp says swaddling is key to helping babies fall asleep.

“Swaddling is one of the few things we’ve found to help babies sleep better, especially when they’re sleeping on their backs. Babies don’t like sleeping on their backs because they feel like they’re falling, they feel like they’re insecure. So swaddling, plus white noise, helps them feel more secure, not startle themselves awake, and helps them sleep better. The idea that swaddling increases sleep risk is not true. Studies show that even if the baby gets unwrapped, and the blanket gets in their face, if it’s a light, thin swaddling blanket, that’s not a risk for the baby. It’s only a risk if it is a comforter, duvet, or something thicker or heavier. Same thing for the hips. You can swaddle perfectly well and protect the hips. In fact, swaddling is recommended by the International Hip Dysplasia Institute. But you have to do it so the legs can bend a little bit – which is how we do it in our culture.”

Training When There’s an Older Sibling at Home

Many parents become lax when sleep training their second, third, and fourth tots because they’re afraid of waking their older siblings. According to Dr. Karp, there’s no need to worry. If you’re using the swaddling and white noise methods from birth, the baby shouldn’t be making much noise.

He adds, “if you have a 5-month-old that isn’t sleeping, start using the white noise. Give it four to five nights and see if that works. Probably 70 percent of the time you can finesse your way out of a sleep problem just by adding white noise. But if you’re determined you’re going to let your baby cry it out, with your older child, put white noise in his room.”

What to Do if the “Pick Up / Put Down Sleep Training Doesn’t Work

If the pick up put down sleep training method doesn’t work, then there’s no need to worry. There are a number of other sleep training tricks that you can try. The pick up put down method will be most effective for toddlers aged 9 months up to 18 months, but it can also be successful as they continue to age.

If you are not finding this sleep training technique effective, then consider using the “longer-and-longer” method for toddlers described below.

Create a bedtime routine

                                                  Adam Berry/Getty Images

Life feels anything but routine to us at the moment, and yet, for your child, routines offer safe little islands of predictability amid the chaos. A regular pre-bedtime routine gives your child that comforting sense of knowing exactly what to expect. 

About 30 to 60 minutes before you start winding down, stop the roughhousing, turn off screens, dim the lights, and switch on some white noise. (White noise is the sound equivalent of a cozy teddy bear). Add something that’s relaxing. Give your little one a warm bath, a massage, or read together while snuggled in bed. (Maybe dab a little calming lavender oil on the sides of your tot’s mattress, too).

These familiar, predictable, and reassuring sleep cues will help her relax into what’s coming next — nodding off. 

Should I be concerned if my toddler snores and snorts?

If he snores and wakes up with a snort on a regular basis, I’d ask your child’s doctor about it. It’s important to check it out because sleep apnea can put a strain on the heart and predispose someone to high blood pressure and other health problems in later life.

Sucking

This S was my son’s least soothing of the 5 S’s. Let me rephrase: Non-nutritive sucking was my son’s least soothing S. In the beginning, he would take a pacifier, but since then he was not really keen on one—although he did discover how soothing his fingers can be. Now, on the other hand, nutritive sucking was a strong S for him. If your baby does take a pacifier, once he has been firmly swaddled and some loud shushing and swinging have been added, top him off with his favorite soothie. It’s the cherry on top.

The product that worked best for us: Phillips Avent Soothie (or any brand your baby prefers).Originally, we had pacifiers for different places in the house. One in our room. One in his nursery. One in the living room. Two in the kitchen. One in the diaper bag. One in the diaper caddy. We would joke about the pacifiers being in the wrong place. “What’s the 2nd floor binky doing in the diaper bag? This is a nightmare,” we would shout in a mock angry voice. Too bad my son lost interest in the pacifier really quickly. We still have them in their respective places just in case.

How can we keep our toddler from popping out of bed?

One father told me he had to sing “Twinkle, Twinkle, Little Star” a hundred times a night to get his daughter to go to sleep. I taught him a technique I call “Twinkle Interruptus,” which is a variation on patience stretching. If all else fails, after a few choruses, say “Oh! Just a minute, I forgot to do something, but I’ll be right back!” Then return in about 30 seconds, and soon after another round, repeat this, but stretch out the time you’re gone. 

Hopefully you’ve already had a chance to practice patience stretching during the day, so your child will be confident you’ll be right back. Then interrupt yourself again with an important errand, and return in about five minutes. By then, if all goes well, your child may have fallen asleep. And after a few nights of this, asking for things won’t seem like as much fun.

Another technique – after you’ve tried other comforting things like loveys and white noise – is to give your child two poker chips and say, if you call me, that’s fine and you can give me one poker chip. But if you have one left in the morning, you can get a sticker. And maybe your child can trade those in later for a special treat.

CRIB NOTES

SUCK: Pacifiers can help fussy babies relax into deep tranquility

During an intimate breakfast in February with a group of new and expectant mothers at The Culinistas Kitchen in New York City, the fit and bespectacled doctor’s tone shifts constantly. Like a doctor with a calm crib-side manner, the 68-year-old Karp is matter-of-fact when discussing facts about the grim state of maternal health in the United States. Occasionally he’s animated and uses a singsong voice while mimicking a typical exchange between a toddler in the trenches of the terrible twos and distressed parent. He will stop at nothing—including committing to role play of both parent and child—to accurately demonstrate his tips and techniques for calming infants, babies and toddlers. 

In addition to caregiving advice, one of Karp’s main messages is shining light on how changes in household dynamics have set up new parents for failure. “Up until 100 years ago, people had five unpaid nannies,” Dr. Karp explains. “The grandma, the neighbor, the aunt, cousins and sisters. Now parents don’t have that and moms think they’re supposed to do this all on their own, which is not at all what a normal mom has done throughout history. So, parents need to recognize they deserve help.”

During his first 25 years in practice Dr. Karp has witnessed how sleep deprivation and stress among new families could lead to postpartum depression (PPD), child abuse and sudden unexpected infant death syndrome (SUID). According to the CDC, more than 3,600 infants die in their sleep each year, with about 900 of those cases due to accidental suffocation. 

This meant designing a bed that would keep babies safely on the back all night to prevent suffocation. In addition to rocking and white noise, the sleeper connects to an app that allows parents to log sleep habits, monitor cries and adjust sounds and motions.

SLEEP TIGHT: The Snoo keeps babies snug and safe.

Snoo

“My goal is to reduce sudden infant death syndrome by 90%,” says Dr. Karp. The Snoo is currently designated by the FDA as a “breakthrough device” and is being evaluated as a potentially life-saving medical device. If it gets approval, the bassinet would be partially covered by health insurance.

Dr. Colleen Kraft of the AAP and a mother to three grown children, agrees that the Snoo was groundbreaking. “We can now use tech to help to address some of the most unsolvable things we faced as parents and pediatricians: how to make a baby sleep and improve sleep,” she says.    

“By improving their sleep we’ve seen women go from suicidal to the road to recovery within 2-3 days once they get better sleep,” says Dr. Karp. According toCDC research, about 1 in 9 women experience symptoms of postpartum depression in the U.S. With approximately 4 million live births occurring each year in the country, it is estimated that 600,000-750,000 are diagnosed with postpartum depression.

“I was getting frustrated with that,” Dr. Karp says. “If I can deliver these techniques all night long, babies can sleep an extra hour or two and reduce stress for parents … think of this as your big sister moving in.”

Aware of the Snoo’s steep price tag, Karp launched a rental program in 2018 as well as new partnerships with government organizations, corporations and insurance companies to subsidize the costs of a Snoo for new parents.

To date, some 50 corporations have signed on, including Facebook, Google, Activision-Blizzard, Snapchat, Hulu, WW International and Under Armour. Companies are then required to survey employees for feedback. “Our little girl absolutely loves it,” Rebecca Resnick, a creative strategist at Facebook reported. “At 6 weeks old she already sleeps five- to six-hour stretches through the night. I could actually cry thinking about how amazing the Snoo is.” 

Consumers can now rent a Snoo bassinet for less than $4 a day—lower if rented through a partner company. At breakfast, Karp removes his doctor’s coat and puts on his marketing cap to explain the company’s ROI. He explains that with 33% of women not returning to the workforce the year after their baby is born, companies will save money on recruiting and retraining. 

“The rented cost equates to a cup of a Starbucks cappuccino, which poor tired parents are already spending on.”  

Shushing

There is often a misconception that you have to be super quiet around a sleeping baby. This isn’t true, especially in the newborn stage. Babies come from a world where there is a constant sound of blood flowing and a heart beating. Therefore, loud sounds are very much soothing to a baby, hence this sneaky entry into the 5 ‘S’s. The best sounds are blow-dryers, washing machines, a strong white noise, ocean waves, and sounds that mimic the womb. All of these have worked with our son.

The product that worked best for us: Hatch Baby Rest Sound Machine.This might be my absolute favorite product of everything I have. The Hatch connects to our phone in which you can set different programs. Mine is so aptly named “Sleep Dammit.” I have it set to peaceful trickling water under a soft pink light as we get ready for bed. Around the time I lay him in his bassinet, it switches to very strong wind sounds under a dim orange glow, which lulls him to sleep on its own with little to no intervention from me. After he’s been asleep for a bit, the machine plays a softer white noise under a glowing red light, which keeps him sleeping throughout the night. Finally, the rain setting under a calming blue light triggers that it is time to rise. In addition, I have nap settings set to various sounds and light. And this is all controlled from my phone, so if he gets fussy at any time, I can jack up the volume or turn it on. It has worked wonders!

Related: Hatch Rest Plus Review (and, how does it compare to the Rest?)

10 When All Else Fails

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According to Dr. Karp, five to 10 percent of babies don’t respond to white noise and swaddling; they still wake every two to three hours. In those cases, he says, “they need to sleep in a fully reclined swing moving at the fast speed.”

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