Soothing Methods for the Newborn



= Introduction =

Becoming A Parent


Becoming a parent can be exciting and scary at the same time. There is a mix of emotions that occupy your thoughts throughout pregnancy and the transition to parenthood. Many new parents go through the stages below while adjusting to the role of parent:


 * Anticipating what it is like to be a mother or father by looking to role models
 * Influenced by expectations of how to act and feel as a parent
 * Begin to develop own parenting style and rhythm
 * True identification with self in the role of mother or father

Common Challenges and Lifestyle Shifts New Parents Experience
List of links to popular parenting books:

Top list of parenting books purchased by parents from Amazon.com

A list of book by Karen Kennedy, mother of two

= Newborn Transition from Intrauterine Life to the Outer World =

Coming into the world is a dramatic shift for the newborn who must leave its dark, warm and wet environment where it is constantly nourished through the umbilical cord from the mother's placenta.

The outer world is one that is loud, bright and cold.

The newborn must quickly adapt to its own physiological processes in order to survive:


 * thermal regulation
 * cardiovascular, pulmonary, vestibular, metabolic and immune functions
 * dependent on others for nutrition, warmth, shelter, and safety

There are many things new parents can do to simulate the womb environment to promote a secure, calm and soothable infant.

= Why Do Infants Fuss? =

All babies cry for a number of reasons. Infants are entirely dependent on others for their needs to be met. Often, crying is due to hunger, tiredness, pain, or uncomfortable temperatures. At such a young developmental stage in life, an infant's only means of communication is through crying. Although parents may think they are addressing the cause of their baby's cry, it is not always so clear! After about four months, infant crying patterns typically decrease due to developmental changes. However, all babies are different and behavior patterns may not fall precisely into these ranges.



= Do you have a colicky baby? =

What is colic?


 * Colic is inconsolable, unexplained, and incessant crying in a healthy infant. It is defined as when your baby's crying occurs at least 3 hours a day, for at least 3 days in any one week, for at least 3 weeks in the first 4 months of life. Onset of colick is sudden, and can disappear as quickly as it began. The prevalence of colic has been reported in up to 40% of infants. A colicky baby can result in a frustrated, tired, and concerned parent.

What causes colic?


 * There is no known cause of colic, and many debate whether colic is an actual "health condition." Some suggest colic[[Image:Colic-baby1.jpg|border|right|200x320px]] occurs due to gastrointestinal (GI) problems, food allergies, environmental problems, hunger, or behavioral factors.

Symptoms of colic:                                                                                                                                      


 * excessive crying (3 or more hours at a time)
 * flushed face
 * arched back
 * high pitched screaming
 * clenched fists
 * irritability and fussing
 * drawn up legs
 * difficulty settling

Recommendations from clinical evidence to reduce infant colic: 


 * Eliminate cow's milk from diet,
 * Reduce other allergens in diet: eggs, wheat, and nuts
 * Reduce infant stimulation
 * Increase parent training to improve the response to infant crying!
 * Visit your pediatrician!

= Research About infant Crying =

What Are the Physiological Responses to Crying?
Infant crying produces a physiological stress response resulting in:




 * an increase or decrease in the hormone cortisol (the flight or fight modulator)
 * elevated body temperature, pulse and heart rate

Prolonged, unattended crying may permanently affect the stress hormones produced in the infant’s developing brain and alter emotional responses.

These physiological changes can have lifelong consequences affecting:


 * memory
 * attention
 * emotion
 * attachment
 * anxiety
 * aggression and depressive disorders

Some argue that by teaching baby self-soothing techniques by “crying it out” or using “controlled crying” methods, the infant will not fuss as much or as long.

Research shows that infants whose needs are not attended to promptly develop the “defeat response”, a term coined by neurobiologist Bruce Perry, where they have learned helplessness and lose trust in their caregivers, so they do not develop secure attachment.

What are the Long-Term Effects of Excess Infant Crying?


One researcher suggests that there is a "critical period" of emotional behavior learning that occurs in the first six months of life that may permanently alter the stress related neurotransmitter systems in the cortical regions of the brain.

Repeat stressful events, such as prolonged infant crying due to unmet physiological and psychosocial needs has an overall effect of increasing cortisol production in the hypothalamus of the brain. Future stressful triggers elicit the same behavioral pathways in the brain, developing a lifelong pattern of emotional behavioral responses to stimuli.

= Cross Cultural Differences in Responding to Infant Crying =

Why do North American Infants Cry More Than the Gusii of Africa?
In comparing childcare practices between North Americans and the Kenyan Gusii, striking differences exist in enculturating specific types of behavior responses to the environment.

Cross Cultural Comparison of Child Rearing Goals



Italian Cultural Beliefs About Infant Crying
One study (Weisner, 2002) examines the relationship between the effectiveness of Italian mother soothing and infant regulation of distress throughout the first year of life. Here is what the evidence concluded:


 * Infants who were quickly soothed at twelve months of age showed secure attachment as a result of sensitive mothering in early infancy.        [[Image:Mother baby75675.jpg|border|right|200x290px]]
 * Effective mothering included:

- close parental proximity

-strong family support for caretakers

-daily routines that were structured around the needs of the infant.


 * Italian mothers value a lively, or “vivace” infant, so crying was well tolerated and not perceived as stressful, but instead as a sign of a lusty, healthy infant.

Differences in Tolerance for Infant Crying Among the Dutch and Immigrant Groups
A cross-cultural analysis conducted in Amsterdam, compares quantity of crying and soothing methods of two-three month old infants among Dutch, Surinamese, Turkish, and Moroccan mother-infant dyads.


 * 20.3% of mothers reported that their infants cry more than 3 hours per day
 * First-time mothers who were irritated by the crying responded negatively towards the infant

'''                                                                                                  The study found that soothing methods included those that were harmful and those that were not harmful. '''



Perhaps harsher methods were utilized because the crying was not seen as a normal way for infants to communicate and the desire was to simply stop the crying as quickly as possible, rather than in a calm, gentle and soothing manner. The key message is that anticipating baby's needs and preventing distress results in quicker and more effective soothing and quieting of baby.

WARNING!!!

'''Shaking and other physical methods to stop your baby from crying can cause serious, irreversible damage. If you feel angry and out of control, immediately call the TALK Line for help:'''

'''(415) 441-KIDS (5437). '''

= A Toolkit of Proven Calming Methods =

Movement
'''Movement has a calming effect because it reminds the baby of the being in the womb - in constant motion floating in a fluid filled world. Being still '''



'''is not familiar or comfortable for newborns. Research shows that babies carried at least 3 hours per day, cry up to 40% less! Nestled against a warm chest and cocooned in a set of arms or a baby carrier mimicks the snugness, rhythm and sounds of the womb. Baby is soothed, relaxed and distracted from crying. Movement is also essential for healthy neurological and brain development. Here are a few ways to incorporate motion into your daily routine with baby. Skin to skin contact incorporated into these movements enhances the calming effects even more!'''


 * Carrying baby in a sling
 * Dancing
 * Swinging
 * Driving
 * Strolling in a carriage
 * Rocking baby
 * Walking with baby

Videos:

[http://www.youtube.com/watch?v=L7Wa7_STgWQ&feature=related Watch a baby fall asleep by driving in a car! ]

Touch


'''Babies need lots of touching, especially to reduce tense muscles - yes even babies get tight muscles! Try these relaxers and see what works 'for your baby. '''


 * Massage
 * Nursing
 * Warm baths
 * Skin-to-skin

Videos:

Watch a video on massaging your infant!

Watch a video on a baby taking a bath!

Sounds
'''Sounds provide calming effects for similar reasons as movements. For 9 months, your infant heard the whooshing of blood through the placenta, in addition to your own physiological rumblings, breathing, talking, and heartbeat. Sounds calm over-stimulated minds into sleep. Plenty of household items can be used to to soothe a baby using sound!'''




 * Recordings of womb sounds, nature, calm music such as classical or lullabies
 * Household white noise from the vacuum, hair dryer, washer machine, ceiling fan
 * Tick-tock of a clock
 * Singing, humming, whistling

Videos:

How to calm a baby using "white noise" from a vacuum!

How to calm a baby using "white noise" from a hair dryer!

Visual Stimulators
''' Babies get bored, frustrated, or lonely just like adults do. A simple change in environment can uplift their mood and stimulate their developing brain:'''


 * Mirror to gaze into                                                                                                                                                           [[Image:MomBaby.jpg|border|right|150x240px]]
 * Toys with different colors and textures
 * Smiling and silly faces
 * Get outdoors into nature: birds, trees rustling in the wind, clouds, ocean waves
 * Fire in the fireplace
 * Ceiling fan spinning around or a mobile

Videos:

Watch a baby entertaining her self using a mirror as a visual stimulus!

= Resources =

Developed By: Jenna and Jennifer, University of San Francisco Clinical Nurse Leader 2010 Nursing Students, Fall 2010.