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The Calming Reflex And Colic

The Calming Reflex And Colic

A hypothesis for colic is presented by Pediatrician Dr. Harvey Karp with a term defined as “The Missing Fourth Trimester”. This refers to the timeframe of a newborn baby’s first three months, and Dr. Karp’s discovery of the neonatal response, also known as the calming reflex or “off switch” for crying in infants younger than 3 months, which is activated by his solution called “The 5 S’s” technique.

According to most doctors, there are four main theories of the cause of colic:

  1. gastrointestinal disorders
  2. difficult temperament
  3. brain immaturity
  4. maternal anxiety

However, Dr. Karp lists several rebuttals to these four theories in detail:

  • Colic starts at 2 weeks of age; gas starts shortly after birth
  • Colic ends at 3 months of age; gas lasts a lifetime. Dr. Karp argues symptoms like gas that are suggestive of intestinal pain are probably an overreaction of an immature neurological system to normal intestinal sensations (e.g., the gastrocolic reflex).
  • Colic peaks in the evening; gas occurs all day. Dr. Karp claims evening predominance of crying may be caused by a gradual accumulation of stress throughout the day in the absence of calming rhythmic stimulation which newborns are used to experiencing in the womb.
  • Colic is absent from some cultures around the world; gas is not. Dr. Karp explains that the parents in these cultures imitate the womb for the baby all day long with constant holding and rocking and frequent nursing.
  • Overfeeding is ruled out, as one of these cultures known as the !Kung San, nurse their children 50 to 100 times a day, but their babies never experience colic.
  • The swallowed air theory also doesn’t seem to apply, due to radiographs of fussy babies demonstrating they have more air in the GI tract when they finished crying than when they began to cry.
  • The theory of brain immaturity does not match either. Newborns do have immature brains that are incompletely myelinated. They display slow transmission of impulses from the retina to the occipital cortex during the first three months of life, have frequent tremors, irregular breathing, crossing of their eyes, and poor state control. However preemies have very immature state control, and they do not experience colic until after their due date.
  • The theory of difficult infant temperament was rebuked by researchers as well through numerous studies which have found the association with temperament to be small.
  • In addition, the theory that maternal anxiety is a cause of colic was rebutted by studies with mothers of colicky babies proving they are no more inherently anxious than other mothers, and colic is as common in a couple’s fifth baby as in their first baby. Dr. Karp explains this argues against anxiety playing a role in colic because parents tend to be more anxious with their first baby than subsequent ones.
  • Lastly, the cessation of colic after approximately 3 months fits perfectly with Dr. Karp’s theory of the missing fourth trimester.

Dr. Karp notes that while these four theories are aspects of colic, they don’t detail its root cause; which is what he calls the missing fourth trimester. He even states babies are born three months too soon. Whether this is the case or not, we need to consider that upon birth, babies are suddenly extracted from a rhythmic, snug and entrancing environment (the womb) to an environment of sporadic noises, new reflexes and sensations. Therefore it is understandable this may overwhelm infants who have poor state control and thus provoke persistent crying.

The exciting part is the solution Dr. Karp has found to be a calming reflex which takes place involuntarily during the last months of pregnancy. The response puts fetuses in a trance, keeping them head down and motionless. Dr. Karp’s clinical experience has found that the calming reflex can be activated after a baby is born as well, by what he calls “The 5 S’s” – maneuvers that mimic uterine sensations. These techniques include:

  1. Swaddling, which keeps the baby snug and mimicking the womb’s motionless hold during the last few months during pregnancy
  2. Side or stomach positioning which halts the Moro reflex as babies aren’t in the supine position
  3. Shushing to audibly reenact the sound of blood flow fetus’ have heard for their entire life before birth
  4. Swinging copies the movements the baby experienced inside of the mother
  5. Sucking, which relocated babies sucking their fingers in utero

I believe every pediatrician, caregiver, and parent should be informed of Dr. Karp’s theory of the missing fourth trimester. In my experience, performing the 5 S’s solution has soothed many babies I’ve cared for and proves to be an important gift every baby deserves in their first few months of their beautiful new life.

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The Secret 4th Trimester

Virtual Tackle the 4th Trimester

The baby’s fourth trimester starts from the moment they’re born and lasts until three months old. The term is used to describe a period of great change and development in newborns, as they adjust to the new world outside the womb. Dr. Harvey Karp, an assistant professor of pediatrics at UCLA School of Medicine and nationally renowned expert on children’s health and the environment, believes that newborns experience “fourth trimester” issues.

The 5 S’s

These five actions re-create the atmosphere in the womb – the “fourth trimester,” and are the secrets to calming colic, or a fussy baby. Babies can have a difficult time getting used to the huge amount of stimuli present in life outside of Mom’s body. Their reaction to all of this is to cry and cry.

What is Colic?

Moms and Dads can be left puzzled – are they hungry? Need a diaper change? Overtired? Is it gas?

Newborns inherently are soothed by recreating their environment, mimicking that of the womb. These are swaddling, shushing loudly, sideways or stomach positioning, swinging, and sucking. Newborn Care Specialists can teach this method to you so you can calm your baby down if they are overstimulated or overtired. The result can be a happy baby on a healthy sleep schedule, better nutrient absorption, and more alertness (for all of you!).

Through mastering these 5 methods and babywearing, getting through the 4th trimester can be so much easier. Babies at this age physiologically cannot self-regulate and rely on an adult to help them to feel safe and secure and even a physical boundary, like being in the womb, which is why swaddling and babywearing is so calming to their nervous system.

If you have a newborn, book a Virtual Newborn Consultation to get fast solutions which can help get you on track.

If you have an infant (older than 6 weeks), book Virtual Infant Care Coaching to learn more tips, solve your issues fast, and master the 4th trimester in a pinch!

If you’re pregnant, you’re on the right path!  Get prepped with our Virtual Tackle the 4th Trimester consultation and our Virtual Newborn Care Class.  Doing this ahead of time can ease you into what to expect for your new life.

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Overstimulating A Newborn

Overstimulating A Newborn

Overstimulating a newborn is very easy to do and it’s important to learn the cues to avoid crossing this delicate line. When your baby is overtired or overstimulated, a pacifier can’t always do the trick! A Doula or Newborn Care Specialist can teach you about the secrets of the fourth trimester and how to nurture your newborn back into feeling a familiar safe, secure environment which mimics your womb.

Signs of Sleepy Baby

They are calming down, they’re sucking slower, they’re yawning, eyes do not look around, eyelids start to droop.

Signs of an Overstimulated Baby

They’re cranky, irritable, they’re crying uncontrollably, they look away from you, they’re staring at a wall (gaze aversion), crying, arching of back and neck, tremors, coughing, flailing arms or legs, sneezing, rubbing eyes, twitching, grasping, sighing, breathing rate may be faster or slower or may have pauses that last 2 seconds or more, skin may be pale, dusky, red or/and blotchy, arms and/or legs may be extended or stretched out, fingers and/or toes splayed, hands in fists, high arm position where arms are over the head and forearms lay across the face in self-protecting or shielding manner, rigid flaccid body, squirming, jerking, mouth open limply, or tongue extending beyond lips.

Calming Your Baby

Too many visitors, whether it be relative or friends, too early just after giving birth can also overstimulate your baby. It is important to have your baby on a sleep training schedule to avoid overstimulating. Ensure there is Daddy time and sibling time, but also be instinctive of your baby’s needs. A Doula or Newborn Care Specialist can help you by telling guests when it’s an appropriate time to visit or distract siblings when Mommy needs to breastfeed or bathe the baby, as well as educate parents on soothing techniques which the baby instinctually already knows and effectively responds to.