Sleep expert Dr. Harvey Karp on postpartum, modern caregiving

Karp was in Toronto recently to promote his new sleep device, the SNOO Smart Sleeper — a $1,500 high-tech basinet that uses in-utero sensations to promote sleep. (Photo by CC BY-SA 3.0)

TORONTO — Any parent will recall the sleep-addled days of having a newborn, and the fears, depression and anxiety that often comes with suddenly being responsible for a vulnerable life.

Many of those moms and dads turned to the books of renowned pediatrician Dr. Harvey Karp, a U.S. sleep expert who rose to fame by igniting a swaddling movement and championing a five-step method of calming even the most collicky baby.

Karp was in Toronto recently to promote his new sleep device, the SNOO Smart Sleeper — a $1,500 high-tech basinet that uses in-utero sensations to promote sleep. It rocks and jiggles, plays white noise and keeps babies snugly secured on their back.

It also incorporates many of Karp’s “5 S” techniques to: swaddle, shush and swing. (The others are to calm your baby while on its side or stomach, and to let them suck on a pacifier.)

Karp insists the steep cost is worth it, saying the U.S. price of $1,160 breaks down to $6 per day over six months. (It’s a little over $8 a day in Canada.)

“You’re spending that on Red Bull or coffee just to stay awake with your baby,” Karp says. “And once you have a child who is on a good path of sleep, they tend to sleep better for the rest of the first year and that becomes their pattern of sleep.”

Still, the ultimate goal is to get insurance companies to cover some of the cost, and to make the beds available for rent, he says. The author of “The Happiest Baby on the Block,” hopes to return to Canada in February to pitch a study at Mount Sinai Hospital on the efficacy of the SNOO.

“Once we get the medical studies, we’ll get the government and the insurance companies to help subsidize it,” says Karp, also author of “The Happiest Toddler on the Block” and “The Happiest Baby Guide to Great Sleep.”

During a break between fan meet-and-greets, Karp spoke with The Canadian Press about a cultural shift in caregiving and how men suffer from post-partum depression, too.

CP: A lot of what you say makes sense, and it probably was common sense at one point. But it seems like we’re now in an era where many parents are at a loss when it comes to childcare. What has happened?

Karp: It used to be that you took care of 20 kids before you had your own kids — you had five, six, seven siblings, you had cousins, you had your next door neighbours. … You felt like you intuitively knew what to do because you’d done it so many times. It is not at all intuitive taking care of a baby. It is intuitive wanting to take care of a baby, but taking care of a baby is a skill set. And so, if you haven’t learned it growing up, then all sorts of mischief happens. You read it in books or on the internet and you get so many conflicting messages and you’re approaching it intellectually, when taking care of a baby is really an experiential type of learning.

CP: I hear more and more about cases of postpartum depression. Is that because of social media or is it on the rise?

Karp: I don’t think we know that, but what we do know is it’s not on the decline. … Many studies (find) postpartum depression was highly correlated to feeling exhausted. Not a great surprise, but it turned out it’s more correlated than anything else to exhaustion. And for me, that’s great news because it means if we can reduce exhaustion, we can reduce postpartum depression and anxiety.

Another thing … is that it’s usually not a “boo-hoo” depression. It’s usually an anxiety-filled depression, perseverative or obsessive depression. So a lot of times, it’s not really that you’re crying — it’s that you can’t turn off your mind, you can’t stop your anxiety. You feel overwhelmed, you just want to run away.

(Now) we’re screening women for postpartum depression and that’s a good thing. But it’s a failure because it means we’ve waited for them to get depressed. One in seven moms will develop postpartum depression. Sometimes it’s right after delivery, sometimes it’s months later. And many men — about a quarter of their partners — will develop postpartum depression as well.

CP: Why are men getting depressed? Are they sleep-deprived? Or upset their partners are depressed?

Karp: It’s probably a mix of all of those. They are sleep-deprived, they have inordinate stresses on them — financial, emotional, etc. — they’re living in a question because they had no baby experience before so they have anxiety around that. And so, to be honest with you, pretty much anybody who is sleep-deprived will tend to be feeling lonely and depressed, it’s just kind of the biochemical change in the brain.

CP: What other prevailing fads bother you?

Karp: In the 1990s, we started back-to-sleep (encouraging sleeping on the back) and that was a huge success … we decreased infant sleep deaths (in the U.S.) from 5,500 a year to about 3,500 a year. In five years, (there was) almost 50 per cent reduction in infant sleep deaths. Do you know how much we’ve decreased it over the last 20 years? Zero. Zero per cent. We have as many babies dying a sleep death today as we did 20 years ago.

The reason is because of a terrible, unexpected consequence of back-to-sleep, which is bed-sharing. Since we started back-to-sleep we’ve doubled, tripled, quadrupled the risk that a mother is going to bed-share. And now, 70 per cent of infant sleep deaths are related to either bringing the baby in bed or sleeping with the baby on another unsafe location like a sofa or things like that.

CP: What can you do, aside from buying a SNOO?

Karp: Sound and motion and snugness are what babies love because that’s what they had 24-7 inside (the womb). Here’s where the problem comes: the (American) Academy of Pediatrics … will now say “You have to stop swaddling at two months.” Well, that is ridiculous. Why? They say it for good reason. They say it because studies show if you roll over swaddled, you can’t get your face out of the mattress and it doubles your risk of SIDS.

(But) they didn’t do a full risk-benefit analysis. Because if you stop swaddling your baby at two months, what do you think happens? Your baby cries more, startles more, wakes up more, the mother is going to be exhausted, she’s going to be more likely to get depression, she’s going to be more likely to bring the baby in bed with her and more babies are going to die.

CP: But if people don’t know how to swaddle properly, shouldn’t it be avoided?

Karp: Fifty per cent of families improperly install infant car restraints and yet they’re still very effective and they’ve greatly reduced injury and death. Now, 50 per cent of people still do it incorrectly, should we stop using car seats because people will do it incorrectly and that may endanger a child here and there? Or should we start a national campaign to educate people how to use car seats correctly?