‘Care of a baby is a skill set’

Sleep expert and pediatrician weighs in on caregiving, postpartum depression

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

Many of those moms and dads turned to the books of pediatrician Dr. Harvey Karp, a U.S. sleep expert who rose to fame by igniting a swaddling movement.

Karp was in Toronto recently to promote his new sleep device, the SNOO Smart Sleeper — a $1,500 high-tech bassinet that uses inutero sensations to promote sleep. During a break between fan meetand-greets, Karp spoke with The Canadian Press:

Q It seems like we’re in an era where many parents are at a loss when it comes to child care. What has happened?

A 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.

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

A 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.

Q Why are men getting depressed? Are they sleepdeprived? Or upset their partners are depressed?

A 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.

Q What other prevailing fads bother you?

A In the 1990s, we started backto-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.

Q What can you do, aside from buying a SNOO?

A 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 a 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 (sudden infant death syndrome).

(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.