Around this period, several changes in infants’ behavioral development can be observed : a more diurnal sleep/wake cycle appears with longer periods of consolidated sleep during the night, infants show enhanced habituation and classical and operant conditioning, and begin to show more responsive socially-oriented behavior, such as eye-contact, smiling, and cooing.
This fits with evidence that infants experience the first biobehavioral shift around 3 months, during which the behavior and physiology of infants shifts from intra-uterine to more extra-uterine regulation. By then infants would be able to regulate themselves better and are more ready for the requirements of the extra-uterine environment. In the first three months after birth, infants would still be very sensitive to these intra-uterine stimulations, after which the CR would gradually diminish. According to Karp, infants would actually need a fourth trimester in the womb to mature, which is biologically impossible. Infant’s age might influence the strength of the CR.
If mechanical soothing using swaddling, sound, and movement is as effective as parental soothing using the same stimuli, mechanical soothing may be used during periods in which the exhausted parent needs rest, such as during the night. Recently, a smart crib has been developed that makes use of three of HB’s 5S’s (swaddling, shushing via white noise, and swinging) to calm infants. A solution to break this vicious circle or to prevent parental exhaustion may lie in mechanical soothing. Parent and infant may then end up in a vicious circle, in which the baby and the parent bring each other out of balance time after time. As a consequence, it is more difficult for exhausted parents to exhibit adequate parenting behaviors and to calm the infant, causing the baby to cry even more. On the contrary, parents who have enduring difficulties with soothing their infant do not get enough rest. Well-rested parents are better able to take care of their infants and to help them regulate themselves, resulting in more successful soothing and positive parent-child interactions. Following Kurth’s system model on infant crying and maternal fatigue, infants who are easily soothed allow their parents to recover. HB, however, requires the availability of the parent to soothe the infant, but parents also need rest, for example during the night. HB also appears to significantly decrease infants’ excessive crying in infants under 4 months of age. Infants who were simultaneously soothed with the 5S’s by a researcher after immunization showed decreased duration of crying and lower mean pain scores compared to infants who were given either water or sucrose pre-vaccination and were soothed as usual post-vaccination. Each of these 5S’s has a calming effect on infants. In HB infants’ CR is triggered via a bundle of 5 stimuli or steps (5S’s) the moment the baby is crying: (1) swaddling (2) side/stomach position in the arms of the parent (3) shushing (4) swinging and (5) sucking. According to Karp recreating the sensory milieu of the womb (e.g., snug position, floating in fetus position, deep resonant sound of the placental blood flow, jiggling motion, swallowing of amniotic fluid) would calm infants by triggering infants’ so called calming response (CR). Such a possible solution is the Happiest Baby method (HB).
New solutions that reduce infant crying are therefore warranted. Effects of behavioral methods to reduce infant cry and fuss problems in infants younger than six months have rarely been reported and do not take into account the immaturity of newborn babies. Only in 5% of excessively crying infants, however, a medical cause for the crying can be found. For some families, the excessive crying is so unbearable that infants are hospitalized to alleviate parental stress and family disturbance. Ĭrying problems are burdening to infants and parents and are associated among others with impaired infant sleep, parental exhaustion and depression, and shaken baby syndrome. Crying is therefore considered excessive when parents experience it as such. In clinical practice, this definition is not very useful as parents may also perceive less frequent crying as a problem. Wessel’s definition of infant excessive crying is often used: crying for at least three hours per day for at least three days per week, and at least for three weeks in a row. However, up to 20% of infants cry excessively. Crying is part of normal infant behavior and plays an important role in the mutual regulation between infant and parent.
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