The key ideas

The Happiest Baby on the Block

Harvey Karp, 2002

Why does a healthy, well-fed newborn scream for hours with nothing helping? Paediatrician Harvey Karp explains: the baby was born three months before they were ready, and misses the womb. You will learn how to switch on their inborn calming reflex with five simple techniques, and where the safety limits lie.

Who it is for

For anyone expecting a baby or spending the first three months with one. And for anyone who paces the room at night with a crying baby and cannot work out what they are doing wrong.

In the first three months of life, you cannot spoil a baby by letting them suck for hours or stay in your arms.

Three in the morning and crying for no reason

Picture it: three in the morning. The baby has been fed, the nappy is dry, there is no fever, and yet they have been screaming for forty minutes, bright red, with their legs drawn up. You walk around the room with them, rock them, sing, and nothing helps. One thought keeps going round your head: either something is wrong with the baby or something is wrong with me.

Harvey Karp is a paediatrician from Los Angeles whom parents like this came to see for years. He published this book in 2002 and fully revised it in 2015. His answer is surprisingly simple: a healthy newborn who cries inconsolably is, most often, neither ill nor spoilt. They are missing the place where they lived for nine months.

Karp calls the first three months of life the fourth trimester of pregnancy, the one the baby was denied. From this comes his main tool. A baby has an inborn calming reflex, and it can be switched on by recreating the sensations of the womb precisely. For this Karp brought together five techniques and called them the “5 S's”, after the first letters of their English names.

You will learn where crying with no visible cause comes from, why the usual explanations of colic do not fit the facts, and how to calm a screaming baby step by step. And, separately, where the safety limits lie: two of the techniques are only for when the baby is in an adult's arms, never for sleep.

Born three months before they are ready

Why is a human baby so helpless? Karp explains it through evolution. A head with a large brain has to pass through the mother's birth canal, and if the baby stayed inside any longer, it simply would not fit through. So, as Karp sees it, we are born about three months before we are ready.

Those first three months are what he calls the fourth trimester. It is not a medical term but the author's image, and a very apt one. In these weeks the baby hardly interacts with the world, as if still ripening. Only closer to three months do they visibly come alive and really start to respond.

Now remember how it was before birth. In the womb it is snug and warm; the baby is always curled up and as if held in a hug. It is constantly noisy there: blood rushes through the mother's vessels. And there is constant rocking, because the mother walks, sits down and stands up.

After birth there is silence, open space and a cot that does not move. To adults this seems like peace. For a newborn, in Karp's view, it is more like losing everything familiar. Silence and stillness do not calm them; they unsettle them.

From this comes the first practical conclusion. In the first months a baby needs not fewer sensations but more, of the right kind. Not bright lights and a crowd of visitors, but rhythm, snugness and a steady noise, as there was inside.

Read in Livria

About the author

Harvey Karp is an American paediatrician from Los Angeles who taught paediatrics at the University of California for many years. His “5 S's” method for calming babies is known to parents all over the world.

All books by this author: Harvey Karp

Terms from the book

  • White noise
  • Fourth trimester: Karp's image, not a medical term: the first three months of life, when, as the author sees it, a newborn still needs the sensations of the womb.
  • Calming reflex: Karp's concept: an inborn response in a baby that calms them when the sounds, movements and snugness of the womb are recreated.
  • Colic: Long, unexplained crying in a healthy baby during the first months of life. It usually eases by three to four months.
  • Wessel: Morris Wessel, an American paediatrician. In 1954, together with colleagues, he proposed a definition of colic known as the rule of threes.
  • Rule of threes: Wessel's definition of colic: a healthy baby cries for more than three hours a day, on more than three days a week, for longer than three weeks.
  • Kalahari: A large semi-desert in southern Africa, spanning Botswana, Namibia and South Africa.
  • Kung San: A people of hunter-gatherers from the Kalahari Desert. Anthropologists have studied how they care for their babies.
  • Barr: Ronald Barr, a paediatrician and researcher of infant crying who worked in Montreal for many years. With Urs Hunziker he studied how carrying babies affects their crying.
  • Hunziker: Urs Hunziker, a Swiss paediatrician. In 1986, together with Ronald Barr, he published a study on carrying babies in arms.
  • Swaddling: Wrapping a baby snugly in a blanket with the arms held against the body. It is stopped once the baby starts to roll over.
  • Moro: The Moro reflex is an inborn startle response in newborns: at a sudden sound or a feeling of falling, the baby flings up their arms. It is named after the Austrian paediatrician Ernst Moro.
  • Sudden infant death syndrome: The sudden, unexplained death of a healthy baby, most often during sleep. Sleeping on the back lowers this risk.
  • Dummy: A teat with no hole that a baby sucks to calm down.
  • Cuddle Cure: Karp's name for combining all five techniques: swaddling, the side position, shushing, swinging and sucking.
  • Wake and sleep: Karp's technique: a baby who has fallen asleep is laid in the cot and gently woken, so that they open their eyes for a few seconds and then fall asleep again on their own.

All terms

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