The Happiest Baby (THB)

New parents, grandparents, teachers and healthcare professionals

THB explains that the current culture’s conceptualization of the first three months of life is flawed. In many ways, newborns are not fully ready for the world at birth, they still need a protected environment filled with rhythmic, monotonous, entrancing stimulation…a fourth trimester. It teaches five simple methods of activating the “calming reflex” by imitating the uterine sensory milieu – the “5 S’s” – Swaddle, Sidestomach position, Shush, Swing, Suck. Laboratory research has demonstrated that elements of this program, including swaddling, sound, and movement, improve the quality of sleep and promote greater arousability, which may protect against Sudden Infant Death Syndrome (SIDS). This program promotes good parent-infant bonding and aims to assist in the prevention of a number of severe and life-threatening consequences of infant crying. These consequences are marital stress, Shaken Baby Syndrome (SBS), Post-Partum Depression (PPD), Sudden Infant Death Syndrome (SIDS), excessive use of Emergency Room/physician time, overly aggressive medical evaluation and treatment for Gastroesophageal Reflux Disease (GERD), and perhaps even in the prevention of obesity.

Harvey Karp, MD

• Agency/Affiliation: The Happiest Baby, Inc.
• Website: https://www.thehappiestbaby.org/
• Email: education@thehappiestbaby.org
• Phone: (310) 476-4440

The overall goals of The Happiest Baby (THB) are:

• Promote good parent-infant bonding
• Assist in the prevention of a number of severe and lifethreatening consequences of infant crying such as marital stress, Shaken Baby Syndrome (SBS), Post- Partum Depression (PPD), and Sudden Infant Death Syndrome (SIDS)

The essential components of The Happiest Baby (THB) include:

• Ideally taught prenatally to a couple or class of up to 6 couples
• Certification of all educators in THB program
• Provide all patients/clients with THB DVD + the Soothing Sounds White Noise CD (many programs also provide a large swaddling blanket)
• Teach the concepts of the “missing 4th trimester,” the “calming” reflex and the 5 S’s
  • Parents are informed about Shaken Baby Syndrome (SBS) and are advised to walk away or get help if they feel they are losing patience or getting angry, but in general parents who get THB training develop great competence during the first week or two of a baby’s life. This allows them to be very good at calming the baby before the colicky crying period begins to trigger such frustration and anger.
• Discuss and demonstrate precisely how to do each S (the technique is critically important to avoid mistakes and frustration and to allow the intervention to be maximally effective)
• Have parent demonstrate their competence on a doll or their baby
• Have the parent use the white noise CD at home during crying bouts and all sleep periods
• Have the parents re-watch the DVD after the baby is born – during early crying episode –and in the presence of any other adults/teens who will be helping care for the baby:
  • This reemphasizes the important points of the technique at the “teachable moment.” It also helps prevent incorrect application of the principles and mitigates the State’s or the organization’s liability by making THB DVD the last information given.
• Emphasize the importance of skill building and boosting the competence of male caregivers:
  • Men are excellent baby-calmers. This program has been included in the curriculum of the National Fatherhood Initiative.
• Can be used in programs for high-risk babies/families (e.g., NICU, drug withdrawal, low SES), teen parents, fatherhood programs, military, Postpartum Depression sufferers, Shaken Baby Syndrome prevention, foster or adoptive parents, and training Pediatric Nurse Practitioners, nurses, lactation consultants, housestaff, child life workers, etc.

Parent/Caregiver Services

The Happiest Baby (THB) directly provides services to parents/caregivers and addresses the following:

• Expectant parents or parents of newborns, especially those who experience crying babies, sleepless babies, breastfeeding failure (women unable to feed because the baby is crying or who want to give up nursing because the baby has begun to fuss more), etc.

Recommended Intensity

A single 90-minute class prenatally; may offer a follow-up postnatal class (or just postnatally if the population cannot be captured prenatally), all participants receive two parenting tools (an educational DVD and a CD of white noise; add a 90-minute home visits and/or telephone follow-ups for high-risk patients

Recommended Duration

One class for most new parents; a home visit and follow-up phone calls at one week, three to four weeks, and six to eight weeks post-partum for high-risk parents

Delivery Settings

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home
• Community-based Agency / Organization / Provider
• Group or Residential Care
• Hospital
• Outpatient Clinic
• School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

This program does not include a homework component.

Resources Needed to Run Program

The typical resources for implementing the program are:

Room to hold class in

Prerequisite/Minimum Provider Qualifications

One year of patient/parent education experience or a medical professional degree

Manual Information

There is not a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

At home: DVD and reading-based with a certification test requiring passage at the 90%.level

Number of days/hours:

Five days for 40 hours total

“What is included in the Relevant Published, Peer-Reviewed Research section?”

• There are currently no published, peer-reviewed research studies on outcomes with the appropriate target population for the topic area(s) in which The Happiest Baby has been reviewed.

• Franco, P., Seret, N., Van Hees, J., Scaillet, S., Groswasser, J., & Kahn, A. (2005). Influence of swaddling on sleep and arousal characteristics of healthy infants. Pediatrics, 115(5), 1307-1311.

• Gerard, C. M., Harris, K. A., & Thach, B. T. (2002). Spontaneous arousals in supine infants while swaddled and unswaddled during rapid eye movement and quiet sleep. Pediatrics, 110, e70.

• Karp, H. (2004). The "fourth trimester": A framework and strategy for understanding and resolving colic. Contemporary Pediatrics, 21, 94-114.