Episode 35: The Happiest Baby Snoo Smart Sleeper with Dr. Harvey Karp

Nati Rodriguez [2:01] 

Good to be with you. And full disclosure, I have a six-month-old, so I’m very excited about this conversation and hopefully, I get to implement some of these tips you’ll have for us.  

Dr. Harvey Karp [2:12]  

How are you sleeping? 

Nati Rodriguez [2:14] 

It’s off and on. Last night was not a great one.  I’d love to hear from you about the “baby whisperer”. Can you tell us how you got that name? 

Dr. Harvey Karp [2:30] 

Well, I learned a long time ago that some cultures around the world were excellent at calming fussy babies. And I started to look around at what research had been done. And it turned out people who are around babies know that there’s a series of little techniques that work to soothe babies, even colicky babies- fussy, fussy babies; things like swaddling them, or wrapping them up, snugly, or cuddling them tightly against your chest; touching of the chest and stomach or a little pressure on the head. All these little tricks turn out to imitate the womb. 

And so, in that book you mentioned, The Happiest Baby on the Block, I talk about this concept of the fourth trimester, meaning that babies aren’t ready for the world after nine months. God knows mothers are ready after seven months of pregnancy. But the babies are not fully baked until they get to be four or five months of age. I’m sure your baby, now at six months, is developing a personality.  

Nati Rodriguez [3:45] 

I wish I had read your book sooner and had that in my mind about the fourth trimester with my son. Can you tell us a little bit about your history as a pediatrician?  What made you want to study this field and become an expert in this field?  

Dr. Harvey Karp [4:07] 

My father was a civil engineer. He worked out of the house, worked for himself, made his hours, and worked long hours. But he also took time off when he wanted to. And I thought that would be fantastic, I would love to do what he did; except I wasn’t very interested in engineering, but I loved biology. And so, I thought, perfect, I’ll be a doctor, then I can do science when I want to and have my schedule. I had no idea. There were no doctors in the family, I’m the first one. And it turns out that it’s not what it’s like being a doctor. You are utterly committed to being there where families are depending on you, or individuals are depending on you. And so, it turns out to be a wonderful profession for me. 

But it wasn’t at all what I expected. And then I loved all forms of medicine. I was interested in lots and lots of things. But I loved the fact that children get better; it was tough working with the elderly and seeing that eventual decline that is inevitable and so, for my personality, it just fit for me working with parents and children. 

Nati Rodriguez [5:23] 

And when did you make the transition to The Happiest Baby? I know you launched that with your wife.  What problem were you trying to solve in creating this organization? And this work? 

Dr. Harvey Karp [5:35] 

I wrote this book 22 years ago and described something that had never been described before, which is this idea that babies have an off switch for crying, a calming reflex that was never really observed before,  never recognized before.  But it turns out that even adults fall asleep in trains, planes, and cars. We like to rock in hammocks; we like the sound of the wind and the ocean. 

In almost every culture around the world, when they want to indicate that someone should be quiet, they go “shh”. Why is that universal? Why is that so profoundly calming? It turns out that this was the aha moment that there is a part of our biology that had never been recognized before, which is a deeply primitive part of the brain. It’s present while fetuses are developing inside that puts babies into a trance, with the rhythms of the womb. It turns out inside the womb before they’re born, it’s a symphony of sensations. The sound is louder than a vacuum cleaner. They’re constantly rocked, they’re constantly held. There’s lots of jiggly motion when you’re up and walking and doing your work. In fact, most mothers will tell you that it’s when they go to bed at night that the fetus gets most active. That’s because you’re no longer giving those rhythms that turned on this comic reflex. And the reflex is there because we need babies to be chill, and to Zen out when they’re inside because they have to keep their head down to be by the cervix so that they go through headfirst. Because if babies are swimming around too much, they’ll get stuck in a head-up position or breech position. Our babies are dependent on this calming reflex to be kept in the right position. And then over the next four, five, six months, finally it disappears. But it becomes still a very ancient echo or part of our biology, ultimately, as we all get older. 

The idea of the book is to teach parents these skills so that they can be great at doing it during the first six months of the baby’s life, so that they can feel competent. Just like you want to be competent in feeding a baby, you want to be good at calming the crying and getting sleep. 

Nati Rodriguez [8:31] 

Great. Thank you. I would love to hear more about the five S’s method. Can you share about that? 

Dr. Harvey Karp [8:44] 

The five S’s are five ways to imitate the womb experience and to activate this comic reflex. The first is swaddling, which is snug wrapping with the arms down, hips loose, but the arms down. 

The second is the side or stomach position. The back is the worst position for calming a crying baby; it’s the safest position for sleep, but it’s the worst position for calming crying. The third S is shushing, or white noise. The fourth is swinging or rhythmic motion.  And the fifth is sucking, which is kind of like the icing on the cake, it makes everything else kind of just go together. And when you do those things in combination –, some babies only need swaddling, but some babies fight swaddling or they need sound; or some baby sound doesn’t do much, but they need motion – and some babies need a combination of several of those. And once you learn what your baby needs, that’s what they will always respond to. 

So, what happens is that the fussy periods of babies start around two or three weeks of age – it’s what we call colic. They are the fussiest around six or eight weeks of age and then usually by three or four months, it’s pretty much resolved. Sleep, on the other hand, can be a problem for years and so, how do we use these interesting ideas to help babies sleep?  We tell parents that they have to just suck it up and deal with it because they’re little babies but that can cause real problems like postpartum depression, anxiety, marital issues, breastfeeding failure, stress injuries, getting sick, and car accidents. So, it can be a tough time.  We can be much more successful with babies than we ever thought possible. And here’s the kind of tricky thing about it; when parents go to their pediatrician and they say, listen, I know you said there’s nothing I can do but I need help because this baby’s not sleeping and I’m falling apart. We doctors whisper to parents the secret way to immediately add an hour to a baby’s sleep and to get them to cry less – drive them all night in the car. If you rock them in a rocking chair all night that works. And so, when I thought through all that, I realized that there is something that we’re not telling parents. There’s a tool that we can use to help make their lives so much easier and help the baby’s lives as well and that’s to introduce some way of rocking, shushing, and swaddling babies all night long to give them that womb experience that they had for nine months before they were born, to help them learn to be good sleepers and help their parents get an extra hour or two of sleep. 

Nati Rodriguez [11:41] 

That’s great. And this is where we talk about the Snoo. 

Dr. Harvey Karp [11:45] 

That led us to the Snoo. I was teaching sleep for many, many years and lecturing, and I started to get frustrated because I didn’t see any reduction in postpartum depression or any reduction in the number of babies who were dying; because their parents brought them into bed, put them in an unsafe location, or put them on their stomachs, all things that we know were unsafe for babies. And I was giving a lecture saying 3,500 babies die every year in the United States of SIDS – Sudden Infant Death Syndrome –– why aren’t we doing more? Because if a foreign country were killing 3,500 of our babies, every year, we would go to war. Why aren’t we doing more? And that got me thinking that I could do more. I had an idea to make this type of bed, and my wife joined me in this project. We started this company to make a bed that imitates the womb, rocks, and shush’s babies – responds to them with more rocking and shushing so it imitates having an experienced baby nurse in the house, or some aspects of having a baby nurse. And then it also secures babies so they cannot roll to an unsafe position. So, it’s kind of like a car seat almost for keeping babies safe.  

Nati Rodriguez [13:05] 

That’s a great way to describe it, the car seat and keeping them safe.  

Dr. Harvey Karp [13:14] 

Here’s the interesting thing. Of course, everybody puts their kids in a car seat when they drive with them, it’s against the law to do otherwise. And even if you put them in a highchair, you belt them in; if you put them in a swing, you belt them in; if you put them in a stroller, you belt them in. But the number one place healthy babies die, and like I said, thousands a year, is in their bed or their parents’ bed. And every night, we put them there for 12 hours and we go well, I hope nothing bad happens. And that’s kind of crazy when you think about it.  

Nati Rodriguez [13:45] 

Yes. That’s a lot of hours in bed. Can you talk a little bit about how much sleep, safety aside, how much sleep can parents expect to have after using the Snoo? And what period of time is it ideal for a baby to be using the Snoo or sleeping in one? 

Dr. Harvey Karp [14:08] 

In the very beginning, babies do have to wake up to eat, so they are going to wake up every three hours, maybe they’ll get four hours. Snoo does add an hour to nighttime sleep from the very beginning. But it’s a half hour here, a half hour there.  You can’t expect them to sleep six hours when they’re newborns. But what we’ve seen with Snoo is that by giving them these rhythms all night long –, this richness of sensory stimulation – we’re maturing their brains, two to three months earlier than we thought was possible when it comes to their ability to regulate their sleep.  A normal three-month-old might give you a five hour stretch of sleep. In Snoo, on average, a three-month-old will give you six-and-a-half to seven hours and many will give you more than that. That’s adding an hour or two to an unbroken period of sleep, which is of course when parents get their sleep too. 

And what we’ve seen is that by six months of age, babies are ready to wean off the bed. It’s a simple process to get them to wean off and then they’re ready for their crib. Because by six months, the brain has doubled in size so, they’re much better at being able to soothe themselves and get themselves back to sleep. And then in addition to that, Snoo is the only baby bed that has the Food and Drug Administration’s De Novo Authorization, as you mentioned, for keeping babies safely on the back. Because by the time babies get to be two or three months old, they can start rolling to dangerous positions. Snoo secures them so that when you put them down on the back, you know they are going to wake up on the back.  

Nati Rodriguez [16:01] 

Got it. Can you talk a little bit more about the FDA approval? What was that process like and congratulations to you and your wife for this accomplishment, and for bringing this to parents who need sleep and babies who need to be safe. 

Dr. Harvey Karp [16:14] 

Well, the FDA was a three-year process. It’s very rigorous, we had to give them lots and lots of information proving that Snoo keeps babies on the back; they don’t wiggle out of it, and demonstrating that when parents use Snoo, they’re much less likely to bed share with the baby or use bulky bedding, which can be dangerous in a baby’s bed. And even to give them evidence showing a reduction in the number of deaths that have been recorded for babies in Snoo. We do not claim to reduce infant death yet. And the reason is that – we have a lot of evidence about that – but most of the Snoo users are more affluent families. We haven’t studied the full cross-section of American families to be able to make such a statement that it prevents the risk of infant death. But what the FDA did say is that Snoo keeps babies on the back, and keeping babies on the back is one of the best ways we know of to reduce a baby’s risk of death. 

Nati Rodriguez [17:52] 

Thank you for sharing that about the Snoo being mostly in families that are more affluent. I know that the price tag can be expensive for most families. 

You could argue that there’s evidence that sleep contributes to cognitive development and all the things that help them be successful once they start school. So how do we get the Snoo and technology like that, to families that cannot afford the Snoo Smart Sleeper? 

Dr. Harvey Karp [18:37] 

That is an excellent question and something that we were very committed to years before we even launched the bed. So, we built these beds to be used for 30–,40 million cycles, way longer than one parent would use it so that we could rent them. Have you heard of renting breast pumps?  

Nati Rodriguez [18:48] 

No, I have not.  

Dr. Harvey Karp [18:51] 

So, when breast pumps first came out, they were very expensive. It was thousands of dollars to buy one. And then they started renting them so people could have access to them. About four years ago, we started renting Snoos to parents. Anyone can rent a Snoo; it costs a little bit more than $5 a day. Not everyone can afford $5, but for those who can, it’s kind of like the cost of a cup of coffee. If you were going to hire a babysitter to hold your baby for one hour, it would probably cost you $20. And so, to get a 24-hour helper, more sleep,  safer sleep, available on the weekends and the holidays, for about $5 a day, that’s achievable for a lot of families. But we’re not stopping there. We’re now working with insurance companies to get them to start covering it as a benefit for insurance subscribers. Thousands and thousands of people get a free Snoo from their employer as an employee benefit. 

Chase Bank, Under Armour, Snapchat, Dunkin Donuts, Cheesecake Factory, the National Football League, and lots and lots of companies give this as a benefit. We’re starting to talk to cities, we’re talking to trucking companies, the National Air Traffic Controllers Union; starting to talk to law enforcement to provide it to support those families. So, for companies, they can rent this for about $4 a day – it’s very, very affordable for them. And now we’re starting to work with Medicaid programs, so that we can get it to a much broader population and starting to work with the U.S. military as well, to expand it for all Americans to have the ability to use this. 

Nati Rodriguez [20:45] 

Thank you. That’s fantastic.  For folks listening, where can they find out more about what programs are available to them, either through their work or through support services? 

Dr. Harvey Karp [21:55] 

Anyone can reach out to us if they’re interested in bringing this to their company, and we’re happy to help them be able to do that and help the employer understand how they’ll save money by helping support families that work for them. And then anyone can get information at our website, which is happiestbaby.com. 

And we have close to 2 million people coming every month to get free information about pregnancy, babies, and toddlers. The work we have is about kids in their first four, five, six years of age, all for free. 

Nati Rodriguez [21:44]  

Great, thank you for these resources. We like to ask all our guests what they’re currently reading, watching, or listening to right now. So, we’d love to hear what you’re up to. 

Dr. Harvey Karp [21:52]  

I am reading a book by Mark Hauser about strengthening children’s development, strengthening their minds. I don’t have the book right in front of me so I can’t give you, the Gosh, what is it called? I don’t have it on the tip of my tongue. But it’s Mark Hauser and it’s about how we build resilience in children. One of the things that we’re trying to do with Snoo, is not just to help babies sleep, that’s the easiest part of it. But studies showed that when you give babies, especially studies that have been done on premature babies, if you hold them and rock them for hours and hours a day for five, six hours a day, 15 years later, you can see improvements in their brain development. So what we’re starting to research and believe to be the case, is that having a baby sleep in dark silence on their back for 12 hours a night is not the most nurturing for a baby’s development; maybe having reassuring rhythms that they had in the womb, and a responsiveness that when they fuss a little bit the bed will respond to them. That builds a sense of confidence and trust. Again, we don’t know this for sure this is something that we’re studying. But it’s an interesting idea because one of the things we learn in medicine is that what we know today is going to be different than what we know tomorrow. For example, I used to recommend that babies only sleep on the stomach, because we thought if they vomit that way the vomit comes out of their mouth. And if they were on the back, they would choke, and maybe it would be unsafe for them. But then we learned that we were exactly wrong – that babies are safer on the back than on the stomach. I think we’re going to learn that babies thrive better when we give them these rhythms of sound and motion all night long instead of keeping them in dark silence for 12 hours a night. 

Nati Rodriguez [24:12] 

Thank you for sharing that. And I’m curious for myself, after six months of age, and when they’ve aged out of the Snoo, how do you recommend we provide that nurturing that supports the brain development as they get older? 

Dr. Harvey Karp [24:28] 

During the sleep period, using white noise – a rumbly type of white noise. We have a little white noise machine called Snoobie that has special engineered sounds that are appropriate for kids. but there are lots and lots of ways of getting white noise for children. and continuing that for years. A lot of adults sleep with white noise as a way of helping them get tuned into sleep. But another thing is having a little teddy bear or security blanket. So that is a little companion for nighttime periods. Maybe using a pacifier. Do you use a pacifier with him? 

Nati Rodriguez [25:12]  

No, he’s never used one. 

Dr. Harvey Karp [25:15] 

Okay, well, it’s not critical. But if you were using that, that would be another way of giving these rhythmic sensations – this sucking is very soothing for babies as well. And then of course all day long, going out for walks getting fresh air, getting good sunlight, getting tummy time, hearing music, watching you guys talk all of that daytime stimulation will feed that little growing brain.  

Nati Rodriguez [25:47] 

Thank you so much for the generous gifts we received at the office. I think we got the Snoo Bear and the Snoobie Smart Sleeper. I’m so excited to try them with my son. Anything else that you would like to share Dr. Karp with our audience before we sign off? 

Dr. Harvey Karp [26:06] 

For people who do have slightly older children – anywhere from eight months to five or six years of age – there’s lots of very practical steps. My work is practical. How do you do something to get a benefit the same day? I’m an impatient person, and so, The Happiest Toddler on the Block is filled with about 20-25 very specific suggestions to help children be able to moderate their emotions better, be more patient, more cooperative, more communicative, and ultimately help parents build these wonderful people that between eight months and five years of age we’re helping to create. So that’s my last closing words. 

• The Happiest Baby 
• The Happiest Baby on the Block
• The Happiest Toddler on the Block
• Snoo Smart Sleeper
• Sudden Infant Death Syndrome