Newborn infants don’t come with a user manual, but if they did, this 275-page, Hebrew-language volume could serve quite well. However, it should be given as a gift or purchased after delivery – as the user-friendly text gives so many details on babies’ sensitivity and how much care they need round the clock that reading it might discourage couples from having progeny at all.
Some people’s hearts skip a beat from even a single wail, while others are rather more resistant – but no mother can continue what she is doing with equanimity when her baby is screaming its lungs out and looking miserable. Women must be naturally wired to get upset by babies’ cries as an evolutionary tool to get them to pick the helpless creatures up.
The book was jointly written by two women, Sivan Ofiri and Irit Shaked, the first the mother of two and the second of four. Ofiri is a childbirth educator and doula (assistant who provides nonmedical support during and even after delivery) and leads courses for mothers and their babies, while Shaked describes herself as a supporter of parents after delivery who teaches baby massage.
While most of the advice they give is scientifically based, they include some techniques such as Bach flowers and other essences, chiropractic, craniosacral, homeopathy, osteopathy and other complementary medicine techniques that have not been scientifically proven to help reduce crying.
A Schneider Children’s Medical Center pediatrician who is also a homeopath writes in the foreword that the book – published among a wide variety of books for new parents – is original and spellbinding as a “first-aid” book and as general guidance for exhausted, frustrated parents. He claims it is unique because the two experienced women “integrate technical details with spiritual perceptions of the world and provide advice and ideas to help young parents who were never prepared for the job.”
Ofiri and Shaked note in their introduction that in an age of “instant solutions,” it is still not easy to understand why your baby is crying and how to help him. Existing information, they state, “ignores the real needs of babies and lack the basic understanding of who the baby is and what are his needs and abilities.” Too often, parents do not pay attention to their instincts and are influenced by other people and confusing information.
After “thousands of years of evolution,” they write, babies have not changed and still have the same needs, reflexes and instincts. “The role of crying is to protect the baby, he will be near his mother or another person and be cared for in the best possible way.
Crying is the communications medium of your baby with the world until you will learn to identify the signs he broadcasts or until he learns to speak and tell you himself what he wants.” But, followed more than 250 pages, this subject is much more complicated.
The story begins during, not after, pregnancy. The authors write that the fetus is easily influenced by the mother. When she is very stressed, she releases the stress hormone cortisol into her bloodstream that reaches the fetus via the placenta and can even induce it to excrete its own stress hormone. Babies whose mothers were very stressed during pregnancy are known to cry more than those born to women who were calm.
But the womb is generally the most peaceful place a baby will encounter. The fetus hears its mother’s (and even father’s) voice; getting food from the mother’s bloodstream through the placenta, it is never hungry; it floats calmly in the amniotic fluid; it is held closely and protected by the amniotic sac; and even early contractions are like a massage. While most other mammals can get up, dust themselves off and start walking or swimming after their mothers after birth, the human baby needs a lot more time to lose its helplessness, develop and make itself understood, hence the role of crying.
But if a baby’s delivery was traumatic – taking a lot time, with induction, the use of medication or an internal monitor attached to its scalp, a forceps or vacuum birth, a cesarean section or lack of oxygen – the baby’s behavior can be affected afterward, they write. Among the signs of trauma are an unevenly shaped head; one eye closed more than the other for some time; tightened lips even when it rests or sleeps; the inability to turn the head to either sides if lying on its stomach; crying when touched on its back, neck or head; difficulty or refusal to open the mouth; and throwing its head backward and arching its back.
If pressure was put during delivery on the upper spine and base of the skull, causing painful movements of the vertebrae, they write, these symptoms of trauma can appear. If the baby is delivered with instruments, the newborn may feel pain that persists for days. If there is a cesarean delivery, the baby may be “unprepared” and liquid may still be filling the lungs because no contractions pushed it out. The baby is suddenly and unnaturally pulled out of the womb; it is best that the mother hold it immediately and give it gentle massage, they advise. With a complementary medicine background, they suggest applying herbal essences such as Bach flowers or “Rescue Remedy” or even have him “manipulated” by a chiropractor, osteopath or craniosacral expert.
Whether the delivery was traumatic to the baby or not, the authors urge that if healthy, it be placed on the mother’s stomach for bonding and warmth and offered the breast. Being totally wrapped up so it cannot feel the warmth of its mother’s skin is not advisable if the delivery room is warm enough, they continue.
Injections and tests can almost always wait.
And when injections are necessary, the mother or father should hold the baby and talk: “Babies understand even if they can’t speak.” In addition, breastfeeding always calms the baby and relieves pain.
The book recommends rooming in rather than having the infants taken to the nursery to be cared for by busy nurses. Even though it is natural for mothers to want to rest after exhausting and painful labor, the first few days of life are best spent with the mother, they write. The baby feels more confident, is served immediately and will cry less. Mothers of low-birthweight premature babies, who may feel “guilt” or the blues for not carrying them to term, should best spend as much time with them as possible, touching and massaging them and carrying them around skinto- skin on their chests like a kangaroo in its mother’s pouches. “Kangaroo therapy” has been shown to speed growth and development and reduce crying later on. Massage therapy, which is easy to learn and taught in many hospitals, can help reduce pain and calm newborns and can be carried out even beyond the baby’s first birthday.
After discharge from the hospital, the mother will often feel frustrated by being unable to calm her baby even though he has been fed, diapered, bathed and burped. Crying can arouse “fear, anxiety, distress, despair, estrangement, loneliness, frustration, disappointment, a feeling of failure, depression, mercy, rejection, exhaustion, the need to protect, love, doubts, difficult, pressure, empathy, identification, a need for closeness, worry, confusion, bewilderment and – first and foremost – a forceful need to stop the crying.”
Remember, they write, that crying is natural, and that you are the only parents the baby knows. “He doesn’t compare you to anyone. For him, you are the best parents…
Remember that your baby will not cry forever.
This period, with all its difficulties, will pass. At the end of a difficult day, go to sleep knowing that tomorrow will be a new day that can be completely different.”
The authors advise parents not to leave an infant crying in the cradle when they have tried “everything” and nothing works. Being left alone without care can reduce babies’ self-confidence and decrease their trust in the parents and the world. The authors deny the popular notion that picking an infant up whenever he cries leads to him “becoming spoiled.”
For the baby to feel emotional and physical calm, “he needs the feeling that you are there for him in the full meaning of the word.” Not only the mother’s body releases the feel-good pleasure hormones oxytocin and opiates, the baby’s body does so as well. When the baby’s needs are met, these hormones can calm him and reduce tears.
Crying will usually be most intensive during the first three months, but some babies can be satisfied by feeding and diapering during that period and only later become crybabies. Crying usually comes on three basic forms at this age: a monotonous da-da-da that calls for the caregiver’s attention and means: “I feel lonely,” “I need a hug” or “Please pick me up.” The second type is much stronger and means: “I need help because I’m hungry, need a diaper change, have gas on the stomach or am frightened.” The third is a highoctave sudden cry that usually is a signal of pain. Even if there is no pain, crying can serve as a release of tension, they write. “You should try to find the source and deal with it immediately.”
The authors provide a variety of tips to parents when they seemed to have tried everything to end the crying: Wrapping newborns up in a light blanket up to the neck can give them the womb-like feeling of “being held”; making the sound shhhhhhhhhhhh is a familiar uterine sound and can work; turning on a metronome at a heartbeat’s pace can help; white noise from between radio stations or even a washing machine or hair drier is another possibility. Various holding positions and massage techniques that calm the baby are illustrated in word and photos. The baby naturally wants to suck, and if the breast or a pacifier doesn’t help, putting a very clean parental finger or even the baby’s own hand into the mouth may, they suggest, along with the possibility of a joint parent/baby bath. Talking to the baby face to face can also trigger his interest.
Physiological conditions such as colic, allergies, constipation and the appearance of the first tooth as causes of crying are also discussed in detail. Advice on how to take the baby out in the car, one parent alone or both, and on the roles of the father and babyminder are also provided. But the book does not cover crying throughout childhood. However, there is mention of toddler tantrums and how to cope with them; beyond that advice, one has best turn to Dr. Spock and his many successors.
Although Prof. Arthur Eidelman – one of the country’s most experienced neonatologists who for decades headed the neonatal unit and the pediatrics department at Jerusalem’s Shaare Zedek Medical Center – had not yet read the volume, he was willing to comment when the complementary medicine components were described to him. “Massage therapy and swaddling are definitely relaxing for babies and can reduce crying, and ‘kangaroo therapy’ is very beneficial for both premature and term babies. Acupuncture has been used for colic, and there is some scientific evidence that it can also relieve pain in older people.”
But all the other complementary medicine claims have no backing by scientific research, said Eidelman, and quality control is very variable. “Manipulation, homeopathy and floral essences to treat pain and reduce crying are a lot of nonsense. Nothing has been proven.” He added that they probably won’t cause harm when offered by a well-trained person, but they probably won’t help.
“Low-birthweight babies in general tend to be irritable, as they have low pain thresholds. Crying may also be due to what its breast-feeding mother eats or drinks – coffee, alcohol, medications and even chocolate – and whether she smokes,” he said. “But if nothing helps, parents should urgently take the baby to the doctor for an examination.”