Raising children without help harms children, says pediatrician – 12/31/2023 – Balance

Born in New York and graduated in medicine from the State University of New York, pediatrician Harvey Karp opened his first office on the other side of the United States, in Los Angeles. There, he served both the people behind the cameras, screenwriters, producers, costume designers, and celebrities. “I had a good number of them, like Pierce Brosnan, Michelle Pfeiffer, Larry David, Madonna. People ended up finding me,” said the doctor, in a Zoom interview, edited in this text.

Karp launched, in 2002, “The Happiest Baby on the Block”, an instant bestseller that continues to sell and is passed from hand to hand from caregivers of older children to parents of newborns.

It became a literary phenomenon that never left the bestseller list. Translated into more than 30 languages, it is based on a very simple concept: it is possible to make a baby calm down and, consequently, sleep, by simulating the tricks that all caregivers resort to when nothing else works: swaddling the baby tightly like a burrito, make a little movement, like driving in the car or shaking it lightly, a constant noise, like a hairdryer or even a person making sounds with their mouth, and give a pacifier.

The book made Karp a rich and famous man and solved the problem of many desperate parents. But he created another, much more complex one. To follow these simple rules, an adult needed to stay awake. So, the pediatrician tried to solve the next problem: how to ensure that the baby slept all night safely and alone in the room, so that the parents could also rest?

And from this challenge came the SNOO, an electric crib that keeps the baby contained and that automatically rocks when it hears crying, makes a little noise similar to what the fetus hears during the months it is being pregnant and transmits information to the parents via Wi-Fi, directly to cell phones.

The problem with SNOO, however, is that it is very expensive, around R$8,500. Now, the pediatrician’s challenge is to make it accessible to all first-time mothers, whether they are rich, poor, healthy, sick, older, younger, with nannies or without anyone. Which, in fact, Karp considers “the great lie” of our times. “The normal family is not made up of two parents and a child. This is a social aberration,” he says.

Why do you say that a family made up of a couple and a child is not normal?

When we consider human evolution, this is completely abnormal. The extended family is normal. The nuclear family is, in many ways, the wrong way to go. Think of it this way: if there are two parents and a child in a house, how many relationships can that child have? The child has a relationship with his mother, with his father, with both parents together and with himself. There are very few people. It’s a lot of work for the parents and harmful for the child.

What would a normal family be?

Throughout history, until very recently, families lived near [uns dos outros]. You had three brothers, grandparents nearby and children from the house next door, which gives a total of 12 people, at least, the number of combinations exceeds one hundred. The impact of this on our children is immense. We saw this clearly during the pandemic. What drives parents crazy is that they not only have to cook, clean, work and maintain a relationship, but they also have to be full-time caregivers and playmates for their young children. It’s not easy. It takes all day to be a playmate. When you don’t have other people around, children and parents suffer.

What should a couple do if they live far from the rest of the family and have a baby?

People who hire nannies or place their children in daycare are not doing anything wrong, much less abdicating their responsibilities, they are doing something good and providing a much richer socially environment for their children. It turned out that the biggest predictor of postpartum depression is not the lack of help you get after the baby is born, but the expectation of having help or not needing it — and then suddenly needing it. It is a mismatch between expectation and reality.

Does this mean it’s better to tolerate a nosy mother-in-law than to do everything yourself?

No need to exaggerate. But then again, it’s normal for relatives to help a new mother. The baby is not a new mother’s only job, she often needs to cook, clean, do laundry. Then the grandmother, the mother-in-law, the sister, the neighbor could hold the baby on their lap. Women used to share these responsibilities. This was a normal family. Now, women are told that they have to hold the baby all the time, sing to the baby while he sleeps because his brain is developing. The responsibilities only multiply. We need to help people learn how to balance themselves so they don’t become so tired that they can’t care for themselves or their babies.

Vare you saying that the women must do all the work? How does this model he can work when both parents need to work on time full?

I’m not saying that at all. It used to be like this and it worked much better than it does today, but things have changed. In the United States we have seen more and more men taking care of children. It’s still a small percentage compared to what women do, but it’s two or three times more than what men used to do. The other thing is that women need to be paid better. Currently, women do more housework because men generally earn more money at work. And that makes sense. But as we pay women more, there will be more men who can take care of children. Men can do this perfectly well. We can’t breastfeed very well, but we can do other things very well.

The Brazilian reality, socially much more unfair in relation to the remuneration of those who do domestic work or take care of children, allows many families to have help all the time. That sounds good for parents and children, but what about those who do housework or babysitting?

This is another problem that needs to be resolved. We need to pay women who work in childcare a lot more so we have smart, capable people, not just 15 year olds with no experience [nos Estados Unidos é comum que estudantes adolescentes cuidem de crianças na ausência dos pais, como um bico], but rather, people who see it as a profession. All of these social changes will occur when we recognize that it is essential to support new families, which will make everyone’s life better and, ultimately, reduce healthcare costs.

It’s very common to hear about postpartum depression, but I think there’s two-year depression and five-year depression. Do you agree with that?

As the child grows, guilt and problems increase. Many people raising children today have never held a baby before in their lives. This did not exist in human culture until the last 50 years. In general, when a woman had a baby, she already had years of experience raising her brothers, sisters, and cousins. She didn’t need any intuition or those popular beliefs about maternal instinct, people learned from experience. Today’s parents don’t have this experience and, worse, as they are well educated academically, they believe that they will solve everything with their brain.

Have things changed a lot in pediatrics since you started practicing until today?

Yes, a lot, and they will always change. When I started practicing, I was trained to give opium to babies who cried a lot. Normal medical treatment was called paregoric, which was opium mixed with alcohol. You could buy this at any pharmacy. Then we learned that babies should be restrained in car seats when they are in the car, and not on their mother’s lap in the front seat. So we learned differently from what I always taught people, that the baby should only sleep on their stomach, which was very dangerous and we had to change our approach. Babies should sleep on their sides. Now, I want to teach people that they should keep their babies restrained when they are sleeping, which is much safer than leaving them loose in their crib where they can roll over and get into a position where they hold their breath.

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HARVEY KARP

A pediatrician with a degree in medicine from the State University of New York, he is the creator of the SNOO electric crib and author of several books translated into more than 30 languages, including the best-seller ‘The Happiest Baby on the Hill’ (2002).

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