The California Evidence-Based Clearinghouse for Child Welfare
The California Evidence-Based Clearinghouse for Child Welfare

This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cachildwelfareclearinghouse.org/

The Happiest Baby (THB) - Detailed Report

Scientific Rating:
4
Lacks Adequate Research Evidence
See scale of 1-6
Scientific Rating:
4 - Lacks Adequate Research Evidence

Relevance to Child Welfare Rating:
2
Relevance to Child Welfare Rating:
2 - Medium

Type of Maltreatment: Physical abuse

Target Population: New parents, grandparents, teachers and healthcare professionals.

Brief Description:

The Happiest Baby (THB) has been rated by the CEBC in the area of Prevention (Secondary). 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, Side\stomach 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.

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Essential Components

Show Essential Components
  • Certify all educators in the Happiest Baby program.
  • Provide all patients/clients with The Happiest Baby 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 episodes…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 The Happiest Baby 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.
  • Able to be used in programs for high-risk babies/families (e.g., NICU, drug withdrawal, low SES), teen parents, fatherhood programs, military, Post-Partum Depression sufferers, Shaken Baby Syndrom prevention, foster or adoptive parents, and training Pediatric Nurse Practitioners, nurses, lactation consultants, housestaff, child life workers, etc.


Group Format

The Happiest Baby (THB) was designed to be conducted in a group.

The Happiest Baby (THB) has not been tested for use in a group setting.

The recommended group size is: Groups of 1 to 6 couples


Recommended Parameters

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). The program is designed so that all participants receive two parenting tools (an educational DVD and a CD of white noise). For high-risk patients, there should be 90-minute home visits and/or telephone follow-ups.

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.


Homework

The Happiest Baby (THB) does not include a homework component.


Delivery Setting

The Happiest Baby (THB) is typically conducted in a(n): Adoptive Home, Birth Family Home, Community Agency, Group Home, Hospital, Outpatient Clinic, Residential Care Facility, and School.


Parent Component

The Happiest Baby (THB) was designed with a Parent Component.

The Happiest Baby (THB) addresses the following presenting problems and symptoms: 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.


Child Component

The Happiest Baby (THB) was not designed with a Child Component.

The Happiest Baby (THB) was not developed for children with developmental delays.

The Happiest Baby (THB) has not been tested for children with developmental delays.


Racial/Ethnic Diversity

The Happiest Baby (THB) was not designed for specific racial/ethnic/cultural groups.

The Happiest Baby (THB) was not tested in specific racial/ethnic/cultural groups.


Education and Training Resources

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

There is training available for The Happiest Baby (THB).

Training contact: Sherry Turney-Mayeux, education@thehappiestbaby.org, 909-980-8062

Number of days/hours: Five days for 40 hours total

Training is obtained: At home – DVD and reading based with a test requiring passage at the 90%

There currently are not additional qualified resources for training.


Identified Resources Necessary to Implement Program

The typical resources for implementing The Happiest Baby (THB) are: This is a home study certification, but enrollee must have access to a DVD player.


Minimum Provider Qualifications

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


Relevant Published, Peer-Reviewed Research

Show Relevant Published, Peer-Reviewed Research

The practice lacks adequate published, peer-reviewed research to empirically determine efficacy, however, the topical expert identified it as a program being used in this area, or it is being marketed and/or used in California with children receiving services from child welfare or related systems and their parents/caregivers.

There are currently no published research studies for The Happiest Baby program.



References

Show References

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



Contact Information

Contact name: Harvey Karp, MD, FAAP

Affiliation/Agency: The Happiest Baby, Inc.; UCLA School of Medicine

Email: dr.karp@thehappiestbaby.com

Phone: 310-207-1111

Fax: 310-207-1221

Website: http://www.thehappiestbaby.com


Date reviewed: February 2008