By: Patti Ideran, OTR/L, CEIM & Mark Fishbein, MD, FAAP
In discussions about helping babies learn to fall asleep on their own, you may hear "self-soothing" mentioned a lot. The term can sometimes be interpreted as a parent making a baby "cry it out" or ignoring their cries. This is absolutely not true.
Allowing babies to learn calming strategies gives them an important life skill. Leading by example and teaching good coping skills from the beginning helps babies become happy, well-adjusted children.
Figuring out what your baby needs & what helps
Teaching how to self-soothe involves a learning curve for you as well as your baby. If your baby is extremely irritable, for example, they may be hungry (and then you need to feed them) or very tired (and then you need to try to help them sleep). If you think your baby is in pain, you need to address that.
If all of these are ruled out and your baby is fed, changed, and well rested but fussy, then you can try a progression of calming techniques (see below).
Too often, when your baby is crying (which may seem like all the time!), you may have the instinct to immediately pick them up. Instead, next time try slow down and take steps to really learn about your baby and what they need. Try each technique slowly, and pause to see how your baby responds; you will both learn what helps and what doesn't.
Soothing techniques to try
The order of the progression is important because you are doing less at the beginning by just using your voice and more at the end when you are holding and possibly feeding your baby. The goal is for your baby to calm with less intervention from you, and for you to move away from holding your baby all day, something that happens frequently with fussy babies.
The CALM Baby Method progression
Look at your baby, letting them see your eyes.
Look at and talk to them.
Put a hand on their belly or chest.
Hold their arms together in toward the body or curl their legs up toward their belly.
Change their position by rolling them onto their side (while awake, only).
Pick up your baby and hold them in your arms or at your shoulder (but don't move yet!).
Hold and rock your baby.
Swaddle your baby and rock them.
Place a pacifier in their mouth (or assist them to get their hand or thumb to their mouth to suck). You can also try this earlier in the progression if your baby likes pacifiers.
Feed them if you think this will help.
Other strategies to help calm your baby
Other strategies you can incorporate include massaging their back while you are holding them, singing to them, walking with them, and using white noise. When babies are extremely fussy, we tend to try many things to help them calm. But sometimes this means we are adding more stimulation to an already overwhelmed sensory system, and this can be backfire.
You may hold them, walk around, change positions, pat, sing, pass them on to your partner, for example, and this is too much input. Some parents we have worked with choose an intense strategy, such as sitting on a gymnastics ball and bouncing; however, this is risky, as your baby's head control may not be strong enough to handle this intense movement or you could accidentally fall off the ball with your baby in your arms.
Give your baby time to settle down
When babies are inconsolable, we advise parents to try one strategy (1 or 2 sensory inputs) for about 5 minutes before moving on the next. This may seem like a long time, but it allows your baby to process the sensations and gives them time to settle. A great position to try is the arm drape or "hanging out" position (holding the baby on your forearm facing the floor, their head near your elbow supported in your hand.) It may take a couple of minutes, and sometimes the crying may escalate before it starts to ease.
Other things you can try include standing up and holding your baby firmly while they are sucking on a pacifier, shushing or patting them, and swaddling and rocking them. Just don't attempt all the strategies at once or in too quickly in a row, or they will get overstimulated!
You can also try decreasing the intensity of the the interaction; talk more quietly, move more slowly, use less animation in your face. Try to stick with one method for five minutes; if it does not help your baby calm, move on to a different strategy and give that one five minutes. Give each strategy a good try before giving up. Every time your baby cries, try the strategy, and do this for at least a day to see if it helps your baby to make a change. If you feel like a certain strategy works some of the time, try that one first.
Consistency is key when trying to establish some behaviors. Your baby might not stop fussing immediately. But when you use the strategy each time she cries, your baby may be getting used to it and may calm more quickly over time. Remember that one parent may have a strategy that works best for them, while the other has a different strategy that helps most, and this is absolutely fine!
Your growing baby
As babies get older, their cries change, and so should your strategies to help them calm. Sometimes parents find a strategy that works well with their baby, such as doing squats with their baby in their arms, that is much more difficult to do with an older, heavier baby! Parents tend to stay with strategies that once worked and may be reluctant to try something different, fearing that it might not work. Babies can get too big for a baby swing, or a parent bouncing a baby while sitting on a gymnastic ball could be more difficult or even risk a fall as the baby gets heavier. Be open to when it is time to try something different that may be more suitable or safer for your baby as she grows.
Seek help when you need it
Don't hesitate to talk with your pediatrician. If you and your baby are still frustrated, there are more resources that can help. Consider contacting a pediatric occupational therapist who specializes in treating infants, an infant mental health specialist, or a pediatric developmental psychologist. These professionals can help you understand your baby, help you learn how to read their cues, and help you promote self-regulation. Interview these professionals to make sure they have the professional experience you are looking for to have the best chance of success.
About Ms. Ideran
Patti Ideran, OTR/L, CEIM, has worked in the field of pediatric occupational therapy for over 35 years; she has specifically focused on the treatment of infants and toddlers in the last 15 years. She is certified in Brazelton Institute's Newborn Behavioral Observations (NBO), is a Certified Educator of Infant Massage (CEIM) and is a certified Baby and Toddler Yoga Teacher. She is also certified in the Neurodevelopmental Treatment Approach.
About Dr. Fishbein
Mark Fishbein, MD, FAAP, is a pediatric gastroenterologist at Ann and Robert H. Lurie Children's Hospital of Chicago. He is faculty member of the Feinberg School of Medicine at Northwestern University. He is medical director of the Pediatric Feeding and Swallowing Disorder Clinic at Central DuPage Hospital. He coauthored Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child's Diet.