National Center for Effective Mental Halth Consultation
   

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Karin, a 25-year-old mother, is seeking help from you as a mental health consultant because she is experiencing difficulties calming her infant, Max. Max is a three-week-old boy. He was born at 41 weeks of gestation. Karin breastfeeds Max every two hours. The schedule of their day is as follows: Max gets breastfed and changed, and Karin places him in the crib to sleep. After 20 minutes of sleep, Max wakes up, cries inconsolably. When being held, Max pulls his feet up to his body. When she places a hand on his tummy, he cries even more. Karin tries to hold her son mostly in an upright position when he cries but this strategy does not seem to work well. Karin is exhausted and tired because she takes care of her son most of the time by herself.

As a mental health consultant, what strategies/ resources do you recommend to Max’s mother to help calm her infant?

Expert’s Response:

First of all, it is important to consult a pediatrician and ensure that Max’s crying is not related to any serious condition that requires medical treatment. Second, you can give Karin some advice on strategies try, such as:

  • Swaddling the infant with a large and thin cotton blanket to give him/her a secure and warm environment.
  • Placing the infant in a body carrier or rock your infant in the rocking chair. Steady rhythmic movement helps the infant to calm down and fall asleep.
  • Turning on calming music.
  • Avoiding overfeeding the infant. Breastfeed the infant at least every 2 to 2 ½ hours. Overfeeding may make the infant uncomfortable.
  • Holding the infant in the basketball/airplane position. This supports the infant’s digestion. See the picture below.
  • Keeping your infant calm and quiet when you feed him/her at night so that the infant realizes it is night time and not time to play. Keep the lights dim and the environment quiet.
  • Trying to find a familiar, trusting adult who can take care of the infant to give you a break if you are feeling exhausted.

Mother holding infant in an airplane position to support the infant’s digestion
Mother holding infant in an airplane position to support the infant’s digestion.

Another reason for fussiness may be due to an infant's difficulty processing multiple types of sensory input such as light, sound, taste and touch. Prior to when the infant was born, the mother’s womb was warm and narrow, and all sounds were muted. After birth, the environment of the infant is the opposite compared to the womb: it is loud and bright, and there is a lot of open space. When the infant becomes over stimulated, caregivers should focus on decreasing the sensory stimulation in order to calm the infant.

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Georgetown University Center for Child and Human Development National Center for Effective Mental Health Consultation