A Conversation with Dr. Harvey Karp: Best Sleep Strategies for New and Not-So-New Babies


Infant sleep – two words that strike fear and anxiety in parents everywhere. I remember excitedly telling family, friends, and coworkers about my first pregnancy, and getting replies like “Better rest up now,” and “You’ll never sleep again!” I was petrified. 

Miraculously, my first daughter was an amazing sleeper. I had a stack of baby sleep books to read but never needed them. I’d rock her to sleep every night, put her in her crib, and she’d sleep for a nice long stretch. I wondered what everyone had been talking about. 

Not too long afterward, my second daughter arrived. And, wow, was she different. Don’t get me wrong – she was (and is!) an amazing baby. Sweet, loving, and playful all day long. But once night struck, it was a different story. 

I tried rocking her to sleep, but was never able to successfully transfer her to her crib. I tried methods where I’d check on her in intervals, which left us both in tears for hours on end. My husband and I were up for hours with her each night, leaving us completely exhausted during the day. 

So, you can imagine how thrilled I was when I heard that Dr. Harvey Karp was coming to DC and that I’d have the chance to chat with him. Here’s everything I learned during our conversation.

Why Aren’t Our Babies Sleeping?

Photo Source: Happiest Baby

Dr. Karp doesn’t need much of an introduction for moms across the U.S., but I’ll give a brief one just in case he’s new to you. He’s a pediatrician, child development expert, and entrepreneur; author of the bestselling “The Happiest Baby on the Block” and inventor of the SNOO. He is one of the country’s preeminent experts on baby sleep. And in conversation? He couldn’t be kinder, more understanding, or easier to talk to. 

His book is a must-read for new or expectant parents, with over a million copies sold. There’s a corresponding video, too, which he recommends because it can be easier to learn by seeing than reading. 

The Fourth Trimester

If you haven’t read it, one of the main themes is the fourth trimester. In short, babies are born too early and need a “fourth trimester” that essentially recreates the cozy, loud, and moving environment they enjoyed in the womb. 

So, the keys to calming babies and helping them sleep better lie in the 5 S’s:

  • Swaddle
  • Side or Stomach Position
  • Shush
  • Swing
  • Suck

Babies are used to these sensations in the womb, but they’re suddenly all taken away once we give birth. Of course they’re uncomfortable and unable to sleep well! As Dr. Karp said, “It’s like saying ‘Hey, I know you like beds and pillows, but now you have to sleep on a cement floor.’” 

Back To Sleep 

Photo Source: Happiest Baby

The Back to Sleep initiative began in 1992 as a way to reduce Sudden Infant Death Syndrome (SIDS). There were immediate positive results. By 1999, there was a 50% decrease in infant deaths, bringing the number down to about 3,600. But then, the numbers leveled off, and today, about 3,600 infants still die of SIDS annually.

How can this be? 

It’s simple. Dr. Karp compared it to when new drugs need approval by the FDA (we are in DC, after all). When a new initiative or drug comes out, there are two things you have to prove – safety and efficacy. If something is safe but not effective, it’s useless. Ditto if it’s effective but not safe. 

Unfortunately, Back to Sleep is safe but not effective. It doesn’t help babies sleep. In fact, it undermines infant sleep. Babies sleep better on their stomachs, but it’s not safe. 

So now, babies are being put to sleep on their backs and not sleeping well. Sleep is so ruined that parents are tempted to do unhealthy things, like bring babies into bed with them, put them into cribs with plush blankets or pillows, lay them down on their stomachs, use rockers or cushions not intended for sleep, etc. 

This isn’t just unhealthy, it’s deadly. 70% of infant deaths occur with babies in bed or on the couch with a parent in an unsafe position. This is why the infant death rate hasn’t decreased in two decades.

What to Do? Try SNOO!

Dr. Karp SNOO
Photo Source: Happiest Baby

Faced with a growing number of very tired, very frustrated parents, and tons of research, Dr. Karp and his wife, Nina Montée, set out to create a solution. Enter, SNOO. 

SNOO is a bassinet that instantly improves a baby’s sleep by taking care of some of the five S’s for you. 

  • Swaddle – babies are securely swaddled in the SNOO Sack that clips in, keeping them cozy while eliminating worries about them rolling over, unable to lift their heads.
  • Shush – three white noise sounds come with the bassinet, allowing you to find the one that works best for your child. 
  • Swing – the SNOO gently rocks, mimicking the natural movement your baby experienced in the womb. SNOO is the ONLY safe way for baby to sleep in motion. 

As for the other two? Well, obviously he doesn’t condone sleeping on the stomach or side (sorry, babies), and sucking can be taken care of by a pacifier if needed. 

Dr. Karp recommends starting the SNOO when your baby is still in the fourth trimester, so before he or she turns 3 months old. 

I’d heard about the SNOO before speaking with Dr. Karp, having read about it in this article from the New York Times, and it sounded amazing. I did wonder, though, how the transition would go from SNOO to crib. Who would want to go from the cozy confines of the SNOO to the big, empty abyss of a crib?

That’s where the app comes in. The SNOO app allows you to control noise and movement, so you slowly reduce those sensations as your baby gets closer to outgrowing the SNOO, typically around 6 months. On the flip side, you adjust for more motion and louder white noise during tough times like teething and growth spurts. The app also tracks your baby’s sleep (babies who use SNOO immediately experience an extra hour of sleep, or two if you’re particularly lucky).

One of the best features, in my opinion, is the support that comes along with it. You get support seven days a week, plus free sleep consultations.

SNOO Affordability and Accessibility

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Let’s just get it out of the way – the SNOO is expensive at $1,295. But, Dr. Karp and his team are working to make it more accessible and bring the price point down. His ultimate goal is to make it an indispensable piece of baby gear that’s covered by insurance, like the breast pump.

In the meantime, there’s a rental option. You can rent a SNOO for $3.50 a day, pretty much the equivalent of a Starbucks run a day. Or, even less than that if you’re a many-coffee-per-day type of mom. You rent month by month, and shipping is free each way. Renters also get the free sleep consultations.

Another option is to speak with your employer. Dozens of companies (including the semi-local Under Armour) are already providing SNOOs to their employees as part of their benefits packages because, let’s face it, a well-rested employee is going to be far more productive than a sleep deprived one. So while it’s certainly not a sure thing, it’s worth a shot to ask your employer if they’d be willing to help cover the expense. 

Non-SNOO Sleep Strategies

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If you’re like me with an older baby who doesn’t sleep well, you may be wondering if the SNOO is an option. Unfortunately, it’s not. I know… I was heartbroken, too.

Luckily, Dr. Karp had some great tips. 

Baby Sleep Tip #1: Put Your Baby To Sleep in the Bassinet or Crib

The first is one you know if you’ve ever read or googled anything about baby sleep, but, like most baby advice, is easier said than done.

The environment your baby falls asleep in is where he or she should sleep all night. 

This means no rocking to sleep, no nursing to sleep, no cuddling to sleep then transferring to crib. Full disclosure, I have done all of these things. It didn’t go well.

Say you always rock your baby to sleep and then put her into her crib. When she gets into light sleep and notices you’re gone, she’ll call (or scream) for you to come back. 

Adults are kind of the same – we go to sleep in our beds, and if something is different when we get into light sleep (you smell smoke, your pillow’s fallen on the floor, or something else weird has happened), you’ll jolt awake. If things are the same, you can seamlessly fall back asleep. 

This was something I really struggled with. For some reason, it felt impossible to just put my daughter into her crib. But I eventually tried it, rubbing her back and shushing until she fell asleep. 

It took over an hour on the first night, but it felt like a huge accomplishment for her to fall asleep in her crib instead of in my arms. She now falls asleep in her crib within a few minutes and it’s amazing! 

Baby Sleep Tip #2: White Noise = Magic (Almost)

Photo Source: Happiest Baby

Lots of so-called sleep solutions are short lived. Swaddling, for example, works great at first. But after two months, it’s not worth the risk. Pacifiers, too, aren’t a long term solution. 

White noise, on the other hand, can be a lifelong sleep aid. Dr. Karp describes white noise as “a teddy bear of sound.”

White noise machines are compact, making them easily adaptable to family life. Plus, they’re packable so you can bring them along on travel. They’re also easy to wean if needed – just turn the volume down little by little each night. 

If you’re already using a white noise machine but your baby still isn’t sleeping well, Dr. Karp suggests adjusting the volume and/or sound. In my case, for example, he suggested trying a rougher, multi-frequency sound vs. a calmer, quieter one to help her not listen to her own thoughts during light sleep. 

Baby Sleep Tip #3: Give Your Baby a Security Object

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When we were discussing my daughter’s sleep, Dr. Karp asked if she used a stuffed animal or blankie to self-soothe. Unfortunately, she doesn’t – I’m her security object. It’s sweet (baby cuddles!) but can also be a challenge for obvious reasons. 

He gave some great advice for moms dealing with this. He recommends you choose an object, like a doll, and then build a bridge between yourself and the doll. Bring it everywhere with you and your child to get your scent on it. Eventually, it’ll become associated with you and will become a transitional object. 

Security blankies, dolls, and teddies tend to run in families, so if you had one of these you will likely be able to get your child to do the same. 

Bonus tip: dab a drop of lavender oil on the doll for extra soothing.

Baby Sleep Tip #4: Every Baby is Different

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There are some universal truths when it comes to babies, and the Five S’s have been proven to work for babies from all cultures, all over the world. At the same time, though, they’re all different individuals with different personalities, temperaments, and preferences.

So when it comes to the Five S’s, take the time to get to know what your baby likes. Maybe yours likes swaddling and sound. Or, perhaps he likes swaddling and sucking. Or maybe, she needs it all and can’t sleep without all five (yikes). 

Accommodate your child’s needs, but don’t compromise his or her safety. If you have a baby who loves to sleep on her stomach, for example, amp up the other four S’s to help make up for putting her to sleep on her back. Dr. Karp compares it to a stew – if you’re out of potatoes, you can always add extra turnips. It won’t be quite the same, but it’ll still be good.

Tying it All Up – There’s Hope!

Photo Source: Happiest Baby

My biggest takeaway from our conversation was that baby sleep is not a hopeless, unattainable dream. There is a wealth of knowledge out there, and people like Dr. Karp who’ve dedicated their lives to figuring it out. 

Take advantage of their resources. Read the books, watch the videos. Don’t be afraid to try something new if what you’re doing isn’t working. And once your baby is sleeping well, he or she won’t just be the happiest baby on the block. You’ll be the happiest mom, too. 


  1. Our family borrowed a SNOO from a friend and it worked like a charm. I’m convinced it built the foundation that allows our daughter to continue to be a great sleeper to this day.

  2. Ahh I wish I had done that! A friend offered one to me to borrow but I didn’t take her up on it because I was worried about weaning Fay off of it. Now I know it would have been so much easier than I thought.

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