The '5 S's': Easing baby pain after vaccine shots
The "5S's" include swaddling (tightly wrapping a baby in a blanket almost like a burrito) and a side/stomach position such as this.
April 16th, 2012
12:01 AM ET

The '5 S's': Easing baby pain after vaccine shots

For most parents -  even the strongest believers in the benefits of vaccines - anticipating how their newborns' facial expressions will turn from curious to shock before they burst into tears from the needle stick, can make the next well-baby check-up something they would love to skip.

But doctors at Children's Hospital of the King's Daughters in Norfolk, Virginia, have found an easy way - actually five easy ways - to help calm a baby's pain (and anxiety), without any medication.

It's called the "5 S's":  swaddling (tightly wrapping a baby in a blanket almost like a burrito), side/stomach position, shushing sounds, swinging and sucking.

If babies were doing four out of five of these "S's," they would usually stop crying within 45 seconds after the shot, according to a new study published in the journal Pediatrics.

Parents aren't the only ones who are concerned about the pain babies feel when they get vaccine shots. Doctors and nurses - the ones sticking the needles into the little babies - are too.

In the past, doctors would recommend giving an infant some baby Tylenol or Advil, to prevent any possible fever from developing and also to provide pain relief.  But that changed a few years ago when a study, published in the medical journal The Lancet,  found  that giving acetaminophen (the main ingredient in Tylenol) before or after vaccination actually made the vaccine less effective because fewer antibodies were produced.

Watch more about easing vaccine pain for babies

Breastfeeding can help reduce pain and calm a child because it gives the infant comforting skin-to-skin contact and  distracts the child. Also, mother's milk contains sugar which is known to have pain-relieving effects.  However, if a mother is no longer breastfeeding or uncomfortable doing so in a pediatrician's exam room, that's not really an option.

So the standard of care for helping reduce pain stemming from vaccinations or circumcision or drawing blood has been sugar.

"A lot of neonatologists use sugar for a painful procedure," says lead study author Dr. John Harrington. "It's poor medicine not to give sugar before medical procedures because it does work."

On the other hand Harrington, who is a pediatrician at Children's Hospital of the King's Daughters, says if children keep getting sugar to help relieve pain, that doesn't help alleviate the obesity problem we have today.

So Harrington was searching for something that would provide a pain-relief alternative.  A guest lecture given by Dr. Harvey Karp, creator of the DVD and book "The Happiest Baby on the Block" gave him the idea for his study.

Karp had found that when parents use the "5 S's" it triggers a calming reflex in the baby.  Harrington knew many parents found this method to be helpful with colicky babies, so he decided to see how it would work when giving vaccinations in his clinic.

He devised a trial with 230 healthy infants who came to his clinic for regular check-ups at 2- and 4-months of age.  They were divided into four groups:  One group was given 2 millilitres of water  2 minutes before getting the vaccine.

The second group was given 2 millilitres of sugar-water.

The third group was only given the "5 S's" after the shot.

And the last group was given 2 millilitres of sugar-water before the shot and the "5 S's" after the vaccination.

At least four of the "5 S's" had to be completed (babies were not always able to suck on a pacifier because they were either crying too hard, already calming down or unfamiliar with a pacifier.

Harrington and his team thought the sugar solution plus the physical intervention using the "5 S's" would be most effective.  The study authors reported that "the pain scores and crying time in the group of physical intervention alone were essentially identical and sometimes even lower than the physical intervention with sucrose group."

Harrington says the babies who only received the sugar solution were still crying 2 minutes after getting the shot.  But most of the babies who got the physical intervention stopped crying by 45 seconds.

"By a minute [following the shot], nobody was crying or making any sort of fuss at all," he says.

Dr. Karp wasn't involved in the study but he says this research shows the that the "5 S's" are twice as effective as sugar, which has been the gold standard up until now.  But he believes Harrington's study actually underestimates the effectiveness of the "5 S's" because the sugar-water is given 2 minutes before the shot and the swaddling and swinging etc. didn't begin until 15 to 30 seconds after the shot.

Karp recommends doctors swaddle the baby before the procedure and just leave the legs exposed (that's where the injections in young babies are made), thus triggering the calming reflex before the procedure.  He also recommends doctors have a white-noise CD on before the shot is given.  "That will give a much faster [calming] response," says Karp.  He says white noise is as important as swaddling when it comes to triggering an infants calming reflex and should be used until the baby's first birthday.

This is the second study that shows how the "5 S's" help babies, says Karp. "A 2011 Penn State report found the '5 S’s' helped increase infant sleep and reduce infant obesity."

The study authors acknowledge they tested their hypothesis on more 2-month olds than 4-month olds.  They attribute that to parents being so amazed by the calming effects of swaddling etc. when they came in for the 2-month check-up, they then asked to learn how to do it themselves.  Therefore the number of parents in the test group who didn't use the "5 S's" to calm their babies at the next (4-month) visit was very small.  Harrington acknowledges that more research needs to be done to validate his study, but the results show you don't need a spoon full of sugar to get a vaccination because using the "5 S's" is more effective.

The real benefit, he says, is that "the parents had learned that they could soothe their child without giving their child sugar or giving medicine."

If this leads to less stress and anxiety at doctors visits, that doesn't hurt either.

soundoff (236 Responses)
  1. Eulalia

    Thank you for the good writeup. It actually was once a leisure account it. Glance complicated to far brought agreeable from you! However, how can we communicate?

    May 4, 2014 at 16:42 | Report abuse | Reply
  2. Ken

    Wow that was strange. I just wrote an extremely long comment but after I clicked submit my comment didn't show up. Grrrr... well I'm not writing all that over again. Regardless, just wanted to say fantastic blog!

    May 4, 2014 at 17:31 | Report abuse | Reply
  3. Nestor

    Hello there! This article could not be written any better! Reading through this post reminds me of my previous roommate! He always kept talking about this. I'll send this article to him. Pretty sure he'll have a very good read. Thanks for sharing!

    May 4, 2014 at 22:43 | Report abuse | Reply
  4. Lizzie

    It's actually a great and helpful piece of info. I am glad that you just shared this helpful information with us. Please keep us up to date like this. Thanks for sharing.

    May 5, 2014 at 00:08 | Report abuse | Reply
  5. Lucia

    This is very interesting, You are a very skilled blogger. I've joined your feed and look forward to seeking more of your great post. Also, I've shared your website in my social networks!

    May 5, 2014 at 02:44 | Report abuse | Reply
  6. Dawn

    Today, I went to the beach with my children. I found a sea shell and gave it to my 4 year old daughter and said "You can hear the ocean if you put this to your ear." She placed the shell to her ear and screamed. There was a hermit crab inside and it pinched her ear. She never wants to go back! LoL I know this is entirely off topic but I had to tell someone!

    May 5, 2014 at 03:31 | Report abuse | Reply
  7. Derick

    Heya i'm for the primary time here. I found this board and I in finding It really helpful & it helped me out a lot. I hope to give one thing again and help others like you aided me.

    May 5, 2014 at 05:53 | Report abuse | Reply
  8. Lincoln

    I absolutely love your blog and find the majority of your post's to be just what I'm looking for. Do you offer guest writers to write content in your case? I wouldn't mind writing a post or elaborating on a number of the subjects you write about here. Again, awesome weblog!

    May 5, 2014 at 07:13 | Report abuse | Reply
  9. Ima

    When someone writes an post he/she maintains the image of a user in his/her mind that how a user can be aware of it. So that's why this article is great. Thanks!

    May 5, 2014 at 11:58 | Report abuse | Reply
  10. Lorena

    Hello, Neat post. There is an issue together with your website in internet explorer, may check this? IE nonetheless is the market chief and a huge section of other people will pass over your wonderful writing due to this problem.

    May 5, 2014 at 12:27 | Report abuse | Reply
  11. Celia

    At this time I am going to do my breakfast, later than having my breakfast coming yet again to read additional news.

    May 5, 2014 at 12:36 | Report abuse | Reply
  12. Clifford

    My partner and I stumbled over here different page and thought I should check things out. I like what I see so now i am following you. Look forward to checking out your web page yet again.

    May 5, 2014 at 15:56 | Report abuse | Reply
  13. Irving

    My brother suggested I would possibly like this website. He used to be entirely right. This put up actually made my day. You can not consider just how so much time I had spent for this information! Thanks!

    May 5, 2014 at 15:59 | Report abuse | Reply
  14. Sebastian

    Please let me know if you're looking for a article author for your site. You have some really good posts and I feel I would be a good asset. If you ever want to take some of the load off, I'd love to write some material for your blog in exchange for a link back to mine. Please shoot me an e-mail if interested. Many thanks!

    May 5, 2014 at 23:45 | Report abuse | Reply
  15. Robt

    excellent issues altogether, you simply gained a brand new reader. What would you recommend about your put up that you just made some days ago? Any positive?

    May 6, 2014 at 05:55 | Report abuse | Reply
  16. Jewell

    Awesome! Its actually amazing article, I have got much clear idea about from this piece of writing.

    May 6, 2014 at 09:37 | Report abuse | Reply
  17. Hildegard

    Hi! Do you know if they make any plugins to help with Search Engine Optimization? I'm trying to get my blog to rank for some targeted keywords but I'm not seeing very good gains. If you know of any please share. Many thanks!

    May 6, 2014 at 17:30 | Report abuse | Reply
  18. Marcus

    I think this is one of the most vital information for me. And i'm glad reading your article. But wanna remark on some general things, The web site style is wonderful, the articles is really excellent : D. Good job, cheers

    May 6, 2014 at 18:37 | Report abuse | Reply
  19. Imogen

    Just desire to say your article is as astonishing. The clearness in your post is just excellent and i can assume you are an expert on this subject. Well with your permission let me to grab your feed to keep up to date with forthcoming post. Thanks a million and please continue the gratifying work.

    May 6, 2014 at 21:26 | Report abuse | Reply
  20. Kara

    It's awesome in support of me to have a web site, which is good in favor of my knowledge. thanks admin

    May 6, 2014 at 21:54 | Report abuse | Reply
  21. Cathy

    Wonderful website. Plenty of helpful info here. I'm sending it to several buddies ans additionally sharing in delicious. And obviously, thank you in your effort!

    May 7, 2014 at 00:25 | Report abuse | Reply
  22. Hollis

    It's going to be ending of mine day, however before ending I am reading this wonderful piece of writing to increase my experience.

    May 7, 2014 at 03:15 | Report abuse | Reply
  23. Whitney

    I do not know whether it's just me or if perhaps everybody else encountering problems with your site. It appears as if some of the text on your content are running off the screen. Can somebody else please comment and let me know if this is happening to them too? This may be a issue with my web browser because I've had this happen before. Thank you

    May 7, 2014 at 04:27 | Report abuse | Reply
  24. Byron

    Ahaa, its nice discussion about this post here at this blog, I have read all that, so now me also commenting at this place.

    May 7, 2014 at 05:47 | Report abuse | Reply
  25. Dianna

    A person essentially assist to make significantly posts I might state. That is the first time I frequented your web page and to this point? I surprised with the analysis you made to create this actual publish amazing. Excellent task!

    May 7, 2014 at 07:23 | Report abuse | Reply
  26. nathan

    I've always had internet explorer and I never used anything else. What can google chrome and firefox do that internet explorer cant?.

    May 13, 2014 at 02:04 | Report abuse | Reply
  27. Yoko Atherholt

    Great post. Thanks for the read.


    January 27, 2016 at 13:41 | Report abuse | Reply
  28. Jamey Dena

    I think this is among the most vital info for me. And i am glad reading your article. But should remark on few general things, The website style is great, the articles is really excellent : D. Good job, cheers


    March 27, 2016 at 05:18 | Report abuse | Reply
  29. Ian Sehorn

    Sustain the remarkable job !! Lovin’ it!|


    May 17, 2016 at 18:19 | Report abuse | Reply
  30. Lyndon Giroir

    http://www.frenchblue7s2015forsale.comcheap French Blue 7s


    July 17, 2016 at 09:31 | Report abuse | Reply
  31. Destiny Amble

    El calor afecta a nuestros electrodomésticos tanto como a nosotros no olvide hacerle una revisión una vez al año antes de la temporada de calor, cuando las empresas de reparacion electrodomesticos están más descargadas de trabajo y pueden atenderle con mayor eficacia y rapidez. Las empresas de reparacion de electrodomesticos de Madrid suelen estar saturadas en las temporadas de calor, y más aun en la temporada de calor de este año, por lo que en la medida de lo posible intente revisar sus electrodomésticos en primavera en otoño cuando menos trabajo de reparación tienen los técnicos más baratos son los precios.


    August 4, 2016 at 08:51 | Report abuse | Reply
  32. DEWI4D

    DEWI4D http://dewi4d.org/

    August 19, 2016 at 03:38 | Report abuse | Reply
  33. Kym Kaighn

    It¡¦s truly a great and useful piece of information. I¡¦m satisfied that you just shared this useful information with us. Please stay us up to date like this. Thank you for sharing.


    August 28, 2016 at 22:16 | Report abuse | Reply
  34. Letha Robusto

    It’s remarkable to pay a visit this web page and reading the views of all friends about this paragraph,while I am also keen of getting know-how.


    August 28, 2016 at 23:05 | Report abuse | Reply
  35. Jeana Larsh

    I want to point out my appreciation for your kind-heartedness in support of women who have the need for guidance on this particular area. Your special commitment to passing the message all around became really powerful and has continually permitted many people just like me to get to their goals. Your amazing useful key points denotes a whole lot to me and further more to my peers. Thanks a ton; from each one of us.


    August 30, 2016 at 16:18 | Report abuse | Reply
  36. Shaneka Newer

    Thanks for any other great post. Where else may anyone get that kind of information in such an ideal manner of writing? I've a presentation subsequent week, and I am on the search for such info.


    September 5, 2016 at 01:04 | Report abuse | Reply
  37. Tabitha Cabiya

    Whats up very nice site!! Guy .. Beautiful .. Superb .. I will bookmark your blog and take the feeds additionally…I am satisfied to seek out so many useful information right here within the publish, we’d like work out more techniques on this regard, thank you for sharing.


    November 9, 2016 at 22:01 | Report abuse | Reply
  38. Gregg Sanderson

    produce,Whitened froth, rather same interest to find area, mild white over a chin, there’s magnificence that the rhythm, and then make a shout might be kinda hot.


    November 25, 2016 at 20:14 | Report abuse | Reply
  39. Daine Hornor

    I definitely wanted to jot down a brief comment in order to thank you for the unique hints you are showing on this site. My considerable internet search has at the end of the day been honored with sensible insight to write about with my close friends. I would point out that many of us visitors actually are unquestionably blessed to live in a good community with very many awesome individuals with very helpful concepts. I feel very lucky to have come across the web pages and look forward to many more enjoyable minutes reading here. Thank you once again for all the details.


    November 29, 2016 at 11:20 | Report abuse | Reply
  40. Johnna Kestle

    https://www.facebook.com/Pro-Fishing-Tricks-942433785889565/ fishing challenge sims freeplay


    December 1, 2016 at 12:38 | Report abuse | Reply
  41. Sunny Isles FL insurance

    Hey from Miami. I can declare that I've found some magnificent facts right here in this particular web-site about everything I necessary. This was really eye opening. Remember to sustain with good perform and supply a lot more useful facts like this. Thanks. PS You'll also come across fantastic linked subject matter on http://www.zoominfo.com/p/Leonardo-Cicarelli/1506225653


    December 6, 2016 at 21:51 | Report abuse | Reply
  42. general insurance agent

    Hi from Miami. I can really state that I have uncovered many great info here through this website about everything I essential. This was definitely eye opening. Make sure you keep up with very good function and supply far more handy details similar to this. Thanks. PS You could also find great very much the same content on http://www.zoominfo.com/p/Leonardo-Cicarelli/1506225653


    December 6, 2016 at 21:54 | Report abuse | Reply
  43. Chase Mondelli

    https://www.facebook.com/Pro-Fishing-Tricks-942433785889565/ fishing near medford or


    December 9, 2016 at 23:30 | Report abuse | Reply
  44. Beatrice Krzesinski

    Thanks , I’ve just been looking for information about this subject for a long time and yours is the best I have came upon till now. However, what about the bottom line? Are you positive concerning the source?


    December 18, 2016 at 20:25 | Report abuse | Reply
  45. Janise Collette

    Hiya, I’m really glad I have found this information. Nowadays bloggers publish only about gossip and internet stuff and this is really irritating. A good site with interesting content, this is what I need. Thanks for making this web site, and I will be visiting again. Do you do newsletters by email?


    December 21, 2016 at 08:13 | Report abuse | Reply
  46. Renato Azure

    I'm gratified by the manner in which thechart.blogs.cnn.com covers this sort of subject! Usually on point, often polemic, always thoughtful and more often than not quite thought-provoking.


    December 23, 2016 at 19:19 | Report abuse | Reply
  47. Issac Medler

    No one can deny from the feature of this video posted at this website Something to Behold | Anchored Amblings , nice job, keep it all the time.Ugg Classic Cardy http://www.projectced.org/En/UggClassicMini.html


    January 30, 2017 at 21:11 | Report abuse | Reply
  48. Ezra Elem

    Have you ever thought about publishing an e-book or guest authoring on other blogs? I have a blog centered on the same ideas you discuss and would really like to have you share some stories/information. I know my readers would value your work. If you’re even remotely interested, feel free to send me an email.


    February 20, 2017 at 08:03 | Report abuse | Reply
  49. Mitsue Soloman

    Well I sincerely enjoyed reading it. This post procured by you is very useful for good planning.


    March 14, 2017 at 07:00 | Report abuse | Reply
  50. Coy Buckman

    I¡¦ve been exploring for a little for any high-quality articles or weblog posts in this kind of area . Exploring in Yahoo I finally stumbled upon this site. Studying this info So i am glad to show that I’ve an incredibly just right uncanny feeling I found out exactly what I needed. I so much undoubtedly will make sure to don¡¦t forget this site and give it a glance on a continuing basis.


    March 23, 2017 at 02:01 | Report abuse | Reply
1 2 3 4

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.