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 (1,997 Responses)
  1. RV Sales And Repair Near Me


    May 31, 2021 at 10:09 | Report abuse | Reply
  2. RV Fridge Repair Near Me

    Aw, this was an extremely nice post. Taking the time and actual effort to generate a great article… but what can I say… I hesitate a lot and don't manage to get nearly anything done.


    May 31, 2021 at 10:25 | Report abuse | Reply
  3. Van Alignment


    May 31, 2021 at 13:02 | Report abuse | Reply
  4. EncoxDev

    cheapest pharmacy for prescriptions without insurance canada drugs approved canadian pharmacies

    May 31, 2021 at 17:17 | Report abuse | Reply
  5. EncoxHtf

    cialis sell cialis extra dosage cialis and lisinopril

    May 31, 2021 at 19:26 | Report abuse | Reply
  6. 2006 Mercedes Sprinter 2500 Turbo Actuator Repair

    This is a topic that is near to my heart... Thank you! Exactly where are your contact details though?


    May 31, 2021 at 20:36 | Report abuse | Reply
  7. Sprinter 2500 Front Glass Repair

    You've made some decent points there. I checked on the web for additional information about the issue and found most individuals will go along with your views on this site.


    May 31, 2021 at 20:59 | Report abuse | Reply
  8. EncoxGtv

    canadian compounding pharmacy association are canadian online pharmacies legit Detrol

    May 31, 2021 at 23:09 | Report abuse | Reply
  9. Gmc Luxury Van Repair

    I really like reading a post that can make people think. Also, many thanks for permitting me to comment!


    May 31, 2021 at 23:18 | Report abuse | Reply
  10. Dodge Sprinter Service Near Me

    This excellent website certainly has all of the information and facts I needed concerning this subject and didn’t know who to ask.


    June 1, 2021 at 01:02 | Report abuse | Reply
  11. EncoxHtf

    cialis free 30 day supply cialis dosages can you take ibuprofen with cialis

    June 1, 2021 at 01:25 | Report abuse | Reply
  12. nova correção do fgts

    This is very interesting 506534749


    June 1, 2021 at 03:00 | Report abuse | Reply
  13. Mercedes Sprinter Service


    June 1, 2021 at 03:27 | Report abuse | Reply
  14. RV Windshield Repair Near Me


    June 1, 2021 at 04:46 | Report abuse | Reply
  15. Mercedes Benz Sprinter Turbo Actuator Repair

    Having read this I thought it was rather enlightening. I appreciate you finding the time and effort to put this article together. I once again find myself personally spending a significant amount of time both reading and leaving comments. But so what, it was still worthwhile!


    June 1, 2021 at 06:50 | Report abuse | Reply
  16. Van Frame Repair Shop Near Me

    Aw, this was an extremely nice post. Spending some time and actual effort to create a really good article… but what can I say… I hesitate a lot and never manage to get anything done.


    June 1, 2021 at 06:57 | Report abuse | Reply
  17. RV Repair Centers Near Me

    Good day! I just wish to offer you a big thumbs up for the excellent info you have got here on this post. I'll be returning to your web site for more soon.


    June 1, 2021 at 08:41 | Report abuse | Reply
  18. Zisseloh

    taking 2 cialis orignal cialis genaric cialis

    June 1, 2021 at 10:20 | Report abuse | Reply
  19. rv parks orange county california

    I could not refrain from commenting. Very well written!


    June 1, 2021 at 10:45 | Report abuse | Reply
  20. rv remodeling companies near me


    June 1, 2021 at 11:27 | Report abuse | Reply
  21. Gmc Luxury Van Repair


    June 1, 2021 at 11:43 | Report abuse | Reply
  22. Emergency Vehicle Repair


    June 1, 2021 at 12:42 | Report abuse | Reply
  23. Freddie Roskopf

    I absolutely love your site.. Pleasant colors & theme. Did you develop this amazing site yourself? Please reply back as I’m wanting to create my own blog and would like to find out where you got this from or just what the theme is named. Kudos!


    June 1, 2021 at 14:13 | Report abuse | Reply
  24. rv parts temecula


    June 1, 2021 at 15:07 | Report abuse | Reply
  25. Inga Millbern

    I blog quite often and I really appreciate your information. The article has truly peaked my interest. I'm going to book mark your website and keep checking for new details about once a week. I opted in for your Feed as well.


    June 1, 2021 at 15:25 | Report abuse | Reply
  26. Van Repair


    June 1, 2021 at 20:47 | Report abuse | Reply
  27. Rudy Collar


    June 1, 2021 at 21:12 | Report abuse | Reply
  28. Joaquin Somoza


    June 2, 2021 at 00:38 | Report abuse | Reply
  29. motorhome repair near me

    I'm extremely pleased to uncover this site. I want to to thank you for your time just for this fantastic read!! I definitely savored every bit of it and i also have you saved to fav to check out new information on your blog.


    June 2, 2021 at 00:51 | Report abuse | Reply
  30. Fermin Natvig


    June 2, 2021 at 01:37 | Report abuse | Reply
  31. rv repair near me now


    June 2, 2021 at 07:52 | Report abuse | Reply
  32. EncoxAni

    canada world pharmacy best ed pills Trandate

    June 2, 2021 at 08:01 | Report abuse | Reply
  33. Jess Reino

    Hi, I do believe this is a great site. I stumbledupon it 😉 I will come back yet again since I saved as a favorite it. Money and freedom is the best way to change, may you be rich and continue to guide others.


    June 2, 2021 at 08:16 | Report abuse | Reply
  34. Sprinter Van Technician Shop Near Me


    June 2, 2021 at 09:16 | Report abuse | Reply
  35. Keenan Wernert

    When I initially commented I appear to have clicked on the -Notify me when new comments are added- checkbox and now every time a comment is added I recieve 4 emails with the same comment. Perhaps there is a means you are able to remove me from that service? Kudos!


    June 2, 2021 at 09:29 | Report abuse | Reply
  36. Gail Janvier


    June 2, 2021 at 10:52 | Report abuse | Reply
  37. rv trailer repair near me

    I used to be able to find good advice from your blog posts.


    June 2, 2021 at 10:57 | Report abuse | Reply
  38. Argentina Huels

    Hi, I do think this is a great web site. I stumbledupon it 😉 I am going to revisit yet again since I saved as a favorite it. Money and freedom is the best way to change, may you be rich and continue to guide other people.


    June 2, 2021 at 11:22 | Report abuse | Reply
  39. EncoxGtv

    are canadian online pharmacies safe free prescription drugs at walmart canadian pharmacy kingcanadian viagra

    June 2, 2021 at 12:03 | Report abuse | Reply
  40. Julio Alldredge


    June 2, 2021 at 13:14 | Report abuse | Reply
  41. solar panels orange county

    Oh my goodness! Incredible article dude! Thank you so much, However I am experiencing problems with your RSS. I don’t understand why I am unable to join it. Is there anybody having identical RSS issues? Anyone that knows the answer can you kindly respond? Thanks!!


    June 2, 2021 at 15:18 | Report abuse | Reply
  42. repair near me

    Hi there! I could have sworn I’ve been to this website before but after going through a few of the posts I realized it’s new to me. Anyhow, I’m certainly delighted I discovered it and I’ll be bookmarking it and checking back often!


    June 2, 2021 at 18:57 | Report abuse | Reply
  43. Nissan High Top Van Repair Shop


    June 2, 2021 at 21:43 | Report abuse | Reply
  44. CrulkAsd

    buy cialis 36 hour online cialis online cialis to buy

    June 2, 2021 at 22:31 | Report abuse | Reply
  45. Sprinter Van Restoration Shop Near Me


    June 2, 2021 at 22:50 | Report abuse | Reply
  46. Demarcus Eilbeck

    Good post. I learn something new and challenging on blogs I stumbleupon on a daily basis. It's always useful to read content from other writers and use a little something from their sites.


    June 2, 2021 at 23:18 | Report abuse | Reply
  47. Bobbie Waidelich

    Have you ever heard of second life (sl for short). It is basically a online game where you can do anything you want. sl is literally my second life (pun intended lol). If you would like to see more you can see these sl websites and blogs


    June 3, 2021 at 00:26 | Report abuse | Reply
  48. Social Media Marketing Agency Around Me

    Way cool! Some extremely valid points! I appreciate you penning this write-up plus the rest of the website is also really good.


    June 3, 2021 at 03:36 | Report abuse | Reply
  49. Video Marketing Consultants

    Your style is very unique compared to other people I've read stuff from. Thank you for posting when you've got the opportunity, Guess I will just book mark this blog.


    June 3, 2021 at 04:18 | Report abuse | Reply
  50. toy hauler remodel

    After checking out a handful of the blog posts on your site, I honestly like your way of blogging. I saved it to my bookmark website list and will be checking back soon. Take a look at my website too and tell me your opinion.


    June 3, 2021 at 04:33 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39

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.