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 Repair Around Me

    Hello, I do believe your website might be having browser compatibility issues. Whenever I look at your web site in Safari, it looks fine however when opening in Internet Explorer, it has some overlapping issues. I just wanted to provide you with a quick heads up! Other than that, wonderful site!


    June 24, 2021 at 17:35 | Report abuse | Reply
  2. RV Collision Repair Near Me

    You are so awesome! I do not suppose I've read anything like that before. So wonderful to discover somebody with a few genuine thoughts on this issue. Seriously.. many thanks for starting this up. This web site is one thing that is required on the internet, someone with some originality!


    June 24, 2021 at 18:29 | Report abuse | Reply
  3. RV Repair Shops Near Me

    This site truly has all the info I needed concerning this subject and didnít know who to ask.


    June 24, 2021 at 19:57 | Report abuse | Reply
  4. RV Appliance Repair Near Me


    June 24, 2021 at 20:08 | Report abuse | Reply
  5. RV Water Repair Man Near Me

    This site definitely has all of the information I needed about this subject and didnít know who to ask.


    June 24, 2021 at 20:32 | Report abuse | Reply
  6. Best RV Repair Near Me

    I seriously love your site.. Excellent colors & theme. Did you make this amazing site yourself? Please reply back as Iím trying to create my very own blog and would like to learn where you got this from or exactly what the theme is called. Thanks!


    June 24, 2021 at 21:33 | Report abuse | Reply
  7. Emilio Bousum

    How to uninstall firefox using command prompt or from registry?


    June 24, 2021 at 21:58 | Report abuse | Reply
  8. Emergency RV Repair Near Me


    June 24, 2021 at 23:10 | Report abuse | Reply
  9. RV Repairs Near My Location

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


    June 25, 2021 at 00:08 | Report abuse | Reply
  10. RV Fridge Repair Near Me

    I must thank you for the efforts you've put in writing this blog. I really hope to check out the same high-grade blog posts by you later on as well. In fact, your creative writing abilities has encouraged me to get my very own blog now 😉


    June 25, 2021 at 00:30 | Report abuse | Reply
  11. RV Repair Shops Near Me

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


    June 25, 2021 at 01:07 | Report abuse | Reply
  12. RV Repair Near My Location


    June 25, 2021 at 01:52 | Report abuse | Reply
  13. Sprinter Repair Costa Mesa


    June 25, 2021 at 02:00 | Report abuse | Reply
  14. Camper Repair Places Near Me

    Hi! I simply wish to offer you a huge thumbs up for the excellent information you've got right here on this post. I'll be returning to your site for more soon.


    June 25, 2021 at 03:46 | Report abuse | Reply
  15. pharmacepticacom

    chloroquinolone malaria https://www.pharmaceptica.com/

    June 25, 2021 at 03:52 | Report abuse | Reply
  16. RV Repair Centers Near Me

    The very next time I read a blog, I hope that it won't fail me just as much as this particular one. I mean, I know it was my choice to read, but I actually believed you'd have something useful to say. All I hear is a bunch of moaning about something you can fix if you weren't too busy looking for attention.


    June 25, 2021 at 05:18 | Report abuse | Reply
  17. toy restoration near me


    June 25, 2021 at 05:48 | Report abuse | Reply
  18. 24 Hour RV Repair Near Me

    An intriguing discussion is definitely worth comment. I think that you should write more about this topic, it may not be a taboo subject but usually people do not discuss such topics. To the next! Best wishes!!


    June 25, 2021 at 07:31 | Report abuse | Reply
  19. RV Refrigerator Repair Near Me

    You made some good points there. I checked on the web for more information about the issue and found most people will go along with your views on this site.


    June 25, 2021 at 08:47 | Report abuse | Reply
  20. Nearby RV Repairs

    Hello, I do think your website might be having internet browser compatibility issues. When I look at your site in Safari, it looks fine however, when opening in Internet Explorer, it's got some overlapping issues. I just wanted to give you a quick heads up! Other than that, wonderful site!


    June 25, 2021 at 09:31 | Report abuse | Reply
  21. RV Repair Centers Near Me

    I truly love your site.. Very nice colors & theme. Did you make this website yourself? Please reply back as Iím wanting to create my own personal site and would like to know where you got this from or what the theme is named. Many thanks!


    June 25, 2021 at 10:27 | Report abuse | Reply
  22. RV Repair Santa Ana

    This web site definitely has all the information and facts I needed concerning this subject and didnít know who to ask.


    June 25, 2021 at 11:55 | Report abuse | Reply
  23. Leadership Connect


    June 25, 2021 at 11:59 | Report abuse | Reply
  24. RV Service Repair Near Me

    This web site really has all of the info I wanted concerning this subject and didnít know who to ask.


    June 25, 2021 at 12:01 | Report abuse | Reply
  25. RV Exhaust Repair Near Me

    Aw, this was an incredibly good post. Taking the time and actual effort to create a superb articleÖ but what can I sayÖ I hesitate a lot and don't seem to get nearly anything done.


    June 25, 2021 at 12:25 | Report abuse | Reply
  26. RV Repair Services Near Me


    June 25, 2021 at 13:17 | Report abuse | Reply
  27. pharmaceptica

    hydroxychloroquine sulfate uses https://pharmaceptica.com/

    June 25, 2021 at 13:20 | Report abuse | Reply
  28. RV Exhaust Repair Near Me


    June 25, 2021 at 14:31 | Report abuse | Reply
  29. Nearby RV Repair

    Spot on with this write-up, I actually believe that this web site needs far more attention. Iíll probably be back again to read through more, thanks for the info!


    June 25, 2021 at 15:17 | Report abuse | Reply
  30. Clifford Einck

    I love to write creative things such as poetry and short stories, but I don't know what I would be able to do with the creative writing degree. . . Besides an author or poet, what can I do with a creative writing degree?.


    June 25, 2021 at 15:29 | Report abuse | Reply
  31. Camper Repair Near Me

    This blog was... how do you say it? Relevant!! Finally I have found something which helped me. Kudos!


    June 25, 2021 at 15:56 | Report abuse | Reply
  32. RV Tire Repair Near Me

    This is a topic that is close to my heart... Cheers! Where are your contact details though?


    June 25, 2021 at 15:59 | Report abuse | Reply
  33. Pearlene Weld

    You made some decent points there. I looked on the internet for more info about the issue and found most people will go along with your views on this site.


    June 25, 2021 at 16:20 | Report abuse | Reply
  34. RV Repair

    Excellent article. I absolutely appreciate this site. Keep writing!


    June 25, 2021 at 16:38 | Report abuse | Reply
  35. RV Repair Near Me


    June 25, 2021 at 18:09 | Report abuse | Reply
  36. RV Satellite Repair Near Me


    June 25, 2021 at 19:18 | Report abuse | Reply
  37. RV Generator Repair Near Me

    You made some decent points there. I checked on the web to learn more about the issue and found most people will go along with your views on this web site.


    June 25, 2021 at 19:50 | Report abuse | Reply
  38. Karine Redburn


    June 25, 2021 at 19:59 | Report abuse | Reply
  39. Dustin Bankos


    June 25, 2021 at 20:17 | Report abuse | Reply
  40. RV Repair Fountain Valley


    June 25, 2021 at 20:50 | Report abuse | Reply
  41. best one hitters

    Intrinsic Muscles Of The Handhttps://www.posts123.com/user/769056/hosekale97All products intended for use with legal smoking/vaping mixtures only .


    June 25, 2021 at 20:55 | Report abuse | Reply
  42. Camper Repair Shops Near Me

    Your style is really unique compared to other people I've read stuff from. Thank you for posting when you've got the opportunity, Guess I'll just bookmark this site.


    June 25, 2021 at 21:32 | Report abuse | Reply
  43. Carlyn Canova

    You're so cool! I do not suppose I have read through something like that before. So wonderful to discover someone with a few genuine thoughts on this issue. Really.. thank you for starting this up. This web site is something that's needed on the web, someone with a bit of originality!


    June 25, 2021 at 21:33 | Report abuse | Reply
  44. RV Body Repair Near Me

    Having read this I believed it was very enlightening. I appreciate you taking the time and effort to put this short article together. I once again find myself spending way too much time both reading and commenting. But so what, it was still worth it!


    June 25, 2021 at 22:08 | Report abuse | Reply
  45. Nearby RV Repair


    June 26, 2021 at 02:20 | Report abuse | Reply
  46. RV Roof Repair Service Near Me


    June 26, 2021 at 03:44 | Report abuse | Reply
  47. RV Repair Huntington Beach


    June 26, 2021 at 04:10 | Report abuse | Reply
  48. Camper Repair Places Near Me


    June 26, 2021 at 05:23 | Report abuse | Reply
  49. Ulrike Tako

    Hi, I do think this is an excellent site. I stumbledupon it 😉 I am going to come back yet again since i have book marked it. Money and freedom is the greatest way to change, may you be rich and continue to help other people.


    June 26, 2021 at 06:22 | Report abuse | Reply
  50. RV Repair Shop Near Me


    June 26, 2021 at 06:57 | 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.