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Shots - Health Blog
2:40 am
Mon April 23, 2012

Swaddling and Shushing Help Soothe Babies After Vaccinations

Originally published on Mon April 23, 2012 6:57 am

Imagine you're a happy baby, off with your folks to visit the doctor.

"They're probably thinking, 'Oh hi everybody, hi!' and suddenly — boom! A shot," says John Harrington, a pediatrician in Norfolk, Va.

Who wouldn't scream at that?

But Harrington says that the same techniques used to soothe a fussy baby can also help an infant overcome the pain of vaccinations.

"It probably generates more pain than you or I have when we get a shot," says Harrington, a researcher at Children's Hospital of the King's Daughters in Norfolk, Va., because infants are so much smaller.

Harrington wanted to find a way to ease the pain and stress of a shot. So he studied 230 infants, who were two months old and four months old. He divided them into four groups. Two groups got water before a vaccination, while the other two got a sugar solution, a sort of liquid lollipop known to distract infants from pain. After the shot, half the babies got typical comfort care from their parents. The others received the "5 S's".

That's a method that Harvey Karp, a Los Angeles-based pediatrician, developed about a decade ago to calm a screeching infant. The technique involves swaddling the baby, putting the baby on her stomach, gently swinging her, shushing into her ear, and offering a pacifier to suck on.

The babies who received the "5 S's" physical intervention stopped crying much sooner than the infants who received comfort care from their parents. And their pain scores, as measured by flailing arms and facial grimaces, were also significantly less, says Harrington. The "5 S's" group did much better than the comfort care group, whether they got sugar water or not.

The results were published in the journal Pediatrics.

Karp says the method works because it simulates the security of the womb. "In the womb, there's a symphony of sensations, constant jiggling, constant whooshing, which is the sound of the blood flow through the arteries, and constant touching against the velvet walls of the womb."

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Transcript

STEVE INSKEEP, HOST:

Let's talk now about an easier problem to solve: comforting your baby when getting a shot. Researchers find that a technique used to calm infants and help them sleep also helps with pain. NPR's Patti Neighmond reports on the study published in the journal Pediatrics.

PATTI NEIGHMOND, BYLINE: Babies get lots of vaccinations. Most of them shots. And shots hurt.

DR. JOHN HARRINGTON: It probably generates more pain than you or I have when we get a shot.

NEIGHMOND: That's because the infant's so small. Dr. John Harrington, a pediatrician at Children's Hospital in Norfolk, Virginia, says it's even more stressful because the babies don't see it coming.

HARRINGTON: They're kind of like thinking, oh, hi, hi, everybody, hi.

(SOUNDBITE OF LAUGHTER)

HARRINGTON: And they get a shot.

RENEE MONTAGNE, HOST:

Harrington wanted to find a way to ease the pain and stress of a shot. So he studied 230 infants, 2 months old and 4 months old. He divided them into different groups. One group received water before vaccination, the other, a sugar solution - a sort of liquid lollipop - known to distract infants from pain. After the shot, one group got typical comfort care from their parents. The other got a specific type of physical intervention called the 5 Ss.

HARRINGTON: The babies with 5 Ss stopped crying at an earlier time and their pain scores were significantly less.

NEIGHMOND: The 5 Ss: swaddling the baby, putting the baby on their stomach, gently swinging them back and forth, shushing into their ear and offering a pacifier to suck on. Even without the pacifier, infants who got the other Ss suffered less pain and stress - as measured by flailing arms and grimaces.

(SOUNDBITE OF CRYING BABY)

NEIGHMOND: The 5 Ss were developed by pediatrician Harvey Karp, who today works with 3-and a-half-week old Henry Wick to demonstrate the technique.

(SOUNDBITE OF CRYING BABY)

NEIGHMOND: Henry's hungry. But not too hungry to be soothed and calmed by Karp.

DR. HARVEY KARP: So swaddling is the first step; in a big blanket because you have to wrap really snugly with the arms down.

NEIGHMOND: Constant reassuring touch simulates the security of the womb. Karp then places Henry on his stomach - the same position as during his last few months in utero. Then Karp shushes in Henry's ear.

(SOUNDBITE OF SHUSHES)

NEIGHMOND: It sounds loud to us. But to Henry it's sweetly reminiscent.

KARP: In the womb it's a symphony of sensations. There's the constant sound, that...

(SOUNDBITE OF SWOOSHING SOUND)

KARP: That's the sound of a blood flow through arteries.

NEIGHMOND: And all the while, Karp gently swings Henry back and forth, jiggling him, sort of like Jell-O on a plate. Henry sucks on Karp's thumb. All these Ss - swaddling, stomach, shushing, swinging and sucking work really quickly. Henry stops crying, appears peaceful - almost as if in a trance.

KARP: When parents learn this - it kind of looks like a parlor trick - could this possibly be so easy? But you have to remember is this is based on a reflex. So think of the knee reflex; if I whack your knee your foot goes out. Now it makes no sense really, why - if I hit the knee here, your foot jumps out. It's kind of magic, but it isn't really, it's just physiology.

NEIGHMOND: The 5 Ss can be used to calm babies through all kinds of stressful situations. It can help them sleep, or nap. Henry's mom, Ann Vanderpool, says it was simple to learn.

ANN VANDERPOOL: It's amazing because he does fuss right away; every time I swaddle him he doesn't like it at first but then he'll just stop crying - altogether. It works when he's a little fussy. It works when he's in a full-tilt fuss, screaming as loud as he can, and just all of a sudden shut off. It's almost unnerving.

(SOUNDBITE OF LAUGHTER)

NEIGHMOND: The technique works well up to four months. But it starts to wane after that - as babies acclimate to the world around them - and memories of the womb fade.

Patti Neighmond, NPR News.

(SOUNDBITE OF MUSIC)

INSKEEP: It's MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.