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Research backs up the power of the 5 S's to soothe babies

To quickly soothe babies after a round of shots, all parents have to do is learn the "5 S's": swaddling, side/stomach position, shushing, swinging and sucking, according to a study out Monday.

A sixth "S," sugar, which previous studies have shown to be an effective pain reliever for infant immunizations, didn't provide any additional benefit when used with the first five, researchers found.

Dr. Harvey Karp, who was not involved with the new study, describes the 5 S's in his DVD and his book, The Happiest Baby on the Block.

"This isn't really just about immunizations," Karp says. Crying babies and the resulting exhaustion and loss of confidence are leading triggers for marital stress, breast-feeding failure and shaken baby syndrome, says Karp, who's speaking Thursday about strategies to calm infant crying and toddler tantrums at the National Conference on Child Abuse and Neglect in Washington, D.C.

The 5 S's grew out of the realization that babies are born with a calming reflex, Karp says. By replicating the womb environment -- "a symphony of sensations" -- caregivers can quickly put babies in the calm zone, he says.

"Parents do many of these things intuitively, but they may not be doing them correctly," Karp says. "You have to do them (5 S's) exactly right, or they don't work." For example, he says, the swaddling must be tight, and the shushing has to be pretty loud (think about how a vacuum cleaner can calm a crying baby).

The new study, in the journal Pediatrics, used a YouTube video to train pediatric residents at Children's Hospital of The King's Daughters in Norfolk, Va., how to perform the 5 S's. The study enrolled 230 2-month-old and 4-month-old babies and randomly divided them into four groups: After their shots, they either got the 5 S's or their parent's standard comforting care, and they received plain water or sugar water.

The babies received three shots in alternating thighs. The residents then swaddled the babies in under 15 seconds and provided at least three of the other 5 S's within 30 seconds of the shots (some of the babies calmed down before sucking on a pacifier, the 5th S, or were unaccustomed to using one).

The residents rated the babies' pain, based on how hard they were crying and their facial experessions, immediately after the third shot and continued for two to five minutes. The 5 S's calmed the babies significantly better than the parents' efforts, whether or not sugar was added to the mix.

Lead author Dr. John Harrington says he came up with the idea for the study after hearing Karp speak. Harrington says he and other pediatricians sometimes give babies acetaminophen (Tylenol) to ease shot pain, but recent research found the drug might reduce their antibody response to immunizations. Breast-feeding is effective, he says, but not all women breast-feed.

"I think the nice thing that came out of this is when we did the 5 S's after the shots, the parents wanted to learn," Harrington says.

Harrington's team might have seen the 5 S's calm the babies even more quickly if they'd swaddled all but one leg before administering the shots, Karp says.

Unfortunately, as many parents might have noticed, the calming reflex goes away after about three months, Karp says, and Harrington found the 5 S's didn't work as well with 4-month-olds as with 2-month-olds.

Did you try the "5 S's" with your baby? Did it work?