The 2 month-old check up may be harder for parents than it is for babies. Getting the first set of shots is anxiety provoking for we moms and dads; no question that it’s unsettling to allow a medical provider to cause our beautiful, new, healthy baby pain. Research has found that the pain and discomfort associated with shots is one of the primary reasons parents “elect not to perform timely vaccination.”
A study published this week affirms two truths. First, structured soothing may be a great tool for families to control crying after discomfort from shots. A group of pediatricians in Virginia used Dr Harvey Karp’s Happiest Baby on the Block 5S’s technique (shushing, swaddling, side positioning, sucking, and swinging/swaying) as an intervention for crying after the 2 and 4 month shots. The technique has been advertised to parents as a way to soothe and comfort fussy and colicky babies in the first few months of life. The researchers found that compared to a control group with no intervention and a group of babies that received a sugary solution for comfort prior to the shots, the 5S technique helped soothe crying and pain more rapidly. Most babies that were swaddled, shushed, swung, and offered a pacifier for sucking stopped crying within only 45 seconds. Second, the great reality is that most babies stop crying within 1 to 2 minutes of getting injections anyway. The study confirmed that, too! In my experience, only rarely does a baby leave clinic still crying. Some of our anxiety about the discomfort as parents can be relieved–we really need to get the word out this is a short process. It’s rare for a baby to cry for even 3 to 4 minutes after their injections.
From a parent perspective, most important task is to find a way that makes you feel you’re providing comfort. Sugary solutions (ie 24% sucrose) have repeatedly been found to provide pain relief for preemies and newborn babies undergoing painful procedures like circumcision and injections. Breastfeeding is a great way to soothe babies after routine injections, too. And although pediatricians previously recommended acetaminophen around the time of shots for pain control, recent research now finds that doing so could decrease the immune response. I routinely recommend no meds for babies on the day they get shots.
Reality is, you may not need to feed your baby sugar and you certainly don’t need to give them medicine when they get shots. In my opinion babies don’t need anything “special” at the time of shots. Your natural comfort and instinct to soothe with swaddling and breastfeeding can be a great comfort. Of course infants clearly don’t like the shot itself, most babies calm within minutes. The study found if you’re comfortable, you can also use the 5S technique to soothe your baby to provide quick soothing.
Of course, knowing that most babies calm in 1 or 2 minutes doesn’t mean the shots don’t hurt our baby’s legs and our Mama/Papa-hearts. No question my heart aches during my boys’ injections…
Details For Swaddling/Shushing/Sucking Intervention After Shots Study:
- 230 two and four month-old babies were put into 4 groups: 1) no intervention 2) 5S soothing by a resident doctor after shots 3) sugar solution 2 minutes before shots 4) sugar solution before shots and 5S soothing by a doctor after shots. Over 70% of babies were 2 month-olds during the study (getting their first round of shots) and over 80% of babies were African-American. None of the babies provided the 5S intervention were comforted by their parents after shots, rather by a pediatric resident trained in using the 5S technique.
- Researchers scored babies every 15 seconds for signs of pain using a standardized scale called the Modified Riley Pain Score. The pain score evaluates verbal/vocal score (no cry to high-pitched cry), body movements (calm to thrashing), and facial expressions (calm smiling to “full cry expression”). Babies received scores from 0 to 9 at each 15-second interval after shots.
- All intervention groups soothed more quickly than the group of babies with no intervention. But even in the group with no intervention (presumedly handed back to a parent), nearly all babies (over 80%) had minimal pain scores (<2 on the Riley scale) after 90 seconds.
- Overall, the study concluded using the 5S technique provided decreased pain scores and decreased crying time in 2 and 4-month old babies after routine immunization.
The takeaway is that infants do a beautiful job calming down after receiving routine 2 and 4-month shots. And that the 5S technique helps babies soothe more rapidly after shots. Talk with your baby’s pediatrician if you’re concerned about the discomfort associated with infant immunizations and tell me, how long did your baby fuss after shots? And what did you do that worked well to soothe (both you and) your newborn?