How can I ease my baby’s pain during immunizations?

Article at a Glance:
• The 5 S’s can be a good tool for reducing distress in infants.
• Other options may also provide relief.
• Parental mood is important, too.

While it’s crucially important that parents bring infants in for their immunizations, even the most shot-positive parents may feel sympathetic pain when the time comes. Luckily, there are measures you can take to soothe and comfort your baby and minimize trauma from the dreaded shot.

One method is called the 5 S’s, developed by Dr. Harvey Karp. This method has gained traction in recent years following a 2012 study featured in Pediatrics that demonstrated its efficacy at reducing pain scores and length of crying in infants receiving shots. According to Dr. Karp, the 5 S’s combined simulate the security and calm of the womb environment.

Dr. Karp’s 5 S’s are easy to remember and can be done by either parent. And as a bonus, they can make the provider’s job easier, too. Giving a shot to a still, calm patient is much preferable to the same task on a squirming, squalling, miserable patient. Here are the 5 S’s:

  • Swaddling (either during the shot, with the legs free, or immediately after)
  • Holding the baby in a side/stomach position
  • Making calming shushing noises
  • Softly swinging the baby to and fro
  • Letting the baby suck on a pacifier

The CDC advocates for a few of the items in the 5 S’s (soft sounds and swaddling) with the addition of three other potential pain relievers: skin-to-skin contact, breastfeeding, and giving the infant something sweet. A 2015 review of multiple studies highlights the effectiveness of breastfeeding, noting that it works to reduce pain in babies in three ways. First, the skin to skin contact soothes and comforts (something most moms know well). Additionally, breastfeeding distracts children from the shot by engaging them in the action of feeding. Finally, it provides a sweet taste, something that has demonstrated soothing properties in infants on its own.

If breastfeeding is not an option, providing another source of sweet flavor (especially sucrose, which comes from cane or beet sugar) has been shown in several studies to reduce signs of pain in infants receiving immunizations. So, if you’re unable to breastfeed (or you’re a dad), a sucrose solution can still help minimize distress in your baby.

While knowing a range of strategies to minimize baby’s pain during immunizations is a great idea, another important “S” for you, the parent, is to stay calm. Some parents believe their children are anxious about shots only to be shocked when the same child doesn’t react that way when their partner is present for immunizations. If you’re intensely afraid of needles (or crying babies) it might be worth it to enlist help. Bringing a friend or family member to your first few well-child visits can be a big help—and an opportunity for much-needed social contact.

For a quick “cheat sheet” to help make immunization appointments less stressful, check out the CDC’s handy resource here.

Reviewed on November 1, 2018 by: Joseph Hershkop, M.D.
Joseph Hershkop, M.D.
Board-certified Pediatrician

Dr. Hershkop is a former New Yorker who really enjoys working with children from birth to age three, and is passionate about asthma, ADHD care, and dermatology. Languages: English, Hebrew

Saratoga Springs Office
Full Bio

Share this article:

Recommended Reading

Stay connected to your children’s health:

Want pediatric news, kid-friendly recipes and parenting tips?
Sign up for our patient parent newsletter:

Other great ways to connect: