The Calming Reflex
Working with new parents, I have found that one of the first realities they encounter is realizing that their new little one is not yet fully “ready” for the world at birth! During the first few months, babies fuss an average of 1.5 hours a day and 10% cry more than 3 hours a day (i.e., the medical definition of colic). YIKES! That is a lot of crying (and that does not include a parent’s crying)!
In a sense, babies are “evicted” from the womb after 9 months – if they remained any longer their heads would continue to grow to a size which makes delivery dangerous for them and their mothers.
Dr. Harvey Karp says the best way to calm a newborn is by re-creating the noises, movement, and the snug environment of the womb. Dr. Karp's critically acclaimed books and DVDs, “The Happiest Baby on the Block” and “The Happiest Toddler on the Block,” have made him one of the most-read paediatrician in north America. In his books, he explains that in the womb babies are constantly rocked, insulated by the warm and soft uterus walls and are soothed by the whooshing sound of blood flowing through the placenta - a sound about twice as loud as my vacuum cleaner! This explains why newborns have so much trouble adjusting after they are born. It is not that the world after birth is over-stimulating to them but rather that it is profoundly under-stimulating – it is no wonder why babies fall asleep when we take them to noisy basketball games or wedding receptions! The complete quiet and stillness oftentimes does more to disrupt their sleep than it does induce it. This is where the “calming reflex” has immediate relevancy. In Dr. Karp’s best selling book, “The Happiest Baby on the Block,” he outlines the “Five S’s” to calming a crying baby with the aims of helping parents and those working with children better effectively sooth infants and boost restful sleep.
The Five S’s To Calming a Crying Baby (Dr. Karp – The Happiest Baby Method)
#1: Swaddle
[?] What is it?
To wrap a crying or fussy baby snugly, arms at his sides, inside in a thin blanket (to avoid overheating).
*NOTE: Always lay a baby down to sleep on his back – never on his side or tummy.
[!] Why it works! Swaddling soothes babies by providing the secure feeling they enjoyed in the womb.
#2: Side or Stomach Position
[?] What is it?
Now that the baby has been swaddled, you can begin to calm him (if crying and fussing) by putting him on his side or stomach. Hold the baby in your arms in a side or tummy-down position, on your lap or over your shoulders.
*NOTE: Use this “S” only for soothing – never* put an infant on his side or stomach when he is sleeping. Once he falls asleep, lay him on his back.
[!] Why it works!
To reduce the risk of SIDS, it is recommended to put babies to SLEEP on their BACKS but, because newborns feel more secure and content on their side or tummy, these are great positions for SOOTHING (not sleeping).
#3: Shushing
[?] What is it?
The "shush" step is achieved by loudly saying "shhh" into your swaddled baby's ear as you hold him on his side or tummy. Put your lips right next to the baby's ear and "shhh" loudly (usually while gently jiggling him – see "S" #4). Shush as loudly as your baby is crying. As he calms down, lower the volume of your shushing to match.
[!] Why it works!
Having spent months in utero, where blood flow makes a shushing sound, newborns are able to calm down and sleep better in noisy environments. However, remember that not all noises are alike.
#4: Swinging
[?] What is it?
While shushing the swaddled baby in a side or stomach position, “jiggle” the baby using very small rapid movements. Be sure to support the newborns head and gentle jiggle (not shake) him.
[!] Why it works!
In utero, babies were often rocked and jiggled – in motion. This makes jigging familiar and comforting to a newborn.
#5: Sucking
[?] What is it?
This simply means giving a swaddled newborn a pacifier/soother if he is upset. This step tends to be more a personal decision for many parents, respectfully so. In combination with being held on the baby’s side or tummy, being soothed with a loud shushing, and being gently jiggled, sucking may help to calm.
[!] Why it works?
Some babies instinctually “suck” on their thumb or pacifier and find comfort in it.
[CHILD LIFE]and the Five S’s: Applications to Newborn Injections/Vaccinations
Over the years, the standards for helping to reduce pain stemming from vaccinations or blood draws ect. has evolved. In the past, doctors recommended giving infants baby Tylenol or Advil to prevent possible fever from developing post vaccination and also to aid in pain relief. That, however, has changed in recent years as research indicated that giving acetaminophen (the main ingredient in Tylenol) before or after a vaccination made the vaccine less effective because fewer antibodies were consequently being produced.
Today, Dr. Harvey Karp’s Five S’s are being used as a highly effective non pharmacological alternative to pain-relief after infant vaccinations or blood work. His method was investigated in clinical trials where results found the majority of infants had stopped crying by a measured 45 second interval…. and, by the minute mark, none of babies who received the 5 S’s/physical intervention were yet crying. This study was published in the journal of Paediatrics and paved the way for the 5 S’s to be a NEW standard of pain relief in hospitals post infants injections or blood work.
As a Child Life Specialist, having implemented the 5 S’s in practice, I have not only witnessed the soothing potential of these 5 easy steps in triggering a newborn’s calming reflex during what can be very painful procedures but I receive the added satisfaction of knowing I have helped to empower parents who oftentimes feel very helpless in these healthcare scenarios –that is, arming them a with a highly effective non-pharmacological way to sooth and calm their infants and provide pain relief.
*TIPS for Use in Hospitals:
- Dr. Karp recommends swaddling the baby prior to the procedure, leaving the legs exposed (this is the spot where injections in young babies are likely made). This will help to trigger the calming reflex before the procedure.
- It is also recommended to have a white noise CD on before the injection happens (or any type of ‘swooshing’ sound).
Thanks so much for taking the time to read!
<3.
“Happy Baby, Happy Child Life Specialist… “
References:
The Happiest Baby on the Block (2003) – Book by Dr. Harvey Karp.
Easing Baby's Pain After Vaccination
Image Sources:
Book cover
DVD cover
How to swaddle
5 S's comic
