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Physical Non-Pharmacological Intervention Decreases Immunization Pain in Infants

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Post vaccination pain and crying commonly seen in infants can be reduced by a strategy known as five S’s-swaddling, side or stomach positioning, shushing, swinging, and sucking on a pacifier.

Physical Non-Pharmacological Intervention Decreases Immunization Pain in Infants
The pain associated with infant immunization can be decreased by the use of five S’s intervention (swaddling, swinging, shushing, side stomach position and sucking), according to a recent study published online in Pediatrics journal. These techniques can effectively mitigate the immunization pain in 2 to 4 months old infants.
A prospective randomized, placebo-controlled trial was conducted by John W. Harrington, of the Eastern Virginia Medical School in Norfolk involving 230 infants in the age group between 2 and 4 months. These infants regularly attended their well-child visits. The experts wanted to analyze whether physical intervention with five S’s technique alone or in conjunction with orally administered sucrose would have a pain relieving effect in routine immunization.

For study purpose, the infants were grouped in four groups receiving 2 mL of water or 24 percent oral sucrose was given to them followed by either standard-of-care comfort measures by parents or five S’s intervention directly after vaccination. Post vaccination pain scoring was done repeatedly up to five minutes.

The experts discovered that the infants belonging to five S’s and five S’s plus sucrose groups showed identical pain scores. This score was considerably lower than the pain scores of those infants who received standard-of-care interventions. Low mean scores were recorded over the time and similar trend was seen with drying.

John W. Harrington said, "This study demonstrates that the physical intervention of the five S's resulted in decreased pain scores and decreased crying time among 2- and 4-month-old infants during their routine vaccinations. The five S's appear to be a viable non-pharmacologic option for clinics to implement when providing analgesia during vaccinations."

The conclusion drawn from the study was that the physical intervention of the five S’s viz. swaddling, side/stomach position, shushing, swinging, and sucking measures can effectively mitigate the pain associated with immunization. However the effects of five S’s were similar to that of five S’s and sucrose.

The authors stated, “This simple physical intervention will require additional studies to see whether it is reproducible for other painful procedures and whether parents can be taught to perform the 5 S's reliably."

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Reference:

Effective Analgesia using physical interventions for infant immunizations; John W Harrington et al; Pediatrics 2012

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