Online-only: Simple strategies can calm infants, reduce pain during shots
=========================================================================

* Teddi Dineley Johnson

While routine immunizations protect babies against more than a dozen serious childhood illnesses, the shots can be distressing for children. But a few simple interventions can go far in calming fears and drying tears, according to a recent study.

The interventions, which include swaddling, shushing, swinging and sucking, can reduce pain and crying among infants receiving 2- and 4-month vaccinations, according to the study. Published April 16 in the journal *Pediatrics*, the study found that the simple interventions significantly reduced infants’ pain with or without the use of a pain-reducing oral sucrose solution.

Giving babies sucrose — a sugar and water solution — by mouth to reduce the pain of infant vaccinations has been well-established, the study noted. Sugar and water solutions work by causing the body to release natural pain-relieving chemicals. However, when physical interventions such as swaddling and swinging were used alone, infants’ pain and crying time were essentially the same — and at times even lower — than when sucrose was given along with them.

The findings are important because research has turned up few options for alleviating infants’ pain during immunizations.

“It is clear that clinicians would like to reduce the pain and parental anxiety, during and soon after vaccination,” the study authors wrote. “However there is little evidence that the use of analgesics such as acetaminophen or ibuprofen are effective.”

Earlier studies have found that giving acetaminophen at the time of vaccination significantly reduces antibody levels to several of the vaccine antigens. And while topical anesthetics work, they are generally not used in medical practices because of the expense and the long waiting period required after application, the study noted.

To conduct the study, researchers examined data gathered during the well-child visits of 230 infants ages 2 months and 4 months. Some or all of the physical interventions were administered by parents in combination with either plain water or an oral sucrose solution immediately after vaccination. Infants’ pain was assessed at 15-second intervals for two minutes, then every 30 seconds for up to five minutes post vaccination. The results revealed that the physical interventions, such as swaddling and shushing, resulted in lower scores on the pain scale and decreased crying time.

The physical interventions provided “significant pain reduction with or without sucrose during routine 2- and 4-month vaccinations,” the authors concluded. They noted that additional study is needed to determine if the interventions can be useful for other painful procedures, and whether parents can be taught to perform them reliably.

The study is available at [http://pediatrics.aappublications.org/content/early/2012/04/11/peds.2011-1607.short](http://pediatrics.aappublications.org/content/early/2012/04/11/peds.2011-1607.short).

*   Copyright The Nation’s Health, American Public Health Association