How many shots are we getting doc? We hear this a lot in primary care pediatrics. As I run through the vaccination counseling and touching on key points in the Vaccine Information Statement, the brow crease I often see on the forehead in the visibly anxious Mom and ah! yes, the crying infant - I get the keen sense the number of shots to be administered and by attrition the pain is a far bigger concern to the family in front of me than the peculiarities of each vaccination type I’m talking about.
How can we best relieve pain in these young ones during vaccination visits? We traditionally use comfort measures that often include administration of Acetaminophen to young ones after vaccinations as an adjunct in our practice. A group of researchers conducted a well designed study, on Effective analgesia using physical interventions for infant immunizations published this month in Pediatrics, 129(5):815-22 May 2012.
The 5 S’s (swaddling, swinging, shushing, suckling and side/stomach positioning) are well known comfort measures, what’s not known is how these fare when compared to a popular method of analgesia using pacifiers dipped in concentrated sugar solution (24% Sucrose). The sucrose is believed to soothe the infant in a complex way that involves the body releasing chemical signals from within that have a lot of similarity to powerful pain medications like morphine. Sucrose dipped pacifiers are popular during procedures like circumcision.
Groups of patients with infants at their 2-month and 4-month vaccination visits were assigned into a group that received comfort measures with the 5 S’s and another group that received 24% Sucrose dipped pacifiers. Their pain response was assessed using a standardized pain scale tool. The results which were recorded over a 7-minute period of observation in both groups and scoring assessment showed that the physical interventions of the 5 S’s decreased crying time and provided proof of effective analgesia that was as effective as what was seen in the group treated with the 24% Sucrose dipped pacifiers.
Hello Moms, lets cheer up! swaddling, rocking and raining all your best TLC moves on your babies after shots works very well for pain control. Now, we can continue the vaccination counseling conversation....