The 5 s's for soothing a crying baby

What are the 5 S's?

The 5 S's are part of pediatrician Harvey Karp's "Happiest Baby" method from his 2002 book "The Happiest Baby on the Block."¹ The idea is based on calming babies by mimicking the sensations they used to from the womb.

The method was formulated by Karp to help soothing babies with colic. For getting the most effect, he recommends combining all of the S's simultaneously.

The First S: Swaddling

Swaddling is a technique where you wrap the baby in a stretchy blanket so that the arms are gently embraced (straight at the sides) while the hips are loose and movable.

Karp suggests that swaddling is calming for the baby as it mimics the snug and embraced sensation of the womb. It also prevents the startle reflex - a sudden jerking of the baby's arms that are triggered by falls, noises, or sudden movements and may wake them up.²

Swaddling should only be done with babies who have not yet learned to roll over on their stomach or side, as it could prevent them from rolling back.

Given the difficulty in predicting when a baby will start to roll, swaddling is discouraged in some countries, including Sweden, due to the risk of suffocation. However, it is a widely accepted practice in the USA.³

If you consider swaddling your baby make sure to read about how to swaddle safely.

The Second S: Side or Stomach Position (for soothing)

Holding the baby on their side or stomach, for example, over your arm or against your shoulder or chest, can also help calm them down more quickly.

It's crucial however, to ensure that babies always lie on their back when sleeping to reduce the risk of Sudden Infant Death Syndrome (SIDS). If they've started rolling onto their stomach by themselves and do so while sleeping, it's okay to leave them in that position.⁴

The Third S: Shushing

Making a "shhh" sound or playing white noise may sooth the baby. Harvey Karp recommends using continuous, soft, rumbling white noise that mimics the sound inside the womb.

Karp explains that babies are accustomed to a noise level similar to a vacuum cleaner from the blood flow inside the mother's body, often preferring a louder environment over silence for calming and sleeping. This is supported by research showing that babies who listen to white noise fall asleep faster than those who do not.

In Napper, you can find various types of white noise, including sounds with heartbeats and softer noises reminiscent of the womb's sound.⁵

The Fourth S: Swinging

In the womb, the baby is used to a lot of movement. While rocking motions can help a calm baby fall asleep or continue sleeping, a crying baby often needs smaller, quicker movements to be soothed.

Karp recommends a technique he calls "Jell-O-head jiggle," supporting the baby's head and neck with small movements less than about 1 inch (2.5 cm). Remember: rocking babies should always be done gently, with their head and neck supported..⁶

The Fifth S: Sucking

Breastfeeding, sucking on a pacifier or the thumb is calming for babies. Sucking has been shown to lower the baby's heart rate, blood pressure, and stress levels.

If you're breastfeeding, it's important not to introduce a pacifier until breastfeeding is well established to avoid interfering with the baby's learning of proper sucking techniques, which differ between breastfeeding and pacifier use. Frequent nursing is also necessary to stimulate milk production

If the 5 S's Don't Work

If you're struggling to soothe your child with these methods, Karp suggests considering if something is making your baby uncomfortable or if they need something else (e.g., if they're hungry, have gas, or need a diaper change).

Otherwise, Karp advises checking if your baby might be suffering from a more serious issue than colic that needs investigation, such as allergies, urinary tract infections, or infant reflux. If you suspect an underlying cause, always contact a pediatrician.

Karp also emphasizes the importance of correctly performing the 5 S's and doing them simultaneously. For some babies, adding a pacifier and learning how to get them to accept it may be necessary.