Dr Harvey Karps 5 S's
Dr Karps 5 S’s refers to swaddle, side-stomach position, shush, sway and suck. Each individual S word is aimed at activating a calming reflex and when used in combination with each other, intends to imitate a mother’s womb.
This settling technique was created on the basis that human bubs are born early, unlike other mammals who stay in utero for around 18-22 months and can walk, even run, on the day they’re born. This early eviction from the womb, which is necessary due to the size of a bub’s head, means they’re vulnerable and immature, completely reliant on their caregivers catering for their needs.
I recommend using the 5 S Setting technique in the order they have been listed above as you may find only 1-2 of the steps is needed to calm your bub. Ideally, these steps should be practiced when your newborn is calm to familiarise them with each step, increasing the chance of success with this technique when your bub is becoming fussy.
Swaddle
When trying to calm a fussy newborn, the initial step ‘swaddle’ aims to imitate your bub being hugged tightly in the womb. Swaddling involves snuggly wrapping your bub with their arms by their side whilst still allowing some movement around their hips. This type of snug wrapping aims to minimalise their startle reflex, flailing arms and accidental whacks that can often wake a newborn or cause them to become upset.
Being wrapped in a tight, warm position that resembles a hug can help soothe your bub and is an essential step to effectively reduce crying and other distractions, allowing a fussy newborn to be in a more relaxed state, feeling reassured and to concentrate on further soothing.
Although initially it may seem like your bub does not wish to be wrapped in this way, within weeks they may be instantly calmed by tight swaddling. If swaddling alone does not calm your bub, it is still the necessary first step used in this strategy and helps your bub pay attention to the next step that will assist in soothing them.
Side or Stomach laying
To further soothe a fussy newborn, side or stomach laying can be used. Placing your bub in a side-stomach position takes the pressure off their belly and simulates a womb like sensation.
Placing your bub on their back can activate the startle reflex which can cause a newborn to have the sensation of falling. Using the side-stomach position helps to prevent this reflex especially if a caregiver has completed step 1 and the bub is swaddled.
This side-stomach position is only to be used when your bub is held in someone’s arms. A newborn bub should never be placed in this position onto any other surface.
Shushing
To further soothe a fussy newborn, side or stomach laying can be used. Placing your bub in a side-stomach position takes the pressure off their belly and simulates a womb like sensation.
Placing your bub on their back can activate the startle reflex which can cause a newborn to have the sensation of falling. Using the side-stomach position helps to prevent this reflex especially if a caregiver has completed step 1 and the bub is swaddled.
This side-stomach position is only to be used when your bub is held in someone’s arms. A newborn bub should never be placed in this position onto any other surface.
Swing
Swing is the fourth S you can use when attempting to settle a fussy newborn. During the nine months prior to being born, a fetus is immersed in a warm fluid and bounces with each of their mothers’ steps.
When trying to calm your bub, mimicking these comforting and familiar movements by swinging your bub from side to side using fast, short movements of no more than an inch or two can be enough to activate their calming reflex.
Once your bub is sleeping, these rapid movements can be gradually eased into a slow sway to keep your bub settled and asleep.
Suck
The final step in Karp’s 5 S’s is suck. By the time you reach this step, it is likely that your bub's calming reflex will have been activated and they will be soothed in your arms.
Sucking releases soothing cerebral endorphins and is usually a good way to further enhance the calming reflex and support your bub getting into a deeper sleep.
This step could be assisted by a dummy (non-nutritive sucking) or even a nipple (nutritive sucking) to provide the ultimate level of comfort.
When used in isolation, each S aims to imitate an element of the womb for a newborn. However, when used in combination with each other, the steps have the ability to turn on a bub's calming reflex and envelope them in a state of familiar soothe simulating the womb.
Click here to view this technique in action.
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