怎样打针宝宝才不哭

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ANAHAD O'CONNOR 报道 2012年12月24日  纽约时报


Noel Celis/Agence France-Presse — Getty Images
最新研究发现，家长通过一系列安抚手段，可以减轻孩子接种疫苗的疼痛。

给婴儿打疫苗，对于父母和婴儿来讲都是个痛苦的经历。不过，一项新的研究显示，家长可以通过一系列快捷的安抚手段安慰小朋友，减轻扎针一瞬的疼痛。其中就包括了最受欢迎的“襁褓法”。

这个方法是由《宝宝不哭》(The Happiest Baby on the Block)的作者、儿科医生哈维·卡普(Harvey Karp)推而广之的。该书传授了被称作“5S系统”的五种方法。除了襁褓法，也就是用轻柔的毯子紧紧裹住婴儿，还可以让婴儿侧躺或趴在看护者的手臂中；轻轻摇动；让他们吮吸奶嘴；以及在其耳边发出“嘘，嘘”的声音。根据卡普医生的说法，这几个步骤合起来是通过模仿小婴儿在子宫中的感觉而使他们镇定下来的，此法亦可广泛用在对付哭闹和闹肠绞痛的婴儿上。

在这项发表于《儿科学》(Pediatrics)上的新研究中，独立研究者将5S系统教给一些住院医师，让他们在为2-4个月大的婴儿做常规体检和接种疫苗时运用，以测验系统的有效性。按照惯例，婴儿在两个月体检时至少要接受三针疫苗；四个月时再接受两针。

领导此研究的是美国弗吉尼亚州诺福克市儿童医院(Children’s Hospital of the King’s Daughters)的约翰·哈林顿(John Harrington)医生。他一开始很怀疑是否光使用5S系统就能达到良好效果，但他猜想，如果和普遍认为能减轻婴儿疼痛的糖水一起使用，5S技术也许真的可以安抚那些刚刚挨了一针、正哭得梨花带雨的小家伙们。

哈林顿医生和他的同事们把230名小婴儿分作四组，在给他们打针前喂一剂液体——两毫升白水（小半勺），或是两毫升糖水。其中两组婴儿在打针后由父母或看护者安抚；另外两组则由培训过的医师用5S方法安抚。注射后的15秒内，医师要把婴儿包在襁褓里，让宝宝侧躺或趴在自己的胳膊上，边摇晃边发出嘘声，同时让他们吮吸安抚奶嘴。

一位受过培训的观察员在诊室里通过观察婴儿的行为，如尖声叫喊、愁眉苦脸、呜咽等，来判断其疼痛程度。观察员用一种标准的等级量表来评估婴儿究竟有多痛。

研究者发现，总体来说运用5S系统——他们称其为“医疗干预”——能稳定地得出较低的疼痛分数，无论婴儿事先喝过糖水与否。

“一开始，我们认为是糖水和医疗干预共同起的作用，”哈林顿医生（他也是这所医院普通儿科学的部门主管）说：“可我们后来发现只用医疗干预就已经效果很好了。确实无需在打针前喂糖水。”

哈林顿医生说通常医师们至少可以完成五步中的四步，看似最无足轻重的一项就是给小婴儿一个奶嘴。“有时候孩子根本不想吸奶嘴，可能会把它吐出去，”他说，“好像这并不是非用不可。”

他说最关键的一步貌似是襁褓包裹，而这同时也是医师们最不容易学会的一步。医师们通过观看示范正确方法的视频来学习包裹。若是包得太紧了，会造成婴儿髋关节发育不良（早先有这类报道）。这项研究还提供了YouTube上演示此方法的视频链接。

哈林顿医生说，他和很多家长都对这一出色结果深感惊讶。

“实话说，我原来是不相信的，所以我才做这个研究，”他说，“但是当你亲眼看见把大声哭闹、胡乱踢打的婴儿包裹起，让他侧躺着，并在其耳边轻轻发出嘘声之后，他就好像进入短暂恍惚状态时，你就会觉得安抚反射(calming reflex)真的启动了。”

“然后家长们就会说：‘哇！快教我怎么做。’”

本文最初发表于2012年4月16日。
翻译：孙舒雯

MP4

求YouTube

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MP4 发表于 2012-12-26 11:26
求YouTube

Baby Calming Magic

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Making Baby’s Shots Less Tearful

http://well.blogs.nytimes.com/20 ... shots-less-tearful/

Infant vaccinations can be a distressing experience for both parent and child. But new research suggests that parents can lessen the sting of an injection by soothing their babies with a quick series of comforting measures, including a popular technique called swaddling.

The method, popularized by the book “The Happiest Baby on the Block,” by Dr. Harvey Karp, a pediatrician, involves five measures known as the five S’s. In addition to swaddling, or wrapping the baby snugly in a light blanket, they include putting the baby in a side or stomach position in the guardian’s arms, gently swaying, having the baby suck on a pacifier, and making a shushing sound in the child’s ear. Together, the steps calm the baby by mimicking the sensations of being in the womb, according to Dr. Karp, and can be used more broadly by parents to ease a fussy or colicky baby.

In the new study, published in the journal Pediatrics, independent researchers put the five S’s to the test by training medical residents to use them on infants undergoing routine vaccination shots at their 2- and 4-month well-child visits. Infants typically receive at least three shots at their two-month checkup and two at their four-month visit.

The study’s leader, Dr. John Harrington of the Children’s Hospital of the King’s Daughters in Norfolk, Va., was doubtful at the outset that the five S’s alone would have much of an effect. But he suspected that in combination with a dose of sugar water, commonly thought to reduce pain in infants, the technique might comfort crying babies immediately after the prick of a needle.

He and his colleagues set up four study groups involving 230 infants. Some were given a small dose of liquid just before their shots — either two milliliters of plain water (less than half a teaspoon) or the same amount of sugar water — and were comforted by a parent or guardian after their injections. In the other two groups, infants received one of the liquids, and then were comforted by a resident who was trained to perform the five S’s. The residents swaddled the babies within 15 seconds of the vaccination, held them in a side or stomach position in their arms, made a shushing noise while swaying, and offered the baby a pacifier.

A trained observer in the room watched for behaviors that indicated the infants’ levels of pain, like high-pitched screaming, grimacing and whimpering. The observers used a standard rating scale that assesses pain in infants.

Over all, the researchers found that using the five S’s — what they called the “physical intervention” — consistently produced the lowest pain scores, regardless of whether the infants were given sugar water before their shots.

“Going in, we thought that maybe sugar and the physical intervention would work together,” said Dr. Harrington, the division director of general academic pediatrics at the hospital. “But what we found was that just the physical intervention was good enough. You really didn’t need to give sugar prior to the shots.”

Dr. Harrington said that the residents were usually able to perform at least four of the five S’s. The least important step, he said, appeared to be giving the babies a pacifier. “Sometimes the babies didn’t want to suck and would spit out the binky or pacifier,” he said. “It seemed like that wasn’t always necessary to do.”

The most crucial step, he said, appeared to be swaddling, which was also the toughest one for the residents to learn. Residents watched a video that outlined proper technique; wrapping the baby too tightly, for example, can raise the risk of hip dysplasia, an earlier report found. The study also included a link to a YouTube clip that demonstrates the method.

Dr. Harrington said that he — and many of the parents — were surprised by the difference it made.

“I’ll be honest, I was a nonbeliever; that’s why I did this study,” he said. “But when you see it happen where you’ve got this child who is crying and flailing, and you do the swaddle and you get them in the sideline position and you’re doing the shushing in their ear and they kind of go into a quick trance, it really does seem like a calming reflex has been triggered.

“And the parents would go, ‘Wow, show me how to do that.’ ”

WHZJ

学习了，不错。

腰果妈

我感觉我娃半岁前打针都不哭

没明白咋回事呢就打完了

偶尔吭叽两声

哄哄就过去了