The 5 S's for soothing a baby: how to do each step safely

The 5 S's are five soothing steps for calming a crying young baby: swaddle, side or stomach position, shush, swing and suck. They were popularised by Dr Harvey Karp in his book The Happiest Baby on the Block, which Seattle Children's refers parents to. KidsHealth describes them for newborns and babies under 5 months.

The 5 S's are a way to calm a crying baby, not a way to put them to sleep. Two of the steps, the side or stomach position and swaddling, have important safety limits, covered below.

What are the 5 S's?

Many parents try them one at a time, then layer them if one alone doesn't work. The AAP's self-soothing guide suggests giving each technique about 5 minutes before switching, and not trying too many at once, which can overstimulate your baby.

How do you do each of the 5 S's?

1. Swaddle

Wrap your baby snugly in a light cotton wrap with their arms in. Seattle Children's calls swaddling the most helpful calming technique for young babies. Red Nose says the wrap should be firm, so it can't loosen into loose bedding, but not too tight, allowing hip and chest movement, and should sit below the neck so your baby's face stays uncovered. See our swaddling guide for step-by-step wrapping.

2. Side or stomach position (while awake and held)

Hold your baby on their side or tummy, lying along your forearm or over your shoulder. The AAP's self-soothing guide suggests rolling a baby onto their side "while awake, only", and its arm-drape hold rests a baby along your forearm facing the floor. It notes this can take a couple of minutes and the crying may build before it eases.

This position is for calming only. As soon as your baby is drowsy or asleep, put them down on their back.

3. Shush

Make a steady "shhh" sound close to your baby's ear. KidsHealth describes "making shushing sounds in the baby's ear". Many parents start fairly loud, roughly matching the crying, then soften the sound as their baby calms. Seattle Children's suggests a low-pitched white noise while a baby cries, but warns against volume that could damage hearing. See white noise for safe use.

4. Swing

Gently rock or sway your baby in your arms with their head and neck well supported, using small, smooth movements. KidsHealth describes "swinging your baby in your arms or an infant swing". The AAP warns against bouncing on an exercise ball while holding a baby, because a young baby's head control may not be strong enough and you could fall.

Swinging is never shaking. The RCH says shaking can cause brain damage and lifelong disability.

5. Suck

Offer the breast, a bottle if it's feed time, a dummy, or help your baby find their own fingers. The NICHD Safe to Sleep campaign suggests offering a dummy for naps and at night once your baby is feeding well. See dummies for more.

Do the 5 S's actually work?

The best evidence is from a trial at vaccination time. In a 2012 randomised trial by Harrington and colleagues, 230 babies aged 2 and 4 months were given either a sugar solution or water, then either usual comforting or the 5 S's straight after their injections. Babies who had the 5 S's had the lowest pain scores and cried least, and adding the sugar solution gave no extra benefit. KidsHealth says doing at least 4 of the 5 S's greatly reduces how long babies cry after a shot.

There's less evidence for colic and long evening crying. During the peak crying weeks, nothing works every time. See colic and PURPLE crying for what to expect and how to cope.

Is the side or stomach position safe?

Only while your baby is awake and you are holding them. The AAP's safe sleep guidance says babies up to 1 year should be placed on their back for naps and at night, and NICHD says the safest sleep position is on the back, including for babies born early and those with reflux.

Never use a positioner, wedge or rolled towel to keep your baby on their side. Once your baby is calm, lay them on their back on a firm, flat surface in their own cot or bassinet.

How do you swaddle safely?

• Stop at the first signs of rolling. The AAP says to stop swaddling as soon as your baby starts trying to roll. Red Nose says to stop as soon as your baby shows signs of beginning to roll, or at 3 months of age, whichever comes first.
• Always on the back. NICHD notes swaddling does not reduce SIDS risk, so it never replaces back sleeping.
• No weighted products. The AAP and NICHD both advise against weighted swaddles and blankets.
• Not too tight. Leave room for your baby's hips and chest to move.
• Face clear. Wrap from below the neck and keep the head uncovered.

If your baby falls asleep in a swing, car seat or carrier during soothing, the AAP says to move them to a firm, flat sleep surface on their back as soon as possible.

What if the 5 S's don't calm your baby?

Some crying spells won't stop, whatever you do. Check the basics first, such as hunger, wind, a nappy or temperature (see soothing a crying baby). If you start to feel frustrated, the NHS suggests putting your baby in their cot, going into another room to calm down, and setting a time limit, such as 10 minutes, before you go back. Never shake a baby. For support, contact a parenting support service (Tresillian or Karitane in Australia, your health visitor in the UK, your pediatrician's office in the US).

Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) if your baby has a weak or high-pitched cry, is floppy or not waking as easily as usual, is struggling to breathe, or has blue, grey or blotchy skin or lips. If crying is constant and your baby seems unwell or isn't interested in feeding, get medical advice the same day.

What is worth noting?

Jot down which S's you tried and what helped. Over a week you may see that your baby settles best with one or two steps, which saves time at 2 am and helps other carers soothe your baby the same way.